We can’t ignore the growing mental health crisis

Last week was a particularly difficult one for those of us working in mental health.

It started with the opening of the Lampard Inquiry, the first of its kind public inquiry investigating the deaths of up to 2,000 people under the care of mental health services in Essex. 

Then came the Darzi review into the NHS, which in amongst the damning data on mental health waiting lists and underinvestment revealed the reality that people are being held in rooms constructed for a Victorian asylum. 

Lastly, the latest Mental Health Act statistics showed more and more people are being detained under the act. The statistics also reveal the racism the act currently enables, with black people 3.5 times more likely to be detained and 7 (yes seven!) times more likely to be place on a community treatment order. 

We have seen the most shocking scapegoating of people with mental illness and a weaponisation of the progress we have made in social awareness.

These findings won’t be surprising to many of us. Mental health was always the ‘Cinderella’ of health, crying out for investment and recognition. But the last 15 years have only served to deepen the nation's mental health crisis and decimate the things we know keep people well.

We did receive investment into mental health, but not at the scale needed. This was coupled with a lack of investment into social care and a disregard for prevention. We have also seen the most shocking scapegoating of people with mental illness and a weaponisation of the progress we have made in social awareness.   

It's hard to stay hopeful, but we at Mind are in the business of hope - we believe that many of the answers we need to address this crisis are within our grasp. We know that politicians often feel that dealing with our mental health is a problem too big, too political, or simply unpopular. But that’s simply not true.  

A "broken" health service

The Darzi review offered a diagnosis of our health services that was bleak and raw, depicting a service that many of us have also described as broken.

But before I talk about what can be done, I want to send a message to our NHS staff. We know you are doing your best, sometimes in the most difficult and under-resourced circumstances. We know that too many of you feel burnt out and under attack. I want you to know that whilst I think we need huge improvement, not just in terms of service delivery but also in the culture of care, we must also look after you and recognise that there is some extraordinary work happening. I recently saw it myself when I shadowed a Modern Matron. I was inspired and relieved to see such compassion in action.

The way forwards

Let’s talk big picture.  We agree with the government’s three key central themes of reform. We do need to move from the hospital to the community, from sickness to prevention and from analogue to digital. This is a drum we’ve been banging loudly for more than 20 years, so it’s welcome to hear those in power playing the same tune.  

Mind is ready, willing and able to work with the UK government to modernise the system and make sure it supports the people who desperately need it. We will continue to campaign and amplify the voices of those who know all too well the consequences of poor inpatient care.  Our friend Tiwa shared her story and brings to life the grim reality of Lord Darzi’s findings. If we truly listened to Tiwa, imagine the changes we would see with the right investment and changes to culture around mental health care - it could be the revolution we need.

Putting people first

We have reams of evidence that shows for some people, mental illness is a consequence of their environment. Isolation, racism, poverty, education, a lack of safe homes, all cause the deterioration of mental health for people and the communities they are a part of. In recent years the pandemic and global instability have compounded things in ways we still do not completely understand. But we know that this tide can be turned by policy making that prioritises community assets and rolls back the erosion of funding for local authorities and schools.

Our network of over 100 Local Minds and our 180 charity shops shine a light on what can happen when we put people first. We deliver all forms of mental health support from peer support groups right up to supported housing, residential care and crisis support.

Not only are our shops expert retailers, they are also community mental health hubs on the high street.

Our shops are home to over 3000 volunteers, many of whom live with mental health challenges. Not only are they expert retailers, they are also community mental health hubs on the high street. I was told on a recent visit by one of the shops neighbours that the staff and volunteers had saved his life when he experienced a devastating bereavement. His mum made them cakes in return - that’s community, and this is what keeps people well.

We also hear stories from those who have used Mind's helplines and local services. Just last week I met someone who spoke about Mind being the gateway to his recovery, and how he now volunteers as a trustee and is a mental health ambassador.

Difficult decisions

We are not naïve to the profound financial challenges facing decision makers; there are some very bleak choices facing us all. But we must not turn to austerity mark two. Mental health represents 20% of the health demand on our NHS, yet we are only funded at 10%. It doesn’t take an accountant to see immediately that this disparity is not only unjust but makes no economic sense.

Mental health cannot be where the government look for savings. It must be the place of investment, alongside a reformed Mental Health Act, evidence-based community building, and underpinned by a cross government commitment. Fair funding for the voluntary sector like the Mind network could alleviate pressures on health and transform peoples’ experiences. This could improve access and outcomes for so many.    

Let’s step bravely into tackling systemic racism and poverty.

We must also resist the temptation to think we have won the mental health debate. We have seen over the last year a weakening of government commitment to mental health, an increase in social stigma and a deterioration of media portrayals. We can see from the news I started out with that we haven’t got to parity yet.

Finally, we urge the government to lean in to mental health, believe the answers we have been giving for 20 years about what prevents mental illness, what keeps people well and what people need in crisis. Let’s step bravely into tackling systemic racism, poverty, let's demand parity of esteem, and campaign for continued and expanded investment. Nothing less will do. We can’t keep chasing unicorns.  The government’s three-point plan fits with what we know - now is the time for the radical transformation once and for all.