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 CAMHS – which 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.

The Internet And Mental Health

The internet. It’s a great invention, & most people use it at least once a day, but is it good or bad for our mental health? How does it impact upon mental health?

There’s a thousand and one ways to answer those questions & of course the answer is at least partially subjective & dependent on a number of factors, but ultimately I think it has got to be one of the best things out there to support people with mental health issues.

Social media is huge in finding support & realising that you are not alone with how you feel. There are an astounding number of twitter accounts which are set up with the aim of supporting people or raising awareness of mental health issues. There’s also plenty of accounts where people vent about their feelings, or talk about their feelings & how they are being impacted on a day to day basis. This can be both a positive & a negative thing.

Certain accounts can be triggering for people, with them talking in great detail about self harm or suicidal feelings. This is something that is crucial to monitor. Firstly, it’s important that these people get professional support, but secondly it’s important that if something is triggering you that you step away from it. They can cause distress & harm, therefore having a negative impact on your mental health, especially of they are something that is seen every single day. The thing is, though, it is crucial to remember that these people have their own issues, rather than criticising them, try to encourage them to seek support from a professional & talk to them about how they can go about doing so, or if they already are, then what it is that they are withholding &/or why.

The support accounts can be helpful, but they should in no way take the place of professional help, & hopefully most will state this in some form or another because it can be dangerous to take advice from someone with no professional knowledge. Make sure that you trust the person & know where they are getting the information they are giving out, from. From a personal point of view, everything I write is based on my own experiences & is geared towards encouraging people to speak about their feelings, & to give people hope, rather than attempting to provide advice. Occasionally I may offer words of advice, & in private I do, but publicly I will always post what is on my mind from personal experience, which generally tends to be what helped me through. Largely, support accounts provide a platform & a tool to be utilised & provide information which can be used to build on what is gained through professional intervention.

The internet more widely, as a whole, is slightly different. There’s far too much stigma out there still, I see it everyday on some of the forums I use that have nothing to do with mental health. However, there’s also plenty of places out there which allow for support, plenty of information & assist in gaining knowledge about the symptoms of mental health issues, ways to combat them & simply people to talk to. It allows people to make more friends, sometimes those with similar issues to themselves & in some ways can create a peer support system. Again, I stress that professional support should not be replaced with this, but that it is still useful.

Overall the internet can have a positive impact on mental health, it can create friendships, increase social opportunities & provide information as well as support. However, it is how these tools are seen & developed that is the most critical aspect in determining how useful the internet is for mental health. Largely it is down to how we use the internet. Use it too much & it can have a detrimental impact on our social lives, thus not helping our mental health. Indeed, it can be far too easy to get to a stage where we are simply focussed on our on-line lives, rather than striking a healthy balance between the two. I refuse to use the term “in real life” because the internet is real life, it’s just an extension of our lives which happens to be slightly different. It’s terms like this which perpetuate the stigma around forming relationships on-line & ultimately can contribute to mental health issues. People can feel trapped between two worlds, the outside world in person, & the on-line world. For some people the internet is their only recluse, to escape from the mundane reality of everyday life, the pain & suffering they experience in their day to day life. Some people find it easier to form relationships on-line, which in turn can also help them to form relationships in person. It can be frustrating to see people say that accounts such as those which trigger people & talk vividly about mental health issues in a somewhat perturbing way, should be closed down. Yes, they need professional support, but you’d be taking away a vital network & resource for them to vent & to talk. It’s absolutely critical that they are allowed to express how they feel, but likewise they need to be challenged, or at least they need to have it told as it is. Abrupt, but polite & sensitively done.

The internet has played an absolutely massive part in my life & assisted immensely in bringing me out of depression & into a more stable, happier place. Most of my closest friends are those who are going through similar to me or similar to what I have been through. They are the people I’ve known through on-line conversations when I’ve sought to find people that help me see I was not alone. They are the people who have come through a lot of difficult situations, low moods & struggles. Most are not “recovered” & they are neither in a place you might want to label depressed or any other label you wish to use. They’ve come through the darkest days & they’ve got somewhere, but they’ve fallen back into confusion & difficulty as a result of x, y & z. However, they are stronger for their experiences & more prepared to deal with what comes at them, finding ways to deal with their issues. These people are friends I have made through on-line conversations. I’d rather have friends who I had things in common with & cared about, than worry about the manner in which I have made those friendships. After all, they are friendships, it just so happens that I don’t get to see them face to face all that often.

