A few weeks ago, I was forwarded a text via my pal Dan. It was a crie de coeur from a south London psychiatrist whose job is to assess people in crisis for emergency admission.
He had written: “There was NOT A SINGLE PSYCHIATRIC BED AVAILABLE IN THE ENTIRE COUNTRY If this was physical health, there would be outrage.“
This really affected Dan as he has a close relative living with schizophrenia. Had he gone into crisis there would have been no safe place for him other than, if lucky, a police cell.
So much for a decade’s worth of government assurances about parity of esteem with physical health.
However, something that mental health has shared with physical health is the steady reduction of overnight and long stay capacity in hospitals.
As the King’s Fund reported, in the thirty years to 2019, the 300,000 or so NHS beds were reduced by 53% to 141,00. The biggest hit was taken by mental health and learning disability beds – reductions of 73% and 97% respectively.
The justification was a shift to community-based care that would produce better outcomes for patients. Spot on in principle but, against a background of massive cuts to government spending that cruelly hit local government, we have seen the availability of appropriate housing and clinical and social care support cut to the bone.
In too many places, the front line of mental health crisis response has become the Met!
Recently, the ONS reported sharp increases in the levels of depression. Before Covid, one in 10 adults reported some symptoms of depression: by the start of 2021 this had doubled to one in five. Unsurprisingly, the largest increases were amongst the poorest and most exposed parts of society.
A UCL report documented a drop in the quality of care available – a switch from face-to-face to video and text consultations, difficulties accessing medication and inadequate access to mental health services.
As we creep closer to the end of furlough support, the rumoured removal of the universal credit £20 supplement and the actual reinstatement of evictions in the private sector, pressures on the already vulnerable are sure to increase.
The next pandemic, this time a crisis in mental health, is already with us.
Just as with Covid, we are ignoring the warnings, have inadequate resources and staffing and are underestimating the impact on people, carers and the economy.
Despite the omens of increased demand for services, last week’s Queen’s Speech vaguely promised that “measures will be brought forward… to tackle obesity and improve mental health".
As if!
So, hats off to the chaps at the Ham&High for organising tomorrow’s Our Community's Mental Health event. Sadly, I fear, important though it is, it will be a drop in the ocean of care that this government has been trying to drain for the past decade.
David Winskill is a Crouch End-based campaigner.
Ham&High: Our Community's Mental Health will be a full day of free events on the subject of mental health, including nutrition, gardening and parenting sessions, and an interview with Alastair Campbell and Fiona Millar.
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