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A moral and economic case against the cuts to mental health services and the need to reform the ‘back-to-work’ programme

The Government’s ‘fit-for-work’/’back-to-work’ programme is harming people’s mental health and thus it is also undermining the economic recovery.

It has been ruled by a coroner that it triggered a suicide. Yes, it is one suicide, but it is one suicide too many, and the programme should be helping people back to work in the right way, in a way that does not create more anxiety and in a way that is sensitive to the issues people have.

I don’t think it’s intentional from the Tories, it would be churlish I guess to suggest it was, but it highlights the incompetency of the system and the inadequacies of the A) advice given and B) some of the people administering the system.

Fit for work is a disgrace as it currently stands, and I could present plenty of anecdotal evidence to go alongside the evidence from Mind that it is detrimental to some people’s mental health.

It needs reforming.

Cuts to things like CAMHSwhich have been partially blamed for an increase in mental health issues among young people – are hindering people’s lives, and are threatening the economic recovery in that they create further problems down the line for people with mental health issues who then need to use the NHS because they have done one of the following. 1) Self-harmed dangerously. 2) OD’d dangerously (still self harm but more severe and slightly different) 3) Sectioned. 4) NHS walk-in centre. 5) Visited A&E due to suicidal thoughts.

Now, of course these things happen anyway and you will never stop them completely, but by cutting CAMHS and cutting early intervention, by squeezing the net so hard that you prevent people from accessing treatment at an early age or an early stage, you are increasing the likelihood of people developing mental health issues or those issues becoming more severe, and you are putting pressure on services down the line.

You also make it less likely people who are out of work due to their mental health issues and have been placed on the DWP’s programme will actually be fit for work in the future because there is less access to support, and that costs the economy billions of pounds a year. In 2009/10 the total cost of mental health issues to the UK was £105.2bn.

It is not solely the fault of the current Government that there are so few beds available for mental health inpatients, that there is so little funding for mental health, but the current Government is exacerbating these problems by cutting funding at a time when it makes economic and moral sense to actually invest.

It is somewhat rich of Norman Lamb to come forward and warn of a crisis (but he is right) when he was part of the previous government which implemented cuts mental health services.

Further, there are areas such as youth clubs which are forced to close because of cuts to local council budgets – with one of the first things councils do to save money is also to scale back Mental Health service provisions – these clubs are places that kids can go and learn about how to cope with things and in some cases I am sure have helped young people and perhaps prevented or at least lessened the effects of issues.

It is short sighted in the extreme to cut funding for mental health services, to implement policies such as fit for work without the necessary safeguards, and to implement it in such an abysmal way. It is a great idea to help people back to work, people with Mental Health issues should go back to work if they are able to, as it is in some cases far better than not working if indeed they have the ability to cope, but if they are not ready they should not be forced to take jobs that will only make them worse, and indeed they should not be pressured into finding work so soon or face the prospect of benefit sanctions.

It is economically (not to mention morally) naive to cut mental health services to the bone, to the extent that a mattress on the floor serves as a “bed” for an inpatient, to the extent that kids (and some adults) have to be held in police cells because there are no beds available. That they have to travel for 79 miles or over 100 miles for the nearest bed. That there are not enough beds.

It is not going to make the NHS more efficient to cut Mental Health services. It’s made out that it’s bureaucracy that gets cut, but it’s not just that, it has a real, and damaging impact on people and that’s so worrying from a moral point of view and also an economic point of view it’s just totally illogical. It will cost a bit more for now to invest in services, but in five years time you’ll see the fruits of it and it will save the NHS money and it will get people back to work and improve the economy in that way too.

This is not me bashing the government for the sake of bashing the government. I couldn’t give care less which party enacted these policies, it is the policies that are wrong, and they need to be changed. It just so happens that the government have made an already precarious situation even worse. I’m not saying that to take a pop, I’m saying that because I actually want people to see the realities of cuts to Mental Health services which are so dangerous.

This is not an “anti-government post”, this is an “anti-cuts-to-mental-health-services” post.

The only way is to invest in the services, and there IS money to do so. It would mean increasing the debt by a tiny, tiny, tiny amount in the short-term, but it would mean in the medium and the long term you’d end up reducing the debt.

I don’t believe economic factors should really come into it anyway- unless you are literally on the brink of economic disaster (and let’s face it, we really aren’t.) We need to reduce the deficit, and we should reduce the deficit, but let’s do it by improving our services, not by cutting them to the bone and condemning people to continued struggles.

The fact that so few people with Mental Health issues have been helped into work by this ‘back-to-work’ programme – with fewer than 9 per cent of people having been helped back into work, so many have said their mental health has been made worse by it, and thousands have died shortly after being found fit to work, means that something is seriously wrong with it. It should be there to support people, not to scare them, to threaten them with sanctions, to force them into jobs they may not be able to do.

People need support, they don’t need bullying into work. People with mental health issues are not shirkers, they do not hide from work, many want to work, but they need to be supported properly – financially and emotionally – but the system is wrong.

In addition, we need to put far more emphasis on educating people, in particular young people in education, about mental health – I don’t know at what age and to what extent because you need to be careful, but we need to do it. We also need to stop using such stigmatic terminology.

That final point is not exclusive to any politicians (or indeed, to politicians in general). John McDonnell made some insensitive comments on Twitter to First Great Western after a person was struck by a train, Douglas Carswell went one step further and deliberately used stigmatising terminology to someone with a Mental Health issue on Twitter and also blocked me for telling him how disgusting his language was, whilst also mocking “the left” for complaining (in a perfectly reasonable way) about the use of the term “nutjob” by Telegraph associate editor Jeremy Warner to describe McDonnell because he disagreed with his economic policies.