Stigma will possibly always exist in some form, as language evolves & meanings become skewed, words become ambiguous. Some people will see things in a different way to others & for whatever reason may find it enjoyable to mock those with mental health issues, or at least to attempt to increase the myths & misunderstanding surrounding mental health issues & mental illness. The internet provides a platform for them to do this, but equally it provides a platform for people to strike back & dispel some of those myths & misunderstandings. A collective effort to find ways to talk more about mental health is required, as it will encompass all of the things mentioned in this post & hopefully save a few lives, improve a few lives, transform a few lives, because your voice, your pen, your keyboard, they’re some of the most powerful tools you will ever have or find. Whilst your actions may speak louder than your words, it is your words which can also put warmth into the coldest of places, to put light back into the lives of people, create a spark & propel people towards achieving what they are capable of, propel people towards greatness.

Be careful with what you put on the internet, be careful who you trust, but don’t be afraid to use it to find like-minded people, those who can relate to your experiences. Feel free to support people, but remember that you cannot help anyone unless you are in a good enough place yourself. By looking after yourself, you look after others who you may support. People who care about you. Next time you go to write something about your state of mind on a forum, a blog, on Facebook or Twitter, take a moment to consider what potential impact it may have on someone. If it’s likely to upset someone, then perhaps write it down privately. Try to seek out that support in a direct, constructive way. It can be difficult when you are led by your feelings & not your head, but it’s not impossible, & it’s a technique which will serve you well in the future. The best way to find support, is to ask for it. Attention seeking? Yeah. Yeah it is. Attention being that fundamental human need that we all have. Quite why there is so much negative association with that phrase I fail to accurately comprehend, but to seek attention is not a problem. It’s how you go about it that matters. Everyone needs attention, & if you’re lacking it, or needing some more to help you through, then please ask for it, because there’s always going to be someone out there who is willing to support you. Hinting at things, posting cryptic things, as a general rule is not going to help anyone. Sometimes you might need to get something out that only you understand & hope that maybe another person might realise what you’re talking about, & that’s ok, but try to limit the times you do that & actively seek support in a direct manner.

The internet has allowed for much greater social interaction, more information & support in terms of mental health, but really, the main benefit of the internet when it comes to mental health is to integrate all of these things & allow them to interconnect. If you write a blog about how you feel, & you share it via social networking or a forum, you gain the opportunity to discuss mental health & mental health issues. By talking about it, you help to understand it better, new ideas form & more detailed, developed discussions occur. More complex & engaging conversations happen, you get to understand the way people think & how to interact best with people. By sharing it with social networks you allow a greater number of people access & you can form relationships through these means. You also will be able to find more information about how to find support in your area, & then you can begin to find better ways to help yourself through the feelings that you may deem insurmountable, but are in actual fact, usually temporary. There are websites out there which allow you to relax & take your mind off of things, websites which allow you to engage with the world & what is happening in it, websites which allow you to discuss common interests & meet people who share your interests. Websites which help you to find information about things. The internet is an extension of our every day life & it’s one of the most important tools when it comes to mental health. The relationships which can be formed assist in recovery, or in teaching about mental health issues. They give another view on things. Ultimately, the internet provides a foundation upon which you can choose to access & build upon. It allows for a journey of greater self discovery, but it needs to be noted that a lot of things which it provides are merely more detailed versions of what you can find in your day to day life in person. Use the internet in an appropriate manner alongside maintaining healthy relationships outside of it & it can be an instrumental part of recovering from mental health issues.

It’s ok to talk.

Depression Awareness Week

This week (beginning 23/4/12) is Depression Awareness Week. A week for us to look at depression and to educate people about it’s causes, it’s effects, and just what it consists of.
It seems to have passed by as somewhat of an afterthought. Or should that be a 4thought. The latter reference is to a channel 4 TV programme which has triggered a complaint from Rethink to OFCOM due to the ridiculous trash spouted by an ignorant being about the causes of depression. My advice would be: do not watch or research the programme.
Anyway, let’s get back on topic. As mentioned before, it doesn’t appear to have been in the news, in the public eye or in the media. There are plenty of campaigns/blogs/websites trying to increase awareness of depression, but it is all focussed online. Of course most things are heading towards the idea of 24/7 online media, but now and again it does just help to have an advert on a train, or at a station, or even (an article or advert) in a newspaper. For instance, the recent campaign by Time To Change that ran in the metro made me feel much more normal. Which it should do, because there’s nothing abnormal about people with depression, it’s just a mental health issue (there’s a reason this phrase is often used by us). Ok, it’s not ‘just’ a mental health issue, but it’s nothing to be ashamed of, or to be treated differently for. Treat us with as much love and care as you would anyone else you care about. The metro campaign was probably seen by millions of people, and that’s great because it helps spread awareness. What is more important for me, is that it was something that people pick up on their way to work or way home from work/school etc. The more it is out there where we can see it with pictures, with bold writing, where we can touch it with our minds, the better. The crucial thing is to balance the idea of having it online and having it out in places that people travel to. Online, we can’t make as much difference unless we find the right contacts, but out there we can grab the attention of different types of people, of people who aren’t necessarily aware of these websites. I haven’t done any research, but as far as I am aware the BBC or ITV have not mentioned depression awareness week at all. Indeed, a quick google search for “depression awareness week BBC” on news articles lends itself to a pathetic return of 3 results. I shall leave you to draw your own conclusions.

