The announcement yesterday from Nick Clegg of a Lib Dem commitment to mental health is as welcome as it is overdue (http://www.theguardian.com/society/2014/oct/08/mental-health-care-120m-funding-waiting-time-targets-nick-clegg). Campaigners have for years sought to break down the stigma and taboo that surrounds the subject but only now is that taking effect at the highest level of policy making.
The World Health Organisation (WHO) defines health in wide terms to include mental health – health is “a state of (complete) physical, mental and social well being and not merely the absence of disease or infirmity”. The links between mental and physical health have long been understood – whether it be the effects of physical problems on one’s mental health or the effect that poor mental health can have on the care one takes of one’s physical health, the two cannot be viewed in isolation but rather have to be seen, as per the WHO approach, as different aspects of the same thing.
In addition, the importance of early intervention, whether in psychosis or in other conditions such as depression and anxiety, has long been understood. The earlier someone gets help, the greater the chances of the individual recovering to live a fully functioning life and, of course, the shorter the period that someone is left to suffer without treatment. Can you imagine what it is like to start hearing voices telling you to do strange things, or giving you evil thoughts about those around you that you love and trust? Can you imagine what it is like to be terrified by the phone ringing, the postman knocking or a police siren passing by your window? It is agony of the greatest kind that leaves people unable to cope, unable to function, unable to venture outside and unable to contemplate a functioning future. Couple this with the general lack of understanding about different mental health conditions and the situation is only compounded. The idea that we leave such people for months on end before they receive proper treatment is, frankly, shameful. Lives are destroyed as a result which need not be.
So the focus from Mr Clegg on waiting times, albeit caught up in the debate about the helpfulness of such approaches and the abuse that can result from NHS trusts manipulating data, re-allocating scarce budgets and pressuring staff to meet the latest targets, is to be welcomed.
Of course the argument is not just a moral or social one, although the case on those grounds is very strong. Research varies but the general consensus is that between one in four and one in five adults suffer from a diagnosable mental health condition at any one time – a fifth or a quarter of the population. This is not an issue about “other people”, about the poor funny folk down the road, or those that used to be put into asylums. It is not an excluded class we are talking about. This is about us, our colleagues, our family and friends. It will happen, it is happening, to us. It happens across all social classes, all age groups and all ethnic groups.
One third of working days lost each year for health and related reasons are caused by anxiety and depression alone – a cost of over £4bn annually. The total cost of all mental health problems (when one takes into account social as well as direct financial costs) is estimated at over £100bn annually.
Financially therefore, for the sake of the economy as a whole, as well as the organisations and individuals who make up that economy, the argument is overwhelming. Indeed in that context, the promise of an extra £120m or even £500m is small beer, but it is a start and to be welcomed as such.
What needs to accompany the commitment to health care is a society wide drive to improve awareness of mental health conditions. Schools, employers, social groups and others all need to include in their education programmes a focus on mental health in just the same way as, and as part of, how they approach physical health. People talk about breaking down the taboo and the stigma. The only way that can happen is through understanding and awareness which starts with education. The reason we now talk about cancer quite freely (as opposed to the “C word”) is because of years of public health awareness campaigns, the work of the many great charities involved, and the advances in medical science which means that many people have survival stories to tell about their cancer and their recovery. We need to have the same progress with mental health.
Not only will this help those who suffer to talk about their problems, it will help everyone to understand the nature of mental health – what it means and the impact that problems can have on how we all see the world, interact with each, react to situations and deal with problems. Given the prevalence of problems, any place where people interact with other – family, school, work, club – is going to be affected by the different mental states of those involved. Understanding them will make those places far happier, understanding and productive places to be.
So well done Mr Clegg for the announcement yesterday and thank you. Let’s keep the momentum going.