mental health services

On the impact of cuts in MH services and the myth of ‘parity of esteem’

This piece was originally written for publication in the press and is due to be published towards the end of the month. I have taken the liberty of reposting it here.

When I’m not writing, I work in mental health. Mental health has always been the poor relation to physical health but it is clear that the disparity between the two is increasing exponentially. Although the public sector as a whole has had to tighten its belt since the economic crash that we, the public, didn’t cause, the NHS has been particularly vilified and, courtesy of the Health and Social Care Act, effectively privatised. Our budgets have been slashed and our workforces depleted. Although there have been some cuts in physical health, the fact remains that no government which aims to be re-elected is going to restrict the care given to people with cancer or heart disease. In the great hierarchy of illness, these people are top of the tree. In contrast, the people I work with, who are amongst the most vulnerable in society, are seen by successive governments as unworthy and ignored.

Since 2005, 30 000 people have lost social care support. 2000 mental health beds – 10% of the total – have been lost in the last two years. I have worked in wards which are running at 120% capacity, so God help you if you require an emergency admission, because it’s quite likely that you’ll be shunted off to a hospital several hundred miles from your home and your family. People with mental health problems are often already stigmatised and may lack social support. To ferry them across the country, effectively cutting off contact with their family and the professionals who know them is an outrage. Imagine the same happening in physical health. Imagine being told that your sibling, who had had a stroke, was being sent 250 miles away because there were no beds any nearer. You wouldn’t stand for it. I wouldn’t stand for it. But we make those in mental health services stand for it and because they are often unable to advocate for themselves it is allowed to continue.

Services aimed at young people have also seen swingeing cuts. Recent figures indicate that staffing levels in these services are only half the recommended level; as a result hundreds of under-18s are being treated in adult psychiatric units. Psychiatric wards can be confusing, frightening places even for adults. They are entirely inappropriate for children. Such an event should take place only in an extreme situation; for it to occur routinely is reprehensible.

In January Nick Clegg declared that there was too much ‘ignorance, prejudice and discrimination’ directed at people with mental health problems. He said that it was imperative that services were valued equally. As I write, it is being reported that mental health services have been asked to cut their spending by 20% more than physical health services, despite the fact that mental health services deal with 28% of the NHS disease burden whilst existing on 13% of the budget. Our services are crumbling; our clinicians are burning out. Lives are being put at risk and as things stand, we are hurtling towards a mental health crisis of gigantic proportions.