So what can we do? How can we raise awareness? Well we can raise awareness simply by having a conversation with someone about it. A white lie if you fear the response, or fear someone finding out you suffer from depression. Something like “did you see on BBC this morning that it’s depression awareness week?” along with an additional comment about how depression is misunderstood (which it is by somewhat large numbers of people, hence why we have stigma) or just a pause for their response. Personally, if I was still at school I would want to do an assembly about it, a presentation like they do on ANZAC day or in Citizenship where they talk about numerous social topics. Obviously that’s one for the more self confident people out there. There are ways to turn conversations onto mental health subtly, a tad difficult to describe, but it is possible. It can be a short conversation, or a long one, either way you are still taking the time to speak about it.
Depression is not an easy topic to broach, but with the right attitude and a lack of fear, we can get talking about it. This is where social media comes in useful. Twitter and facebook. Facebook is more difficult for those who fear “reprisals” so to speak, the fear of the unknown, the unkown being what the response will be. If you suffer alone, things will take much longer to improve, so maybe the first step is to be able to share it. If you put a status such as “this week is depression awareness week, it’s important people don’t feel afraid to talk about it” then how many people are honestly going to assume you have depression? People don’t assume you have cancer if you put a status about raising awareness of that. Ok poor example but the point stands. No-one is forcing you to do anything, no-one will think any less of you if you don’t do it, but if you do then that is a great way to help people think about it. Sometimes we look at things and think “that’s interesting” and we go away and research. The same can be true of depression, if you get 1 person to change their view on depression for the better then it will have been worth it.
We at Talk_Out marked depression awareness week by having a twitter discussion asking for people’s experiences, and here is a summary of all the tweets we received with the #TalkOut hashtag: #TalkOut marks Depression Awareness Week: http://storify.com/Time4Recovery/talkout-marks-depression-awareness-week?awesm=sfy.co_qTJ&utm_campaign=&utm_medium=sfy.co-twitter&utm_source=t.co&utm_content=storify-pingback

Take the time to read through these tweets. Are they all positive? No. Are they mostly positive? Yes. Are they all talking about how rosy life is? Of course not. What are they doing then? Well they are simply helping to break down the stigma around mental health. They are helping others to see new ideas for coping, and hopefully to see that others have improved and become happier, therefore so can they! You don’t have to be happy all the time, or positive, but if you can talk about how you feel openly, then you are well on your way to bringing happiness back into your life.

To finish this entry, I leave you with a quote from Dr Tim Anstiss who wrote in the Guardian today that: “There is so much bullshit out there about mental health and mental illness…” The trouble is, unfortunately it’s hard to disagree with him. However, he goes on to claim that “people are ready for an accessible and helpful resource where they can share experiences, concerns and feelings, learn about new things and explore issues without feeling judged or told what to do.” (http://www.guardian.co.uk/social-care-network/2012/apr/26/social-media-depression-support) We agree, and the purpose of #TalkOut is to do exactly this, begin a community, bring a community together to help each other alongside getting professional help, to return happiness to those whom it belongs to.

It’s A Parent-Child Thing

We all know what it is like to have arguments with our parents, most of us probably got on better with one of our parents than the other. Certainly it’s part of growing up and maturing, the fight for independence and the struggle for the parent to let go of their baby whom they have cared for, for so long. The question which sits in my mind though, is: ‘When does an argument become emotional abuse?’

This is a very personal subject, and I don’t particularly intend to put anyone across as a villain or criticise anyone, merely to explore the thought process that occurs in my mind at times like these.

So when does a series of arguments become emotional abuse? Let’s not look at it in terms of the dictionary definition, but let’s look at the effect it has on a person.

19 years of age. Living at home. Suffered from anger issues, a short temper and emotional issues since the age of about 12. They call it ‘depression’. I’m not a label, it does not define me and it never will. However, it did help me to tell my parents. My mum, she’s a very intelligent person that is obvious, but certain things have happened which have caused her outlook to become blinkered, and this is where the conflict occurs. The war of attrition as the waves crash down upon the rocks, gradually wearing them away to require either a compromise of soft defences, or a more hardened approach of re-inforcing that cluster of rocks preventing any penetration. I digress slightly. The conflict results in blame, arguments, “fights” and hatred being spouted.

