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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.

No Place to Hide

Not here. Not over there. Not anywhere.

Ian Gilbert’s conference for teachers about mental health was an inspirational and empowering event, encompassed by first hand accounts from a teacher & students themselves. People who had suffered at the hands of mental health issues.

One of those speakers would take particular interest in the term “mental” due to the negative connotations it brings. Indeed, Nina Jackson has seen first hand what difficulties students face when suffering from a mental health issue. Her experience in Bridgend as a teacher is harrowing yet powerful. A detailed description of events which occurred in the small mining village in Wales left the room in stunned silence. It nearly moved people to tears, but it truly hit home what an impact hiding away can have on a person. It came at a terrible terrible price for those who suffered in silence from the stigma, but some were saved because of her quick thinking, her gentle attitude, awareness and kindness.

It’s OK to Talk.

Having come from a very dark place myself, I can empathise with many people out there who struggle with their emotions, who suffer from mental health issues. I don’t want to just empathise. I want to make a difference. So, despite my anxiety I spoke for 30 minutes about how it’s OK to talk. A room filled with 100 teachers and school counsellors.

How do you follow something which makes you cover your face with the notebook provided, which makes you feel so much in your stomach, which almost induces tears? How do you follow a speech like that?

It wasn’t about following anything or anyone. I wasn’t there to hide behind anything or anyone. I was there to be myself, just as everyone told me. That shone through as I discussed how it’s OK to talk.

An unconventional opening led me to introduce the person who has been my rock through the dark, difficult times, and is still there for me now that things are better, who means the world to me. They were there with me in spirit, supporting me through texts throughout the day. Calming my nerves. My best friend, the young woman I love, who helped me to gain the confidence to actually speak at this Conference.

I continued. “I was four years old…” what has that got to do with anything? What could I possibly have experienced aged 4? The answer:

“I was four years old when Tony Blair swept to power under the mantra ‘Education, Education, Education.'” Regardless of what you think of the man, the mantra, the slogan, it’s a powerful one.

I was happy to quote the former British Prime Minister, explaining that one of the most important things, the most important tools we have, is education. Education. If we educate ourselves, we give ourselves a greater chance of succeeding, of combating our troubles, of defeating them and finding a way through the dark. This conference was about what teachers could do for their students. How can they better support their students? Education. It’s Ok to Talk. To Educate students to see that it’s OK to talk about how they feel, about what they feel. If you educate a teacher, they can then pass that knowledge on. Teachers are in their job because they are able to communicate knowledge in a manner which is understood by students.

Trust. Teachers have a hugely important personal bond with students. A position in which you hold great responsibility and power. Teachers are the people who students see every day and you get to know them well. They form bonds with you & you learn that they trust you with all sorts of things. This is critical when a student suffers from emotional issues or mental health issues. Be approachable, sensitive and aware. Making promises and saying that a student can miss lessons until they need to go back, or extending deadlines and then reneging on such promises is only likely to create further problems for the student, making it more difficult for them to recover. Teachers can help students by easing them into talking about things. Phrases like “is everything OK?” “are you feeling OK?” Prompt questions which force them to give some sort of response which can give you an indication of how they feel.

Listen. To listen to a student is one of the most powerful tools at your disposal. To use your eyes, mouth and ears properly. Teachers are not counsellors, but they are the first port of call for a student who is struggling. So the care and the attitude they receive as a first impression is essential in determining how much they share and how likely they are to continue talking about how they feel. The best thing a teacher can do is listen & give positive signs such as acknowledgements to show they are listening. It’s not necessarily your place to offer advice, it’s your place to listen. People need you to listen & hear what they are saying. Don’t tell them what they think or feel is wrong, but let them know that what they feel & think is OK. Let them know that it’s OK to talk to you or anyone else. Empowerment. Empower the student so that they realise they have the ability to get better, to see this through and for things to be OK. The power is in the hands of the person who is struggling, only they can help themselves, but you can help them to help themselves.

