And are also in a mess because although this Tory led government has no constitutional mandate whatever to make these vast changes it seems that nothing can be done to stop them and the momentum is likely to return us to pre-industrial revolution conditions of life for ordinary people. What price the charge for keep in the new Tory workhouses?
I did read the new mental health strategy, of which there several documents, the most informative of which I found to be ‘No health Without Mental Health, Delivering better mental health outcomes for people of all ages.’ However, by now, we all know that all governments are adept at crafting warm, slithery words and there are some mental health charities that have already been seduced by the rhetoric into lauding the strategy as wonderful. Naive fools.
Looking at it face value it makes interesting reading (at some length). The core is: ‘six shared objectives which are:
“i) More people (throughout this document we will use the word people to mean individuals of all ages: infants, children, young people, working-age adults and older people) will have good mental health - More people of all ages and backgrounds will have better wellbeing and good mental health. Fewer people will develop mental health problems – by starting well, developing well, working well, living well and ageing well.
(ii) More people with mental health problems will recover - More people who develop mental health problems will have a good quality of life – greater ability to manage their own lives, stronger social relationships, a greater sense of purpose, the skills they need for living and working, improved chances in education, better employment rates, and a suitable and stable place to live.
(iii) More people with mental health problems will have good physical health - Fewer people with mental health problems will die prematurely, and
more people with physical ill health will have better mental health.
(iv) More people will have a positive experience of care and support - Care and support, wherever it takes place, should offer access to timely, evidence-based interventions and approaches that give people the greatest choice and control over their own lives, in the least restrictive environment, and should ensure that people’s human rights are protected.
(v) Fewer people will suffer avoidable harm - People receiving care and support should have confidence that the services they use are of the highest quality and at least as safe as any other public service.
(vi) Fewer people will experience stigma and discrimination - Public understanding of mental health will improve and, as a result, negative attitudes and behaviours to people with mental health problems will decrease.”
Please excuse my guttural chuckle. Isn’t it so that almost anyone can invent utopian outcomes (i.e. the Lib-Dems will disinter their human consciences and vote against the Tory ranks!). And the strategy documents are peppered with this kind of wishful thinking - in fact the whole strategy turns on these intangibles.
What the ’Delivering better outcomes’ document does do though, is to set out clearly the important aspects of mental health that need to be properly addressed and it is worth reading just for these sections. In this respect it is almost an antithesis of Cameron’s ‘localism,’ budget cuts and ‘Big Society’; note the references to ‘public services’ of which there will be none in Cameron’s ‘Big Society.’
There are too, just under the surface, some disturbing factors in this strategy. When it talks about ‘evidence’ and ‘measuring outcomes,’ particularly the latter, it relies on tick boxes galore - it seems a favourite Tory way of proving, to their point of view, people conform to one box or another, viz the incapacity work capability tests in which the unskilled robots of Atos Healthcare use inflexible computerised questions to determine who is and who isn’t eligible for continuing incapacity benefit (The use of the private company Atos a herald of things to come!). In fact, just look at the statistics they intend out future mental health services to rely on on pages 23 and 24 and then look at the Outcomes Compendium recommended by ‘Delivering better outcomes.’ You may be as horrified as I am by the reliance of ticking boxes on the forms this strategy has (see 2.98. on page 52). With all these neat compartments they’re squeezing us individuals into, is there really any future for Personalisation?
Coming back to Cameron’s clodhopping, I was part of the demonstration against the local authority cuts at Norfolk County Hall on Valentines Day. Like most other parts of England, there is, I understand, a massive contradiction between the decimation of voluntary work and small charities caused by local authority cuts and Cameron’s ‘Big Society.’ No health without Mental health nicely illustrates this:
- “improve outcomes for people with mental health problems through high-quality services that are equally accessible to all.” (Introduction).
- Local authority adult social care services are being reduced or cut altogether - Norfolk has specifically butchered it’s mental health services.
- “Public understanding of mental health will improve and, as a result, negative attitudes and behaviours to people with mental health problems will decrease”. (page 7)
- One hospital in this area directly discriminates against people with mental health problems and, in my experience, has actually refused to admit for treatment; in my experience, a major ULO (user led organisation) here insists on people with physical and sensory disabilities being separated, with different standards of approach, from those with mental health problems and I have heard discriminatory statements by physically disabled users; some mental health service users here insist on denying a label of ‘disabled,’ and separate themselves from people with physical and sensory impairments; the across-the-board cuts by Norfolk County Council will exacerbate these discriminatory attitudes.
- “Poor mental health is strongly associated with a number of social determinants – examples include socio-economic deprivation and social isolation. These determinants can both contribute to the development of mental health problems and result from them.”
- The cuts being made by the (Tory) Norfolk County Council are affecting transport for large rural areas, adult education, small charities, environmental services, roads, community day care groups, elderly community care, etc, etc. Because of these cuts, standards of care are falling, socio-economic deprivation is burgeoning and social isolation escalating.
- No Health without Mental Health rightly shines a spotlight on the importance of early prevention and prophylactic intervention with children and young adults. Some statements are:“Anxiety and postnatal depression affect 13% of mothers shortly after birth and 22% of mothers one year after the birth...It is associated with a five-fold increased risk of later mental health problems for the child and can affect the child’s cognitive and emotional development.” (page 10) “the National Institute for Health and Clinical excellence (NICe) clinical management and service guidance on antenatal and postnatal mental health (2007) recommends the establishment of clinical networks for perinatal mental health services in all parts of the country, to co-ordinate input from across the relevant maternity, mental health, primary care and social care sectors.” (page 12) “Adolescence is a particularly important transition point. It is a distinct developmental stage in its own right, and a time of major physical, emotional and neurological change...Increased health risk behaviours are associated with increased levels of mental ill health and lower levels of wellbeing...systematic reviews of interventions to prevent conduct disorder, anxiety and depression before adulthood have shown that programmes targeting at-risk children that use parent training or child social skills training are the most effective.” (page 13) “Whole-family approaches in which adult and children’s services work more closely together have also been effective in supporting young carers – a particularly at-risk group. (page 14)
That’s enough, but there are many more examples throughout NHWMH (You’ll notice I’ve just quoted up to page 14 of 99 pages) which underline the wraithlike nature of the government mental health strategy. The constructive phrases clothe its ghostly nothingness brightly to deceive! Its positive visions are, in reality, made impossible by defaecating on the local authorities it relies on to deliver the services.