The Conservatives are in. Is mental health out?

The Care Quality Commission has found that the mental health care system is ‘struggling to cope’ after reviewing the help provided to people in ‘mental health crisis’ (including those who are suicidal, or are having a severe panic attack or psychotic episode). Last year, 1.8m people sought help for a mental health crisis.

The review by CQC found that 42% of patients did not get the help that they needed. Patients were asked about the attitudes of staff towards them when they presented with a mental health issue, and it was found that staff in A&E did not fare well. 5% of all A&E attendances are recorded as relating to mental health problems, yet only one third of patients attending A&E thought that they had been treated with compassion and warmth. Attending A&E is a daunting experience in and of itself, and to add the extra layer of feeling shut out by staff and looked down upon because you suffer from a mental illness and not a broken leg, will surely only make those suffering with mental health problems less likely to access the help available.

CQC’s Mental Health Lead, Dr Paul Lelliott, has stated that these findings must ‘act as a wake-up call’. According to the Chief Executive of Rethink Mental Illness, Mr Mark Winstanley, “for too many people, going to A&E is the only way they can get care if they’re in a crisis”.

Mental health receives only 13% of NHS funding, even though it accounts for 23% of the disease burden. Care Minister Alistair Burt has stated that improving mental health care is his priority, and that the government is trying to tackle the problems in mental health through its new treatment targets and extra funding.

The Conservative manifesto this year included numerous promises relating to mental health care : increase mental health spending; improve access to talking therapy and ensure that therapists are available throughout the country; introduce new waiting time standards; pregnant women should have access to mental health support both during and after pregnancy; ensure that veterans with mental health problems receive proper care; provide health and community based places of safety for those detained by police under s136 MHA 1983.

Rather memorably during the election campaign, the Conservative parliamentary candidate for Cambridge suggested that those with mental health issues should wear colour-coded wristbands to identify their conditions. According to the candidate, this wristband system could improve the system.

Thankfully, this idea was dismissed as ludicrous pretty much straight off the bat – not only is the idea of a colour code for mental illness entirely unworkable, given that mental health issues do not tend to group into one single illness (most wristbands would probably be rainbow coloured), but it would add so much more stigma to those struggling with mental health problems. It would be adding to the idea that mental illness is not viewed as on a level with physical illness – you can see that someone has broken their arm but you cannot see that someone is bipolar and, for some reason, this scares people.

Our focus needs to be on ending stigma, not adding to it. The Conservative manifesto itself, whilst thankfully not mentioning a colour code system, included that “People who might benefit from treatment should get the medical help they need so they can return to work. If they refuse a recommended treatment, we will review whether their benefits should be reduced”. Thus the first mention of mental health in the conservative manifesto is related to benefit sanctions – fantastic. The manifesto appeared to view those with mental health issues as a burden on society, with a return to employment being viewed as the ultimate goal.

With Jeremy Hunt as Health Secretary, we can hardly be surprised – Mr Hunt once stated that he did not understand how Alastair Campbell could be depressed as he looked like he had a ‘great life’. The Mental Health Policy Group estimates that 2 million more UK adults will experience mental health issues by 2030. With the Conservatives set to make £30bn of cuts, £12bn of which will be welfare cuts, and with no clear breakdown of where exactly these cuts will come from, the worry is that mental health will be overlooked once more. Let’s face it, the Conservatives don’t have a great track record when it comes to mental health – in 2011, the coalition boasted about its ‘No Health Without Mental Health’ strategy document and just one month after the document was published, the National Mental Health Development Unit was thrown in the garbage. Now, the Conservatives no longer have the Lib Dems to keep them steady and I certainly worry about what the future may hold for our mental health care system.

It is safe to say that I am not the biggest Tory supporter but the evidence does speak for itself. Over the course of the Coalition, referrals to Community Mental Health Teams increased by 20% and yet there was a £600m cut to mental health trust budgets. Not only this but, since 2011, the number of available mental health beds in inpatient facilities has dropped by 12%.

BBC news has stated that data from 75% of trusts shows that, from 2014/15 to 2018/19, income is expected to fall by 8% in real terms. NHS England correctly noted, however, that no accurate predictions can be made until the government sets out its spending plans.

Only time will tell whether Mr Cameron will stick to his promises but my fear is that he will not. I hope that I am wrong.

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