In the UK, 14 million people - one in five - live in poverty. The welfare state has shrunk, there have been drastic cuts to local authority budgets, and many social services have been eliminated. Austerity is continuing, child poverty is approaching record highs, the NHS remains underfunded, many mental health wards are crumbling and decrepit, there is a growing shortage of psychiatrists, especially in child and adolescent mental health services, and waiting times for mental health treatment are increasing.
In this context, it is unsurprising that more than four out of five people exhibit the early signs of poor mental health, approximately one in four people experience a mental health problem each year, and one in eight children and young people have at least one mental disorder.
This nationwide crisis brought together mental health campaigners and practitioners, service user groups, unions, and the public at the Mental Health Crisis Summit 2019 in London at the end of September. It was organised by Health Campaigns Together, Keep Our NHS Public, and Mental Health – Time for Action. Themes that ran through the event included how poverty contributes to mental ill health and how structural change is needed, demands for an end to austerity and the underfunding of the NHS, calls for the social model of health to become standard and UK law, demands for the end of the ‘hostile environment’ in the NHS, and discussions about how service users must be prioritised in any conversation about mental health.
At the summit, Rachel Bannister, co-founder of Mental Health – Time for Action, shared her daughter’s moving personal experience of stretched and inadequate child and adolescent mental health services. Denise McKenna, co-founder of the Mental Health Resistance Network, criticised both the medical model and abuses within mental health services. Film director Ken Loach sadly relayed cases of suicide in response to the hopelessness of insecure and low-paid work, and Jon Ashworth, Shadow Health Secretary, discussed how mental and physical wellbeing can be secured by dealing with social and economic problems such as poverty and inequality. He told the conference, “Delivering social wellbeing isn’t just about legislating, but about dealing with the wider social and economical determinants of ill health.”
Earlier this #mentalhealthawarenessweek the government made two announcements. The first was a £35 million, five-year research programme on adolescent mental ill health which explores biological and environmental factors, as well as upbringing. Apparently the programme “will build a better understanding of the adolescent mind to improve the standards of care available”. It also aims to uncover ways to “reduce instances of anti-social behaviour, substance abuse or low educational attainment”.
The second is a mental health campaign and resource called Every Mind Matters, which launched with a star-studded, anti-stigma short film. Its online Mind Plan quiz asks users about their mood, sleep, anxiety, and stress, and offers simple advice. It also asks users what has been worrying them, listing their personal life and relationships; money, work and housing; life changes and difficult times; health issues; traumatic events; and addiction as factors which have negative impacts on mental health. As the film says, “Everyone knows that feeling, when life gets on top of us”.
So both the research programme and Every Mind Matters pay attention to the social and economic determinants of mental health – as they should. but the government must acknowledge the part their own austerity policies have played in the mental ill health of so many.
And these initiatives have issues. The research programme’s aim to study the “adolescent mind” as if it were a standardised phenomenon which may be at the root of young people’s mental issues, is problematic. Also, because the programme aims to reduce anti-social acts, it is an attempt to alter young people’s behaviour rather than just prioritising their mental wellbeing. Further, an integrated mental and physical health quiz, available alongside Every Mind Matters’ Mind Plan, asks users how they feel on a spectrum of insensitively named options from “Feeling Calm” to “Totally wound up”, “Lean and mean” to “Fat and flabby”, and “Down in the dumps” to “Over the moon”. This kind of stigmatising language must not be used and shows a lack of understanding by this government.
Although mental health research, anti-stigma campaigns, and online resources can be helpful, the socio-economic issues which contribute to mental ill health also require more urgent and widespread intervention. Poverty and inequality must be reduced, and the welfare state revived. More than studies and websites, we need to build a compassionate society. It is only through campaigns like the Mental Health Crisis Summit, and a social and economic transformation, that we can turn the promise of these new government initiatives into a reality.