Remind people, reassure them. THEY ARE NOT ALONE. Be gentle, sensitive. Take care to listen. Don’t force anyone to talk if they don’t want to. Ask a lot of questions but don’t be to intense. Remind them that how they feel is OK. Discussions don’t have to be candid, they don’t have to be completely based around speaking. There are many ways to communicate how you feel, such as writing or images.

If someone doesn’t want to talk about how they feel, then no-one can get them to talk. There’s no point in trying to force them, as this will most likely cause them to recoil and withdraw further, potentially setting back their recovery.

It’s about letting them know that if there is a point that they need or want to talk, then it’s OK to do that. 

How can you better inform about mental health? – Lesson  plans, incorporate ideas into a lesson plan, assemblies. Link mental health with physical health. When you talk about physical health, talk about how exercise can improve the mental state of a person.

How would you react when behaviour outside of the classroom had been impacted by a person’s mental health? Focus on discussing the causes of the behaviour, speak to a counsellor/pastoral care. How would you deal with bullying that has arisen as a result of someone having a mental health issue?

Teachers are not the ones who can solve the problem, it would be important to show them how they can explain to students that it is in their power to change things around, ensure they have access to all the information available. EMPOWER THE STUDENT.

Head girl/boy/prefects – maybe somehow get them to be a part of a push on information about mental health. Have a day where the assembly is about mental health. Role models who have suffered?

The BASICS – Make yourselves approachable. Let them know it’s OK to feel the way they do. Let them know it’s OK to talk. Help them to know they are in control & there’s no pressure. Support them. INFORM THEM. EDUCATE THEM about mental health. EDUCATE YOURSELVES about mental health.

It’s OK to talk. If you think a student is struggling then let them know that it’s OK to talk about how they feel. Show them, don’t just tell them. Show them by listening attentively & being approachable.

I’ve come a long way in 4 years because teachers listened to me, took on-board what I said & helped me to address how I felt. They were kind & considerate, they encouraged me to seek support & they were never negative. They didn’t just roll over & accept me doing no work, but they suitably adjusted things so that I could still succeed.

No Place to Hide.

The conference opened with former children’s commissioner Sir Al Aynsley-Green discussing his personal experience of children’s services and Government policies with regards to children. A specific focus on the United Nations’ Convention of The Rights of The Child ensued, noting particularly that students have the right to be involved in decision making. Aynsley-Green produced a report from the British Medical Association which claimed that “politicians are failing students on a grand scale.” This is evident throughout the cuts being introduced by the Government, but more specifically, those being made to mental health services. If we deal with the problem at its root causes, rather than simply treating the symptoms, then the likelihood of recovery is significantly higher & a quicker recovery can be ensured. Funding cuts on mental health are simply going to make things far more difficult, and ironically put more pressure on the NHS in the medium to long term. The former children’s commissioner continued by discussing the negative portrayal of children in the media, urging people not to tolerate local injustices such as being banned from shops or having “mosquitos” which make shrill noises designed to stop children congregating in certain areas.

Following this, it was Oliver James who was next to speak. The child psychologist launched a fierce attack on Thatcherism and Tony Blair. James claimed that Thatcher increased the materialistic nature of society, which was later reinforced by Blair. Essentially, the speech was about how children had been failed by politicians and what he called “selfish capitalism.” To an extent, the speech was useful, as it focussed on certain aspects of society and how there is a culture of expectancy in academia. It also discussed how this became the norm from a previous norm of doing whatever people were best suited to. How does this link to mental health? The link to mental health is that these things have arguably caused a far greater increase in mental health issues and dissatisfaction with life. The focus was on where, why and how society has contributed to an increase in mental health issues.

Next up was Andrew Curran. A breath of fresh air, the neurologist gripped his audience with an engaging presentation about the human brain.

The key point of the speech was the focus on the psycho-emotional well-being of people. A natural follow on to Oliver James, Dr Curran noted that children have two unconscious role models in life; one being their parent and the other usually their grandmother. A scientific explanation of memory and the role of the medium spiny striatal nerve cell being the specialist facilitator of learning was engrossing, whilst the idea that emotional engagement results in a feeling of reward is surely one which resonates within all of us. The Independent Thinking Associate’s speech was fascinating but most of all very informative.

