A personal view: ending the stigma and waste of mental illness

Less than two months after he was elected as leader of the Liberal Democrats, Nick Clegg made a widely-reported speech at the Guardian Public Services Summit in St. Albans, on the subject of mental health. Nick pointed out that “One in four Britons suffers from a mental illness at some point in their lives. One in six is suffering at any given time. Mental health issues directly affect most of Britain’s families today.”

It was laudable and maybe surprising for Nick to use a keynote speech so early in his leadership to highlight such an unfashionable subject. For there is no doubt that mental health issues are seen by some as not really an illness, but some spiritual or character weakness on behalf of the sufferer. And yet most of us have either suffered with mental illness, or have a close family member who has done so.

When you look at the figures, it seems incredible that mental health has been ignored for so long. Whilst these health issues remain invisible to many, they are easy to sideline behind cancer, stroke and heart disease. But ignoring mental illness brings huge costs to the welfare, housing, education and criminal justice budgets, costs which could be avoided, with resultant increases in the quality of life of sufferers and their ability to contribute to society. The total economic cost of mental ill-health has been estimated as likely to be over £100 billion. The most stunning statistic is that 90% of all prisoners are estimated to have a diagnosable mental health problem.

The ‘No health without mental health’ strategy announced today  a new emphasis on early intervention and prevention to help tackle the underlying causes of mental ill-health. It sets out how the Government will work with the NHS, local government and the third sector to help people recover and challenge stigma. Central to these plans is an additional investment of around £400 million to improve access to modern, evidence-based psychological therapies, with early intervention, offering personalised support to 3.2million people across the country.

It is clear from Nick’s early and frequent comments on the issue that this is an important issue for him, that he was determined to bring forward within the Coalition government. This is very much a Lib Dem policy, which would have not have been actioned without Lib Dems in government. Nick said:

“The evidence is clear: mental health needs to be addressed with the same urgency as physical health. We need to end the stigma attached to mental illness, to set an example by talking about the issue openly and candidly and ensure everyone can access the support and information they need.

“The strategy today shows how we will put people at the heart of everything we do, from a new focus on early intervention to increased funding for psychological therapy, so that everyone has a fair opportunity to get their lives back on track.”

After his departure from Downing Street, Alastair Campbell opened up about his own nervous breakdown 25 years ago and his resulting bouts of depression.  He was delighted to find that most of the reaction from colleagues and the public was sympathetic, yet infuriated by the reaction of some media commentators. Campbell singled out the reaction of the Telegraph who talked about depression as being “the new must-have disease among those in the public eye”.

Today Campbell has been as fulsome in praise of Nick’s stance as party politics will allow. Campbell said:

… what he [Clegg] seems to be saying is that if we adopt access to psychological therapies more routinely within the NHS, including for people with serious mental illnesses, more people will get the help they need early, and acute care beds may not be needed so much. Let’s hope so.

This has never been the sexiest or easiest issue in the world. If Nick Clegg is seeking to become the voice of the mentally ill within government, then he deserves support.

Over 14 years ago, I suffered from post-natal depression after the traumatic and premature birth of our daughter. I was immediately offered Prozac, but shied away from chemical treatment. I was then offered counselling at the local health centre, but only if I was prepared to pay for it – otherwise there was an 18 month waiting list. At a time that the household budgets were stretched, with a new baby, new mortgage and only one salary coming in, I was fortunate that we were able to find the money to pay for it.

I suspect that the cost of a short course of counselling would have been less than a couple of years of prescription antidepressants. And the value of the treatment greatly exceeded the finance – it left me able to parent effectively and return part-time to the workplace. Nick’s proposed reforms will not only allow others to escape the shadow of mental illness, but also its stigma, improving the lives of millions as a result.

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  • Dave Warren 2nd Feb '11 - 7:59pm

    I have suffered from depression and it is a terrible illness.

    I welcome this announcement because i had real difficulty
    getting counselling when i needed it and when it became
    available the number of sessions were strictly limited.

    If you request more sessions you have to wait for a further
    six months.

    On a positive note i underwent a real evaluation of my life
    while i was recovering and discovered the Lib Dems!

  • I can’t agree with the idea that doctors can have £150m in bonuses for identifying mental illnesses (see The Guardian). What sort of message is that sending out? We’ve gone from pretending illness don’t exist, to doctors dishing it out willy nilly.

  • This is excellent news – as it is at the moment, there is far too much reliance on medication, and that simply isn’t a long term solution in many cases – in fact, it can make matters worse. I think the way in which mental health is handled in the NHS is nothing short of a disgrace. I’d be happy if ‘take some prozac’ were no longer the default position, but ‘talking therapies’ could be considered at least as a ‘normal’ alternative, rather than a luxury that’s almost certainly not available when it’s needed most. Honestly, what’s the point of counselling if you have to wait months to get there?

  • Very good news.

    Working in Occupational Health I know that mental health problems account for a great deal of workplace health issues leading to strain on companies as well as individuals. All too often we are called upon to identify and arrange private counselling simply because the required treament is not easily or readily available via the individuals primary care team. Alistair Campbell is very correct is that it is not seen as a sexy issue, and sadly sexy issues generally get the best funding.

    Three other things I’d like to highlight are:

    1. There can be a tendency to focus purely on the clinical issue. Idenitfying and either dealing with, or providing coping strategies for the root cause of an individuals issues can also form part of the solution.
    2. The correct therapy / therapist needs to be identified. This can vary according to the character of the individual and the presenting condition. Good triage is required by referring clinicians.
    3. Beware the short term funding issue. Many firms offer EAP schemes that provide (as an average) 6 sessions of counselling before referring back to the comapny for more funding which may not be available. This can lead to people building a rapport with a private therapist and then being moved back to a different therapist provided through their primary care team or worse finding their treatment just stops. There is a danger of counselling becoming a crutch if countinued too long, but it can be hugely counter productive if it is withdrawn too soon.

  • Now lets have the figures for how much funding is being cut for clinical treatment of severe mental illness around the country.I suspect this will be a bit like cutting off someone’s legs and giving them an aspirin.

  • Harold A. Maio 3rd Feb '11 - 12:52am

    It is always fun to see which “stigmas” edfitors promote into print and from whom.

    Harold A. Maio, retired Mental Health Editor
    [email protected]

  • I’ve said this before but I really hope that something comes of this.

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