Coalition’s new mental health strategy should be supported

Our guest writer is Mark Davies, director of communications for Rethink, the largest voluntary sector provider of mental health services in England; Mark is a former adviser to the Rt Hon Jack Straw MP at the Ministry of Justice and the Foreign and Commonwealth Office

With very little fanfare, and very little follow up in the media, the coalition has announced how it plans to frame its strategy on an issue which affects one in four of us – not that we like to talk about it very much.

silhouette-of-man-in-twilight Mental health is one of the defining issues of our times. Always present, rarely talked about, people affected by mental illness represent a massive group who continue to face a degree of discrimination which would trigger street protests in any other context. Nine out of ten people with mental health problems experience prejudice.

It is estimated that 25 per cent of the population is affected by some sort of mental health problem at some point in their lives. Severe mental illness affects 1.5 million people and their families. It’s a fact that we all know someone who has experienced a mental illness.

The human cost of this is often devastating. People with severe mental illnesses like schizophrenia, for instance, die up to ten years younger than the rest of the population. And there is a massive financial cost too – according to the King’s Fund, mental illness costs us all at least £33.75 billion every year through the NHS, benefits, homelessness, substance misuse and the criminal justice system. It is probably much more – the government itself estimates the cost at £77 billion a year.

Judging by his words, the health minister Paul Burstow recognises this. In an article published in Community Care to set the scene for the government’s new mental health strategy, expected later this year, he argues that poor mental health is a key factor in a “miserable chain” which links family breakdown, worklessness, drug and alcohol abuse and crime with long term poverty and exclusion. Tackling this issue, he suggests, is critical to any attempt to reduce deprivation.

He’s right, of course. The economic arguments are obvious. The social arguments are clearer. And there is an opportunity to make progress in rectifying them – thanks to the Time to Change campaign Rethink runs with Mind, there is evidence that the stigma which affects mental illness is falling, albeit from a disturbingly high level, and by no means far enough.

That said, we do believe that thanks to the social movement we are building – with more Facebook followers than Oxfam, for instance – the possibility of reaching a tipping point where discriminating against someone on the grounds of their mental health becomes socially unacceptable is within reach in the next few years.

The last government (for which I worked, though not in the health field) can take credit for pushing mental health up the agenda through the New Horizons strategy. The development of Improving Access to Psychological Therapies (IAPT) services, for instance, is an important step forward in terms of helping thousands of people with mild to moderate depression.

But as Mr Burstow points out, there is a need for a more fundamental change, that of a shift in culture in the NHS so that mental health has parity with physical health. It is encouraging that the new focus on patient outcomes rather than process targets is to take mental health outcomes into account, as is Mr Burstow’s desire for more emphasis on prevention and early intervention.

He’s also right, of course, that it is crucial that mental health concerns are embedded in the likes of housing, employment and children’s services: mental illness does not happen in isolation and nor does it require only a response from health professionals.

Rethink’s advice service in Plymouth magistrates court is a good example of this – by identifying problems among low level offenders which can contribute to or even cause mental illness – things like homelessness or debt, it is possible to divert them away from repeated appearances in the court room and tackle their mental health issues.

So far so good. And of course Mr Burstow is also right to point out that making changes in such a difficult area at a time of austerity is a big challenge. His belief that it will still be possible to land a “major blow against poverty and deprivation” through a new approach to mental health is therefore refreshing.

For that hope to come to fruition will, however, require a degree of innovation and a healthy dose of courage. It means supporting words with actions and committing to tackling the stigma around mental illness, extending talking therapies to people with severe mental illness, ensuring that GPs as commissioners have the tools they need to commission in the field of mental illness and being prepared to invest in early intervention to make savings down the line. Providing early intervention services in every new case of schizophrenia, for instance, could save £44m according to the King’s Fund.

Charities like Rethink, a Big Society organisation if ever there was one, are well placed to play a part in this. Through contracts with local authorities and PCTs, we already deliver more than 300 services in England, from advocacy to housing to talking therapies, costing around £50m a year. All these services play their part in reducing the human cost of mental illness as well as the economic costs.

But there is such a long way to go. Our recent report, Fair Treatment Now, highlights that when it comes to severe mental illness only 16 per cent of our service users are receiving the interventions recommended for their diagnosis. If that were the case for diabetes or asthma, for instance, it would regarded as a national scandal worthy of front page coverage in the Daily Mail.