To explain the relevance of that paragraph, this is only achievable with better education and with the removal of the stigma that is perpetuated by the cuts to mental health services, by stopping comments about the disabled essentially being abnormal from the likes of ministers such as Iain Duncan Smith, by the attitudes of people in the fit for work programme and by the way the fit for work programme works.

Essentially, cutting mental health services in the way that the government has done (and previous governments not investing to anywhere near the necessary level), is foolish, morally abhorrent and just an example of how cutting the deficit dramatically in a very short space of time has usurped absolutely everything, and unfortunately, it is absolutely ridiculous economic policy.

Investment is needed in both services AND also in research into the causes of mental health issues or a crisis will hit and will just make things even worse in the future and will not help the economy at all. Reform things, but improve efficiency while also investing and put people’s needs at the heart of this scheme.

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Talking Out With Your Tribe

Yesterday evening I got to meet Ruby Wax, the comedian & founder of BlackDogTribe whilst I also met Laura Davidson from Mental Health Research UK Charity (http://www.mentalhealthresearchuk.org.uk/) & a very inspirational, polite & brilliant young woman by the name of Fiona, who by her own admission pretty much eats breathes and sleeps mental health!

Ruby performed her play “Losing it” or also known as “Out of her mind” which was to raise funds for MHRUK Charity. Essentially it documents, in comedic fashion, her own upbringing and realisation that she was a member of the 1 in 4 tribe, that, of course being the 1 in 4 of us who suffer from a mental health issue or mental illness. Furthermore, it went on to discuss this tribe and how in reality the 1 in 4 might as well be the 4 in 4, in that anyone can be affected by mental health issues or mental illness, and we should all talk about it. I think Ruby was trying to get across that we identify ourselves with particular groupings, for instance a football team, and we should apply this to mental health as well. If we stick with our “tribe”, in this case people who know how we feel, what we think, the emotions we go through, and the difficulty we have in opening up, then we can overcome these demons, and we can learn to deal with them, to accept and challenge them.

Having studied Psychology at AS Level, and having an interest in it, it was fascinating to listen to Ruby describe the workings of the mind in a scientific manner, speaking about the neurones and the affect that negative thoughts have on our minds. But the reason this was so fascinating, was because Ruby managed to integrate an academic subject into a comedy & an informal, easy to understand way! I seldom look at the scientific side to depression, but I am aware of it, and the play enabled me to make the link between our way of thinking and the impact it has chemically on our brain.

Ruby focussed a lot on the humorous side of living life with depression, and the old adage “you have to laugh otherwise you will cry” is probably relevant here, in that she detailed her story through laughter. Not only this, but she noted how people she knew with similar issues would find solace in laughter & laughing about being “insane” (please note, this was not in any way mocking people!) or about their thoughts/feelings.

The one main thing I took out of a wonderful play was that if we all group together and act as one large community, if we find people who are similar to ourselves, in that they are 1 of the 4, then we can find ways to cope, to live, to laugh, and to enjoy ourselves. Life is too short to be stuck in a depressive haze, and one of the best ways to get out of that, is to find likeminded people, and to bond with them. Personally, most of my friends, certainly my closest ones, are those who I know because I’ve talked to them about my depression and found that they too, share similar thought patterns and similar emotions to me.

Mental Illness is not something to be ashamed of, it’s something we can make into a positive by sharing our experience with likeminded people. Hope and belief, love and compassion, these things go a long way towards helping.

I hope to work with Fiona to spread the message throughout at least London universities that mental health is not something to be ashamed of, and to raise more awareness of it, and the research being carried out by MHRUK Charity. They were set up in 2008, and prior to this there had never been a mental health research charity. When you consider just how large cancer research charities have become, it is mindblowing to think that a mental health charity had never been set up prior to this! Talking about mental health is so important to us, to me, to everyone who suffers from mental illness.

If you get a chance, then please do visit the website of Mental Health Charity UK, they have really inspired me alongside Ruby. Laura stated that she believes the best way to eradicate stigma is to fund research into the causes of mental illness and therefore help find better treatments without so many side effects, which actually work. I firmly believe in this charity, having spoken to Laura via twitter, but also meeting her last night. By talking about mental health, if you can participate every Sunday in #TalkOut discussions at 8pm onwards, using that hashtag then you will be doing your little bit to help reduce stigma around mental health. Furthermore, if you could raise awareness of MHRUK Charity by tweeting about them, by visiting their website, or even by donating some money to them, you would be doing something amazing to help fund research into the causes of, and the treatment of mental health issues & mental illness. Furthermore, if anyone knows of a company which will distribute wristbands to individuals then please let me or MHRUK Charity know! I aim to produce wristbands to show that talking out about mental health is important and not to be ashamed of. The only issue is the distribution.

As a slight aside, there was an interesting discussion when I last did #TalkOut assisted by @Time4Recovery who combined all the tweets into one place. It centred around the idea that 5 year olds had been diagnosed with depression, and whether or not labels/diagnoses are a help or a hindrance. The general conclusion was that they were a hindrance, especially at the age of 5 where it is arguably even more difficult to determine the mental state of the individual in question, but for some people, being told they had depression or bipolar or another mental health issue/illness was a relief because they finally knew what these feelings and emotions were. I personally believe that we should be very careful in using diagnoses and labels, and it should be down to the individual to either accept or reject them, but I do believe unless the individual has sufficient evidence that their GP is incorrect, they should always follow their advice, so with regards to medication etc. They may not have to accept that they are depressed just because their doctor has said so, but I firmly believe they should take the advice given to them. After all, outside of that doctor’s room, it is just a word. I think that it is important to discuss how we feel, but we don’t have to use the terms depression, bipolar, mental illness if we do not believe we actually have them, or they actually exist so to speak.