We have made considerable progress with mental health, but there’s a long way to go.
Mental illness and ‘Britishness’ have always been a toxic pairing. The combination of dark episodes, depression or anxiety, and a national identity built on a stiff-upper lip, has made our collective mental journey slow and difficult.
Mental illness still makes us uncomfortable, and it has only been through considerable force that we have brought it into sharp focus and, more importantly, stared it down; often in our own mirror. Consequently, in 2017, we are a little more comfortable with what we see and, indeed, what we hear.
In these passages, we confront our position on mental health and our experts ponder where we are in the great scheme of things. As a nation, have we really made progress and are we anywhere near reaching parity with physical conditions?
Leila Reyburn, Mental Health Services Manager at Mind
Mental health has been neglected for decades; by government, by public services and by society as a whole. As a result, mental health services have suffered huge underinvestment by comparison to physical healthcare services. We see the impact of this in people who do not get the help they need, when they need it, and in the distinct lack of investment in the prevention of mental health problems.
In contrast, we have seen considerable change in public attitudes towards people with mental health problems over the last decade, with a 9.6% improvement (around 4.1m people) since our anti-stigma campaign, ‘Time to Change’, began in 2007.
Alongside efforts to decrease the stigma around mental health, initiatives like Mind’s ‘Find the Words’ campaign aimed to give people greater confidence in seeking support from their GP or primary healthcare provider. Now that stigma is starting to dissipate and more people are seeking help, it is vital that we have the funding and resources in place to cope with high demand.
We are also a year into the Five Year Forward View for Mental Health, a robust and clear plan to start improving mental health services, which comes with an additional £1bn investment in mental health services by the end of 2020-21.
We need to keep up the pressure to make sure these promises are fulfilled and that money reaches the frontline. The proof will ultimately be in the improved experiences of people accessing mental health services. Go to mind.org.uk
Sean Duggan, Mental Health Network Chief Executive, NHS Confederation
There has been huge progress in the way mental health is talked about and recognised, with campaigns such as ‘Heads Together’ having a positive impact on tackling stigma. With greater awareness of mental health, however, comes extra pressure on services, which are already stretched.
The Government has pledged to put mental health on a par with physical health, but this needs to be reflected in investment and the continued progress of the Five Year Forward View for Mental Health. Getting mental health services right will relieve pressure on other parts of the health system and we urge the Government to deliver on its promises and ensure mental health gets the equal status it deserves.
Kenny Johnston, Founder of the CLASP Charity
Mental health has progressed positively in the last decade, though the road ahead is difficult if parity with physical conditions is ever going to be achieved.
Part of the problem is the general public’s failure to realise the normality and variety of mental health difficulties, which we all encounter in our daily lives. The lack of support towards someone with a mental health issue remains different compared to the reaction towards an individual with a broken arm, cancer or a heart attack. Sadly, we still live in a society with a need for visible proof of an illness, before there is an acknowledgement.
More people need to speak about their mental health experiences in order to engender normality, while empowering and inspiring others. The power of people speaking openly has been proved throughout history, assisting in ending negativity about different social aspects and illnesses, ending stigmas and formulating parity across different races, religions and sexual orientations.
A perfect example is cancer, which 40 years ago had a stigma due to the the low prospects of survival. Nowadays, there is early screening, effective medical treatment, support and information, while events such as ‘Race for Life’ enable unity.
Normalising mental health will build positivity, showing there is no need to fear it. The more people speak, the more we can achieve as individuals and as a society.
Mental health can find parity across society, institutions, employers and wider healthcare; but it needs to learn from cancer, the LGBT community and other social stigmas in order to achieve it. Go to claspcharity.com
David Thorne, Pf Magazine Columnist and former mental health nurse
Mental health has progressed since I was a nurse in the 80’s but, sadly, far too little. It remains characterised by dichotomies – patient rights versus public protection, excellence alongside abuse and empathy for celebrities, but fear of ‘that guy on the bus’.
The rhetoric is for mental health integration with mainstream healthcare, but psychiatrists and mental health nurses have helped to isolate themselves and their services through a sub-culture of lost confidence. Services are not designed for those most in need and the third sector is where positive practice invariably sits in addressing self-harm, substance misuse and crippling isolation.
Andreas Papadopoulos, Consultant Psychiatrist at Avon and Wiltshire Mental Health Partnership NHS Trust
For years Government mandates have pushed for parity of esteem between mental and physical health. Although NHS England has urged local CCGs to increase their funding for Mental Health Trusts, almost half have seen theirs drop. Trusts continue to be paid through block contracts, which don’t reflect the increases in demand, making them endure funding cuts in a disproportionate way.
Mental health only receives 6% of the total UK health research funds and, as a result, many of the drugs used in the treatment of mental illness have not changed for the last 20 years. Patients with mental illness, therefore, continue to suffer inferior quality of life and fail to achieve functional recovery.
Mental illness is much more difficult to diagnose and treat compared to physical illness, due to a lack of treatments which actually cure, rather than simply treat mental illness. Add to that a reluctance among patients to seek help and you have a big problem.
Inpatient treatment is helpful, but very expensive, and the number of NHS inpatient beds has significantly shrunk, opening opportunities for independent providers to charge vast amounts . Community services that provide support to people at risk are invaluable, but to ensure success in the long-term an upfront investment is necessary.
In the meantime, inequality continues to widen, and for that to be corrected a political and societal change is needed which allows people to achieve their potential.
Ian Cartwright, Diagnosed with depression 27 years ago
My journey into depression, like so many other people these days, was due to excessive stress at work.
I worked in the outdoor event hire industry for many years, climbing through the ranks and eventually becoming a general manager. Stress for me was about seeking to be perfect, to be productive and not let anyone down. I became and still am a workaholic.
For me, depression also has a physical element. During one meltdown, I slept all day and all night for weeks, with very little energy. My GP’s diagnosis was depression. Men don’t generally admit to it, but my road to recovery began when I eventually said: “I suffer from depression”.
The diagnosis in 1990 paved the way for life as a Methodist Minister. During my seventeen years in the ministry I had three major breakdowns and the last one, in 2016, lead to my early retirement.
Depression is like existing in a desert; a dry, dark, lonely, uncomfortable and debilitating experience. I did, however, discover many healing and refreshing streams of healing in my personal desert.
This included help from my tremendous GP, taking medication and the use of talking therapy, because it is vital to be open about mental health. The NHS is wonderful, but I had to wait a long time for treatment and it finished early due to lack of funding.
Fortunately, I have had incredible help from a range of other sources. A local mental health charity introduced me to compassion focused therapy, which has been amazing. My family and friends are also very supportive, encouraging me to go for walks, while volunteering at York Council for Voluntary Services has kept me active. If you are experiencing mental health problems, there is amazing help out there.
It’s great to be feeling better, but it’s been a long journey back. Ian’s book ‘Healing Streams in the Desert’ is available at imagineprojects.co.uk
Deborah Carpenter, Psychotherapist, Nightingale Hospital
“The problem with mental health is that it’s not solely about funding, it’s about understanding what patient needs are and being able to provide necessary care on a consistent basis.”
Megan Johnstone, Mental Health Nurse at an East London Foundation Trust
“It is not being given parity. If somebody has diabetes, they receive treatment almost instantly. In contrast, someone with depression could be waiting six months. There are constant cuts – our assertive outreach team is being discontinued and one of our rehab wards is being shut.”