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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.

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:

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.” ( 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.