Streams of consciousness enter the atmosphere & it becomes like a book. Dialogue is merely these streams of consciousness battling against each other. Nothing actually goes through, we both listen but do not hear. Shouting and screaming. It’s better than the alternative, but it’s far from perfect. “I can’t live like this anymore” comes the cry after half an hour of my thoughts being battered against her mind, trying to worm their way in to make that breakthrough and create an understanding. What happened?

An offer of money for a box to change to digital TV or no TV. We’ll give you £25 and you can pay the difference. I’ve just spent £102 to get my laptop fixed and money is not exactly in abundance right now. “Can I?”. Immediately the words are regretted because it results in an argument which centres around the idea that I have spoken in a “tone of voice” which she does not like. The irony here is that tone of voice is subjective. The ‘discussion’ continues & the annoyance is there due to being accused of something which is not true. The blame comes my way, it’s all because I spoke in that tone of voice. The frustration eminating from my heart and mind is blatantly obvious by now as I throw the cup down in frustration as she mocks my reaction, walks away knowing full well that it will anger me further. Why? Knowing full well it will anger me further, why does she do this? Is it some sort of petulant act of childishness, or is it just a form of regaining that control she lost when I grew up? Only one person knows the answer. The frustration boils over as whenever an explanation is forthcoming I am interrupted by a reaction designed surely just to wind me up further.

There is much more to it, & to be blamed for something constantly is perhaps a form of emotional abuse, but as noted, there is far more too it than this.

What causes this? Mental health issues? Perhaps. Really though, it is just emotions & personalities. Define it as depression if you so wish, but I do not see it in this way. How you see yourself is entirely your choice, depression is a serious condition and certainly something I experienced. Past tense. For now it is just a label to say that because I react in this way to life, I have depression. There is a chemical imbalance in my brain, the positive impact of this new medication suggests this is true, but depression does not define me.

Let us take that the two people here suffer with mental health issues, predominantly depression. What is it like to live with a parent with a mental health issue?

I love my mum, there’s so much I regret from my childhood about how she treated me, but instead of that being violence and abuse, povertyesque conditions, it was love. I love her because she loved me. I feel her actions contributed to who I am today, and whilst there’s so much I want to change about the past & some things about the present also, I love the way my mind works. The speed of thought, the analysis and the questioning of everything. Even something like football and the way it changes over decades, I was knackered and it was 1am on the DLR on the way back from Portsmouth, I asked my friend how football had changed, what he thought of the way I think, this that and the other. I explained the speed that my mind worked and how I love it. For this, I have my mum to thank. She protected me from harm for fear that I, her baby, would be hurt. She could not bear to see me hurt and that was born out of her unconditional love for me as her son. So despite the many negative aspects to her somewhat overprotection of me, there were some positives.

What does this have to do with living with a parent with a mental health issue? Well it needs saying that my mother loves me & I love her, regardless of what may be said in this blog, on my twitter or elsewhere. Love is there, and it will always remain, but we are at each other constantly.

The sheer bloody mindedness of us both creates conflict, and our inability to channel our stress and emotions in a positive way is a recipe for disaster. We both struggle. When you have a bad day and get in a bad mood, what happens? Often you become snappy, aggressive and somewhat withdrawn. Try living like that every day, and combine with it two people who refuse to give in. The 19 year old admits some wrongdoing begrudgingly to keep the peace, but the mother is blinded by her own problems, seeing things only from one perspective.

This blog entry does not appear on the surface to explain what it is like to live with a parent who has a mental health issue, it just shows conflict between parent and child, but deep down there is much more than that. The devil is in the detail.

What is hardest is to see the impact I have on her. The conflict that already penetrates my mind every second of my life is further exacerbated by the frustration at the suffocation of me as a child, but the realisation that the actions were out of love. The love is therefore repaid albeit not very clearly. How? Well when I see my mum struggling with her emotions, breaking down and crying, getting angry for (seemingly) no reason, my heart sinks a bit. I don’t want her hurting, regardless of the fighting we have. I love her, but she feels suicidal, she is depressed, low and somewhat alone. Solemnity, sorrow, scared. She’s scared, I’m scared and we both know it. Yet there is a silent acceptance of each others’ desire not to discuss it, that being my fault as such, my way of relucantly punishing her for her previous actions, for I cannot break the chains which are held tight due to the fear and embarrassment of the past.

Living with someone who has a mental health issue is difficult, but it shows your strength, their strength, the power of love and hope & the rays of light that shine through every now and then. Don’t be afraid, just show your love, because love is most powerful, moreso than hatred, loathing, of hopelessness.

Matt