This is the scale of the issue facing Mr Burstow. He deserves support in this endeavour from across the political divide and it would be good to see Labour’s new leader making an early commitment to working on this agenda. We wholeheartedly welcome the thrust of Mr Burstow’s commitments and will do everything we can to help him deliver real change for the millions of people affected by mental illness.

http://bestblogs.labourhome.org/2010/09/07/coalition%e2%80%99s-new-mental-health-strategy-should-be-supported/ Coalition’s new mental health strategy should be supported « The best Labour blogs

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firemonkey

This is the coalition that is intent on scaring the hell out of the mentally ill with welfare reform policies even more draconian and reactionary than New Labour’s.
http://www.libdemvoice.org/praise-for-governments-approach-on-mental-health-21039.html Praise for government’s approach on mental health

[...] and stress the importance of doing so regardless of the issue’s usual low public profile. The full piece is here. Share: Tweet This entry was posted in News and tagged mark davies, NHS, paul burstow. [...]
Mike

but surely devolving nhs budgets to GPs
goes against the whole stratergy
GPs wont buy in

Gps should/must not be given control of the mental health budget
Trevor Cheeseman

Mark – I too welcome Paul Burstow speaking on mental health issues. I was especially interested in his first point, that “being unemployed increases the risk of mental illness fourfold compared with those in employment”, given the Institute of Personnel (CIPD) predict that 750,000 public sector workers will lose their jobs from the Coalition’s planned spending squeeze.

I am a Trustee for a charity running dementia services, and they are anticipating 5% funding cuts in all local authority funded services every year for the next 5 years.
http://twitter.com/mindinflux/status/23264688532 Mind In Flux

Coalition’s new mental health strategy should be supported | Left Foot Forward: http://bit.ly/c1X5aC #mhuk Comments can be made.
http://twitter.com/stayyoungernow/status/23265614467 Donald Powers

Coalition's new mental health strategy should be supported | Left … http://bit.ly/dlXgnO http://bit.ly/OuUHe
http://wellescent.com/health_forum/topics Wellescent Health Forums

While there may come a change that allows the medical establishment to treat mental and physical illness at the same level, convincing the public will be a whole other challenge. In general, people are not tolerant of excessive cultural differences that affect behavior so hoping for acceptance of the unexpected behaviors that accompany mental illness will require consistent ongoing education efforts to even achieve even some level of success.
http://twitter.com/pellegrino5/status/23266487885 Sue Pellegrino

RT @MindInFlux: Coalition’s new mental health strategy should be supported | Left Foot Forward: http://bit.ly/c1X5aC #mhuk Comments can be made.
http://twitter.com/checkbias/status/23267040405 .

Rethink's Mark Davies links mental health,substance abuse and criminality in a clumbsy self serving appeal http://bit.ly/c1X5aC #mhuk
http://twitter.com/checkbias/status/23267283293 .

Rethink's Mark Davies links #mentalhealth,substance abuse & criminality in a clumbsy self serving appeal http://bit.ly/c1X5aC #mhu
Beatrice Bray

It is about time all parties started thinking about the reasons why they do not recruit the best people in mental health policy. We are not welcome. Not in any party. Who wants to join an organisation which effectively bars you from holding any position of responsibility? Most party political activists right, left and centre view us as an embarrassment and a liability. So we work outside party machines, sometimes openly and sometimes covert. Not everybody wants to go public about their diagnosis.

To a greater or lesser extent each of the big parties has thought through positions on race and sex. There has been some thought on other disabilities but to many it is still not shocking that Tony Blair could speak of “two types of crazy people” as he did just this week. Most MPs take little interest in mental health but the subject looms large in their constituency cases. That is why you get the lacklustre prose of the Burstow statement. Never mind journalists and MPs. It would bore most service users rigid.

Where’s the passion? Where’s the belief? Where’s the commitment? How’s this going to inspire anybody? Will it make desperate people pull back from the edge? Will it sway others away from prejudice? This is a new audience to Mark Davies. Paul Burstow is an old hand. I suspect both are intimidated by fear of the media. Niether seem to have a feel for the diverse range of public views in this area. Well talk like that with a live audience of service users and you will get a pasting. They are mostly poor and ill and in a hurry for solutions. Don’t assume they’re mad and are asking daft questions just because they’re not speaking to your agenda. Maybe it is the politicos who are out of touch with reality.

