Britain Needs a Holistic Approach to Mental Health
Britain's political parties must put a comprehensive mental health action plan at the heart of their forthcoming manifestos, says Jessica Marchant.
Brexit will undoubtedly be foremost in most people's minds as they enter the polling booth on 12 December. But just as Theresa May's ill-fated 'dementia tax' two years ago shows us: the broader substance underpinning the forthcoming election manifestos is important.
Action is needed across many areas of government, but few more so than mental health.
Every year in the UK one in four people experience a mental health problem. Meanwhile, one in five adults has, at one stage, considered taking their own life. These figures aren't new. Most will have seen them before, but that shouldn't undermine their significance.
It's essential that the occupant in Downing Street on 13 December has mental health policy at the front of their mind. Mental health treatment in this country requires joined-up thinking rather than the piecemeal approach that has come before it. Delivering a modern and effective mental health strategy requires both investment and reform. Money alone will not solve the problem. It must be accompanied by reform right through from diagnosis to treatment to recovery.
Primary Care
GPs are the Pretorian guard of our NHS. Across the country they are faced regularly with patients who have symptoms associated with common mental illnesses, such as depression. Taking depression as an example, it typically affects one in 10 people throughout their lives. It is the single largest cause of disability worldwide and costs the UK around £7.5bn each year due to the cost of healthcare and loss of employment.
Despite this, only around 16 per cent of those suffering from depression and anxiety in the UK are able to access important treatments, including talking therapies. The problems with the delivery of effective treatments for anxiety and depression are symptomatic of mental health treatment in this country in general. Investment is needed urgently to bolster the number of GPs and mental health practitioners to ensure that those suffering from mental illness are diagnosed and treated more quickly. Failure to do so only increases the burden on other parts of the system.
Secondary Care
The shortcomings with mental health diagnosis and treatment in primary care cause knock on effects in other parts of the healthcare system. In many instances, patients only receive treatment when they reach crisis point and require inpatient treatment. This approach puts further strain on already stretched resources and is a false economy. By investing more resources in primary care, the load on secondary will be lightened.
There is also a common misconception that with time and investment the situation as a whole will improve. This is false.
In its latest annual State of Care report the Care Quality Commission (CQC) found that the quality of care provided at inpatient units across England for those with mental health, learning disabilities and autism has deteriorated in the last year.
Concerns were raised by the CQC over safety standards on wards, staffing levels and inappropriate care. It found that 10 per cent of inpatient services for people with learning disabilities and autism were rated as inadequate compared to one per cent the year before. Meanwhile, seven per cent of child and adolescent mental health inpatient services were rated inadequate, up on three per cent previously.
Recovery
Another common misconception with mental illness is that once you have your prescription or are discharged from hospital the story ends. This is rarely the case and often only constitutes the 'end of the beginning'.
In my spare time I run a voluntary not-for-profit organisation called Work-to-Recover. We exist to assist those recovering from mental illness and help them get back into work. Often, it's only when everything is in place that the circle of recovery is finally complete. This includes living in safe surroundings, having a reliable group of friends and family and, importantly, having secure employment.
I feel fortunate to have the opportunity to work with the people that come to us for help. You are offered a privileged insight into the challenges they come up against. But above all, you recognise that recovering from mental illness is dependent on many external building blocks to a person's life being in place. Failure to address these other areas will often lead to repeated dependence on primary and secondary treatment services.
Only when policymakers recognise that effective mental health recovery requires much more of a holistic approach will they truly get to grips with the crisis. Whoever gets the keys to 10 Downing Street after the election, it's essential they have a comprehensive mental health treatment plan central to their health reform agenda.