Dr Curran reminded people “don’t underestimate the importance you have through compassion and kindness.”

Compassion and kindness are two essential attributes to have when dealing with mental health. The relation to mental health here is the way in which the brain works, and how we can alter it’s development, hopefully enhancing it, from a young age. Teachers have a great role to play, and to educate students about mental health is one way to improve it and break down the stigma.

The subsequent speaker was Poppy Jaman from Mental Health First Aid England. MHFA is about increasing the mental health literacy of the population. There is a distinct difference between mental and physical health, but MHFA looks to help reduce that difference by engaging with the public in how to treat mental health issues. The idea of “ALGEE” is particularly relevant

  • Assess for risk of suicide or harm
  • Listen nonjudgmentally
  • Give reassurance and information
  • Encourage appropriate professional help
  • Encourage self-help and other support strategies

All of these things were mentioned in my own speech aimed at teachers. They are extremely important, specifically for teachers when approached by students with mental health issues. The MHFA speech was fascinating and gives an excellent insight into how best to treat people with mental health issues without prior professional training.

The first speaker after a lunch break was Dr Sara Evans-Lacko. Intent on breaking down stigma, Dr Evans-Lacko produced statistics which highlighted the severity of stigma that surrounds us. In everyday conversations, stigma is perpetuated by the language used by people. But what can we do to break this down?

Time to Change launched in 2009, with a particular video “The Stand up Kid” most notable for its powerful content describing the way in which it is so easy to ignore mental health issues and not deal with them properly in schools.

Dr Phillippa Diedrichs then produced more statistics whilst discussing body image concerns and how to promote a positive body image. Focussing largely on avoiding the discussion of body image at all, or at least keeping it to a minimum,

Dr Diedrichs gave an outstanding presentation of how society has created a world in which 50% of adolescent girls don’t feel comfortable leaving the house without make up on.

An interesting point on how eating disorders and body image concerns can affect academic performance was made, with the explanation that without eating it is more difficult to concentrate in class and process the information communicated.  The Succeed Foundation member discussed the social and economic burdens of a negative body image perpetuated by the media with particular reference to the internalisation of cultural beauty ideas. This was then exemplified with examples of what society tells us the perfect male and female body looks like.

Nina Jackson followed up with her harrowing tale of loss whilst teaching in the Welsh Valleys. Claiming the students whom she lost were given “no chance” due to the severity of the poor economic situation, Nina spoke with emotion and a real desire to make a difference. Discussing anxiety at the point in which a student’s life comes to a crossroads, it was clear that she herself had suffered in the past. Which road do we take? That was the key question. Labelled with behavioural difficulties, perhaps the system deemed the Welsh students to be troublemakers, when in reality what they needed was someone to listen, someone to care. They were kicking out against a seemingly hopeless and endless pit of despair that presented itself in the area. Abandoned. No-one was there to listen.

Putting it very eloquently, Nina explained that we need to “Feed the heart with emotional well-being” and to learn to love ourselves, learn to know ourselves and learn to love our own company.

The final speaker was Charlotte, from VIK Young Minds who is involved in the AcSeed programme. Her story is one which, sadly, too many people can relate to. Having suffered from a distorted body image which drove her to self harm, she was admitted to hospital. However, she found her way through the darkness and into the light, sufficiently to spend 30 minutes talking about how to improve emotional well-being in schools.

To end this review of the Mental Health Conference “No Place to Hide” I will share an idea from Dr Andrew Curran.

What the system does is somewhat irrelevant. We do not need the system. If everyone of us tries to improve the psycho-emotional well-being of people by giving good quality one to one care then we can help people, we can help people recover & help people with their well-being.

There really is No Place to Hide any more. No place to hide from the realities of the situation, no place to hide from the fact that unless we break down stigma, unless we act, unless we stand up and be counted, nothing will change.

It’s Ok to Talk.