It is time ministers and ex-special advisers in charities learned to carry on a dialogue with the public. Speak the same language. Do not just ask for support. You won’t get it. Negotiate. That’s what we want.
http://twitter.com/checkbias/status/23267336556 .

Rethink's Mark Davies links #mentalhealth,substance abuse & criminality in a clumbsy self serving appeal http://bit.ly/c1X5aC #mhuk
http://twitter.com/beatricejbray/status/23268792661 Beatrice Bray

@checkbias @markdavies67 tells ppl with #mentalhealth probs to support Coalition. Why? My reply awaiting mods. http://bit.ly/c1X5aC #mhuk
http://twitter.com/chipletmum/status/23269224630 Mum to chiplets

RT @MindInFlux: Coalition’s new mental health strategy should be supported | Left Foot Forward: http://bit.ly/c1X5aC #mhuk Comments can be made.
Robert

Sorry but it’s New Labours medical, not the Tories, I’ve been thought it, I was not allowed to use my medical files, the chap I spoke to was not even medically trained and they use a computer tick box.

For example can you pick up a cup, using any part of your body including your stumps, thats one questions.

Can you use a wheelchair on your own, yes then your deemed to be the same as having legs.

Most people will prove mental health by using a doctors diagnoses, but this is rejected by the test.

I could go on but what for most are so blind to what new Labour did not the Tories, and as Blair said I should have gone further with welfare reforms.
http://twitter.com/beatricejbray/status/23856116200 Beatrice Bray

@gabyhinsliff Cease fire @leftfootfwd: @markdavies calls for support for Coalition #mentalhealth strategy http://bit.ly/9IdmhT Count me out
Fay Kelly-Tuncay

Care not Custody

In June 2008, the AGM of the WI passed, by an overwhelming majority, the following mandate:”In view of the adverse effect on families of the imprisonment of people with severe mental health problems, this resolution urges HM Government to provide treatment and therapy in a more appropriate and secure residential environment.”The mandate highlighted an enormously important and often hidden issue – how we treat people with mental health problems when they come into contact with the criminial justice system and what impact this treatment has on their families and therefore society as a whole.

Please read this PDF the WI Care not Custody Action Pack
http://www.prisonreformtrust.org.uk/uploads/documents/WICarenotCustody.pdf

Video message from the WI on Care not Custody Campaign
http://www.youtube.com/watch?v=qcJhtjjYKXM
5 hours ago · Unlike · 3 people ·

Please support us – thank you.
Anon E Mouse

Mike – Any GP who does not do as he or she is told should be sacked – they are way overpaid and underworked as it is.

Certain GP’s need to get a grip and more money could then be freed up for other illness’s such as mental health.

See the big picture please Mike…
http://twitter.com/mindsanctuary/status/23897091390 Tina Gibbons

@markdavies67 Director of Communications for @Rethink writes about mental health strategy of new coalition government http://bit.ly/9F105H
http://twitter.com/beatricejbray/status/23898928140 Beatrice Bray

@kmachin See my reply to @markdavis http://bit.ly/c1X5aC. I don't think he represents the @rethink_ ppl I know.
http://twitter.com/beatricejbray/status/23899109407 Beatrice Bray

@kmachin See my reply to @markdavis67 http://bit.ly/c1X5aC. I don't think he represents the @rethink_ ppl I know.
http://twitter.com/beatricejbray/status/23899126419 Beatrice Bray

@MarkOneinFour See my reply to @markdavies http://bit.ly/c1X5aC. I don't think he represents the @rethink_ ppl I know.
http://twitter.com/beatricejbray/status/23899143830 Beatrice Bray

@MarkOneinFour See my reply to @markdavies67 http://bit.ly/c1X5aC. I don't think he represents the @rethink_ ppl I know.
http://twitter.com/beatricejbray/status/23899169779 Beatrice Bray

@rethink_ @mindcharity See @markdavies67 put his foot in it @leftfootfwd http://bit.ly/c1X5aC > He expects us to support Coaltion!!! @mhuk
http://twitter.com/beatricejbray/status/23899200618 Beatrice Bray

@rethink_ @mindcharity See @markdavies67 put his foot in it @leftfootfwd http://bit.ly/c1X5aC > He expects us to support Coaltion!!! #mhuk
http://twitter.com/beatricejbray/status/23899514793 Beatrice Bray

@Quinonostante Judge for yourself @markdavies67 in Left Foot Forward http://bit.ly/c1X5aC
http://twitter.com/kmachin/status/23899547291 karen machin

everyone should read @BeatriceJBray eloquent reply to @markdavis67 of @rethink http://bit.ly/c1X5aC. I hope he responds #mhuk
http://twitter.com/beatricejbray/status/23900019718 Beatrice Bray

RT @kmachin: everyone should read @BeatriceJBray eloquent reply to @markdavis67 of @rethink http://bit.ly/c1X5aC. I hope he responds …
http://twitter.com/checkbias/status/23900107340 .

