Talk is cheap. Something I’m sure Theresa May is aware of as she continues to embark on her programme of saying nice-ish, sensible things whilst backing them up with fuck all.
Today it was all about the ‘shared society’ (very different from the ‘big society’, you understand) and reforming mental health services. Today she uttered the ground-breaking words that will, no doubt, go down in history:
“For too long mental illness has been something of a hidden injustice in our country, shrouded in a completely unacceptable stigma and dangerously disregarded as a secondary issue to physical health.”
Well, thank God a political leader is finally talking about this… If only we’d had someone like Theresa May in a prominent cabinet position for the past six years… Oh wait…
Another Prime Minister, another pledge to end the neglectful injustice of the mental health problems that afflict our society at alarmingly increasing rates. We’ve heard it all before, and yet budgets continue to be cut as the NHS buckles under financial pressures across the board. And the fact remains (admitted by the Tory Health Minister himself) that there are over 6,000 less mental health nurses in the UK than there were in 2010; that’s a 15% drop. Awkward.
So, Prime Minister May, you’ll forgive my cynicism while I take a moment to read between the lines of your nice-ishly worded ‘shared society’ speech.
For quite a while now people in the public eye – from the wonderful Carrie Fisher to the insufferable David Cameron – have been saying that the stigma around mental health must be ended. And I think we can all agree on that. Like, not all of us in the entire world, but most of you lot who have a voice in the public domain. We get it – parity; end of stigma; caring for the most vulnerable; looking after our young people. My response to all this is:
‘Yes, and what you gonna do about it?’
Stigma is still there, of course it is. Wonderful campaigns like ‘Time to Talk – Time to change’ are all about bringing the experience of suffering from mental illness into the public domain. The idea being that no one should be ashamed of suffering from depression, anxiety, bipolar disorder, schizophrenia or any other debilitating condition that happen to occur due to the chemical imbalances of your brain rather than another organ in your body. So, hells-to-the-yeah on that one.
My problem with speeches like May’s, though, is that she’s fundamentally misunderstood her role in this whole de-stigmatisation business. Because, actually, you can’t remove the stigma from something just by talking about it. The real, societal shift in perceptions comes when the people in power start LISTENING to those who are affected by the issues they seek to address.
If the words spouted from a podium don’t come from a place of genuine understanding and empathy, if they’re not a response to actual problems rather than perceived ones, then those words are flimsy, intangible, they are cheap talk to their core.
Don’t get me wrong, there were some legitimate issues raised today in May’s speech. Like how it’s probably not a good idea to send children and young people 300 miles away from their family and friends to receive the mental health care they need, and we should stop doing this. #NoShitSherlock
Oh, and that people who are simultaneously suffering from mental illness and in debt crisis probably shouldn’t have to pay their GPs £300 for documentation to prove they are ill. Well, aren’t you quite the revolutionary, Theresa!
So, good, you’re going to try, sometime in the next 5 years, to stop some really fucked up shit happening to really ill people. Meanwhile, the rest of your ground-breaking reforms read more like an exercise in passing the buck (or at least not spending it).
One of the major initiatives announced today is the reallocation (note, not new funding, something else is getting cut) of £67.7m, for ‘online services’. Sigh.
Don’t get me wrong, there is definitely value in symptom checkers and computer-based CBT, but I wager that no suffer of severe depression has ever uttered the words “If only there had been more web-based resources!” These things are add-ons, stop gaps whilst you wait to be seen by an actual human being who has training and experience and, with any luck, enough time and energy to offer a little compassion. So why are we funding these more? Is it because mental health waiting lists are the Pinocchio’s nose of health policy? They get a little longer for every lie told by Jeremy Hunt… (ba-doom-boom-cha!)
Probably the reforms main focus, though, was put on the rise of youth mental health issues. There was some really good stuff about ‘strengthening links’ between NHS Mental Health Services and schools. And also offering “mental health first aid training – which teaches people how to identify symptoms and help people who may be developing a mental health issue”.
Well, this all sounds fab. No money for it though. Or extra staff. Or explanation of how teachers – already overworked to the point of quitting in their thousands – will be supported in these new responsibilities for spotting and ‘helping out’ with mental health difficulties. Sooo… good luck with that one.
Oh, but behold! There is some actual funding promised after all. A whole £15 million for community-based care: only £354 million less than we’ll be spending on renovating Buckingham Palace! Good good.
Even without the palatial comparisons, £15 million is a pittance. With the help of Google I’ve done some entirely hypothetical maths (not a feature you’ll see often on my blog). The government’s website says that there are 418 ‘principal councils’ in the UK. £15 million divided by 418 is approximately £35,885.16p. That’s if it was split equally, which it wouldn’t be for reasons as political as they are demographic. But I digress! The point is that this amount isn’t even enough to pay the salary two qualified mental health professionals – and that’s per council in the UK? Come one May, you know this is Bullshit (with a capital B, obvs).
In fact, my main problem with this whole community-based care (such as crisis cafes and local clinics, appaz) isn’t even the laughable funding allocation, it’s the sting in its tail. Because apparently the focus on this kind of care (all 15 million quid of it) is accompanied by “less emphasis on patients visiting GPs and A&E”.
In fact what May actually said about ‘transforming’ the way mental illness was dealt with was “not in our hospitals but in our classrooms, at work and in our communities”.
Erm, not in our hospitals?
Can I get ‘now that’s what I call disparity of services’ up in here?
I’m not being funny, but I’m majorly of uncomfortable with this kind of talk. Like, local clinics sound good, but I’d rather not lose emphasis on, you know, emergency treatment for mental illness. I’ve written elsewhere about my own arrival at A&E one Janaury afternoon three years ago.
Or, like, GPs being trained as thoroughly in diagnosing and treating depression as they are about any other prolific, life-endangering, society-impacting illness. #justsaying
Could we not just have more emphasis on community care whilst maintaining current levels of emphasis elsewhere? I mean, could we not just, like, holistically provide both prevention and cure for issues arising from mental health?
Cos, Mrs. May, if you are seeking to prevent a mental health crisis in the UK you are about eight governments too late. Yes, spot the signs early in school and work, but also, maybe deal with actual, existing cases of serious mental illness with, erm, money, maybe? Or some nurses? I’m just free-associating here.
No ring-fencing for the funding that already exists; a pittance in promised funding; the responsibility for prevention put on the shoulder of already over-worked public servants; a host of relatable yet ultimately meaningless platitudes; and some more computer stuff. That’s the reality of what we were offered today. And it’s not good enough.