RT @kmachin: everyone should read @BeatriceJBray eloquent reply to @markdavis67 of @rethink http://bit.ly/c1X5aC. I hope he responds …
http://twitter.com/kmachin/status/23900113082 karen machin

everyone should read @BeatriceJBray eloquent reply to @markdavies67 of @rethink http://bit.ly/c1X5aC. I hope he responds #mhuk
Isla Dowds

There is, of course, a correlation between poverty, disadvantage, inequality, life stressors and poor mental health. However I would want this to be balances with ongoing recognition that mh problems can occur to anyone, and often those in the ‘middle’ – too ‘rich’ to be pickd up through other services, but too poor to be able to e.g. afford private health care or even be able to pay for quick access to counselling or therapy, or not confident enough to challenge a GP who may not do any more than issue a prescription for anti-depressants – can be just as disadvantaged when it comes to getting quick and effective help with mental health problems.

I’m also extremely dubious about this governments commitment to the hard facts that this area needs investment not cuts. We are already seeing the tell tale signs of disinvestment, not encouraging investment, and I fully expect to see services, including those contracted to 3rd sector providers being cut to the bone or cancelled altogether. In fact, I would put money on them banking on the liklihood that when they do so, the voluntary workers of the 3rd sector will be prevaled upon to step in and fill the gap…. which is great, but not always what is needed.
I am equally concerned about the whole idea of GP commissioning. The very patchy successes ( and overspending to boot!) of Practice Based Commissioning, the widespread unwillingness of GPs to give any priority or value to patient experience and expertise, the lack of expertise on mental health amongst GPs, and the financial constraints that could well influence their choices, suggest that the lines being repeated ad nauseam by Andrew Lansley and his ministers that ‘ GPs know best what you need’ and are ‘keen to forge ahead’ is far from being true. Yes there are successful PBC schemes – in some places. It would be interested to know how many of those are mental health schemes – maybe the Rethink Comms team should look into that… I know of one – it consisted of a 1 day training in ‘ CBT techniques’ so they could be used in the context of the standard 5 – 8 mintue GP consultation. Hmm. Not only that but the attitude to patient consultation in the development of the scheme was pretty much ‘ Do we have to do it? yes? really? Well what is the least we can get away with?’ As for Equality Impact Assessments? Ha! ‘My staff don’t have the time to do this and it costs far too much…’. Less than half of GP practices even have patient participation groups, and of those who do, on paper, the number who have a significant number of patients, are reasonable representative, and have an effective role supported by the practice is really quite small. That should tell you something about the attitudes to patient involvment. Not a good sign.
I understand that Rethink will be trying to work with the government, but please, ask some hard questions, push and challenge them, and don’t be too quick to play nice – let’s see some actions, not fine words, from them.
http://twitter.com/beatricejbray/status/23900232145 Beatrice Bray

@CommunityCare everyone should read @BeatriceJBray eloquent reply to @markdavies67 of @rethink http://bit.ly/c1X5aC. via @kmachin
http://twitter.com/xtraspirit/status/23900429162 Lindsey Cree

RT @kmachin: everyone should read @BeatriceJBray eloquent reply to @markdavies67 of @rethink http://bit.ly/c1X5aC. I hope he responds …
http://twitter.com/celticchickadee/status/23900563832 isla dowds

RT @BeatriceJBray: @HSJEditor Rethink's new comms man fails 2 speak for #mentalhealth service users or front line staff http://bit.ly/c1X5aC Toadying up to gov
http://twitter.com/liz_ids/status/23904405092 Liz A

Nine out of ten people with mental health problems experience prejudice | Left Foot Forward http://bit.ly/9w0nnl
Beatrice Bray

Wellescent Health Forums – you seem to be struggling with your own feelings about mental health. Lots of people are confused here and realising you’ve got some things to learn is no bad thing.

One of the first things you have to learn to avoid is projecting your own views onto the wider public. You think one way but there is no guarantee that the wider public will think the same way. You are fatalistic. At best you say that only “some level of success” is possible given “consistent ongoing education”. You say people are “tolerant of excessive cultural differences”. Who are those people? What sort of differences are you talking about? What counts as success? Why are you qualified to define success for us?

In some ways mental health politics is like any other form of politics. It is best to set precise objectives. Be clear in your campaign goals.

Of course there are obstacles. There always are but the ones I notice most are the ones created by people who are supposed to be of sound mind. For example I once went to the Henley Centre for Management to discusss productivity with a specialist. She knew I was from the All Party Parliamentary Mental Health Group. I thought that was a bit of a give away and we were getting on quite well over coffee so I relaxed and said that her strategy would well with people with bipolar. I added I had the illness. She became alarmed and frightened. She jumped up and told me I must leave the building at once. As she escorted me to the street outside she told me: “You’re mad.” I did not protest. I just accepted it but the incident has stuck in my mind.

Of course this is nothing compared to the crimes of violence and exploitation that get directed against people with mental health problems but people like Wellescent Health Forums should consider the hostility we face. Not everyone calls us names and pushes dog shit through the letter box but some people do behave badly towards us.

This may sound odd but in some ways I am optimistic. If you forget about the economic conditions in some ways it is great time to be in mental health politics because we have a confidence about us that we did not have twenty or thirty years ago. We have knowledge and skill and good people in our midst. To be sure there are sceptics but I think we, the people with mental health problems, are capable of playing politics. I am not saying we are going to get all we want but we can make a respectable stand. We are not looking to get our strategy accreditated by the media or party leaders or even by charity chiefs. We’ll just focus on what we need to do. That is good enough for us and because we are considerate people it will be good enough for everyone else.
http://twitter.com/rethink_/status/23921098993 MentalHealth Charity

Our Director of Communications, Mark Davies has written a blog about Care Service Minister Paul Burstow's new… http://fb.me/H9NKwxWo
http://twitter.com/nhsc_sdonetwork/status/23921938692 Jenny Hawkins

RT @Rethink_: Our Director of Communications, Mark Davies has written a blog about Care Service Minister Paul Burstow's new… http://fb.me/H9NKwxWo
http://twitter.com/dcpinfo/status/23949732231 DCPinfo

Left Foot Forward: Mark Davies of Rethink on new government mental health strategy http://ow.ly/2BpeY
http://twitter.com/lordbonkers/status/23949760633 Jonathan Calder

RT @DCPinfo: Left Foot Forward: Mark Davies of Rethink on new government mental health strategy http://ow.ly/2BpeY
http://twitter.com/whydelila/status/23950544956 siobhan jones

If the con-dems reconsider their benefits/ housing policies their mental health policy would be more believable http://ow.ly/2BpeY
http://www.thebufferzone.co.uk Tony Lea

Regarding mental health and personality disorders.Recently at a conference, it was recognised that 12% of the population of Cornwall had this disorderThat equates to 17000 sufferers, this equates to over 38% of offenders suffer from many MH issues, times that by £38000 per year per offender. We are currently investigating opportunities for 3rd sector involvement. We have suggested that early inervention of all issues are dealt with during six weeks before release via advocacy, then 6 months mentoring, allowing training, voluntary work and adapting to social intergration. We may not help all to brak the cycle or the revoving door syndrome, but most of offenders with MH shouldn’t even be there. Sometimes it needs the system to allow someone to change and support them to
http://dawnwillis.wordpress.com/2010/09/10/contoversial-you-decide-former-spad-mark-davies-on-supporting-the-coalition%e2%80%99s-new-mental-health-strategy/ Contoversial? You decide. Former SPAD Mark Davies on supporting the Coalition’s new mental health strategy. « Dawn Willis sharing the News & Views of the Mentally Wealthy

[...] Posted September 10, 2010 by Dawn Willis in Uncategorized. Leave a Comment http://www.leftfootforward.org/2010/09/coalitions-new-mental-health-strategy-should-be-supported/ [...]
http://twitter.com/erskinehowcroft/status/24233567605 erskinehowcroft

RT @leftfootfwd: Coalition’s new mental health strategy should be supported http://ow.ly/2BpeY Encouraging but continuity too,please.
http://twitter.com/charceeholden/status/24278806849 Charlie Holden

RT @leftfootfwd: Coalition’s new mental health strategy should be supported http://ow.ly/2BpeY