“The Invisible Big Kahuna”

Andrew Zak Williams discusses this week’s New Statesman article in which prominent atheists told him

Richard Dawkins, Steven Weinberg, Sam Harris, AC Grayling, Polly Toynbee ... I expect that most writers who have tried to interview an equivalent stellar cast have found that their phone calls went unanswered and their emails were assigned to the Trash Box. But there's something about the perceived irrationality of belief in God which brings many atheists out fighting.

The religious sometimes wonder why anyone would choose not to believe in God. But, as Sam Harris told me, it is they who must shoulder the burden of proving their case. After all, "every Christian can confidently judge the God of Zoroaster to be a creature of fiction, without first scouring the universe for evidence of his absence."

For Harris all that one needs to banish false knowledge is to recognise an absence of evidence. And there is one hymn sheet from which even atheists are willing to sing: that headed "Lack of Evidence". For instance Richard Dawkins told me that he doesn't believe in leprechauns, pixies, werewolves or a whole range of gods, and for the same reason in every case: "there is not the tiniest shred of evidence for any of them, and the burden of proof rests with those who wish to believe."

Particle physicist Victor Stenger added that the God of Jews, Christians and Muslims supposedly plays such an important role in the universe that there should be evidence that he exists. But instead, "there is nothing in the realm of human knowledge that requires anything supernatural, anything beyond matter, to describe our observations."

But it's not just an absence of evidence upon which several atheists relied. Rather, there was perceived to be clear evidence which suggests that God is no more real than an imaginary friend. The clearest pointer seems to have been suffering. No wonder that Polly Toynbee told me that the only time that she is ever tempted, momentarily, to believe in God "is when I shake an angry fist at him for some monstrous suffering inflicted on the world for no reason whatsoever."

Some believers - and Christian philosophers - respond that suffering on earth actually enriches our lives. But as psychologist Richard Wiseman told me, if that were so, it would paint a picture of heaven being a rather miserable place. For other believers, it may be that God has a very good reason for allowing suffering but we can't understand what it is because we lack his divine knowledge. Biologist Jerry Coyne gives this argument short shrift: "If there is a god, the evidence points to one who is apathetic - or even a bit malicious."

Publisher and author Michael Shermer gave me an intriguing overview to the question of God's existence:

"In the last 10,000 years there have been roughly 10,000 religions and 1,000 different gods; what are the chances that one group of people discovered the One True God while everyone else believed in 9,999 false gods?"

When it comes to the God Debate, one can't ignore the commodity to which the religious cling to sustain their beliefs: faith. Several months ago, I carried out an equivalent investigation when I asked many prominent Christians to give me their reasons for belief. Several of them admitted that it must ultimately come down to whether you take it on faith; once you do, you'll experience God's love and you won't worry about having the answer to every intellectual argument.

For many believers, faith is all that matters, shielding them from arguments and evidence which they would rather not have to consider. These are the ones who oppose the Critical Thinking of science and prefer the Critical of Thinking inherent in their faith.

But if you rely on blind faith, what are the chances that you're going to see the light?

For others, their religion satisfies them intellectually. Yet when they can't reason their way past specific problems (say, suffering or biblical inconsistencies), their faith comes riding to the rescue. But faith is hardly a white horse: more like a white elephant, trumpeting a refusal to engage in debate as though it were something about which to be proud.

The atheists that I spoke to are the products of what happens to many intelligent people who aren't prepared to take important decisions purely on faith, and who won't try to believe simply to avoid familial or societal pressures. And as philosopher Daniel C. Dennett put it: "Why try anyway? There is no obligation to try to believe in God."

I could hardly end this piece without mentioning PZ Myers who evidently managed to dig out a metaphorical old joke book from his vast collection of weighty tomes about the God Debate:

"Religious beliefs are lazy jokes with bad punchlines. Why do you have to chop off the skin at the end of your penis? Because god says so. Why should you abstain from pork, or shrimp, or mixing meat and dairy, or your science classes? Because they might taint your relationship with your god. Why do you have to revere a bit of dry biscuit? Because it magically turns into a god when a priest mutters over it. Why do I have to be good? Because if you aren't, a god will set you on fire for all eternity. These are ridiculous propositions. The whole business of religion is clownshoes freakin' moonshine, hallowed by nothing but unthinking tradition, fear and superstitious behavior, and an establishment of con artists who have dedicated their lives to propping up a sense of self-importance by claiming to talk to an invisible big kahuna."

Amen to that.

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British mental health is in crisis

The headlines about "parity of esteem" between mental and physical health remain just that, warns Benedict Cooper. 

I don’t need to look very far to find the little black marks on this government’s mental health record. Just down the road, in fact. A short bus journey away from my flat in Nottingham is the Queens Medical Centre, once the largest hospital in Europe, now an embattled giant.

Not only has the QMC’s formerly world-renowned dermatology service been reduced to a nub since private provider Circle took over – but that’s for another day – it has lost two whole mental health wards in the past year. Add this to the closure of two more wards on the other side of town at the City Hospital, the closure of the Enright Close rehabilitation centre in Newark, plus two more centres proposed for closure in the imminent future, and you’re left with a city already with half as many inpatient mental health beds as it had a year ago and some very concerned citizens.

Not that Nottingham is alone - anything but. Over 2,100 mental health beds had been closed in England between April 2011 and last summer. Everywhere you go there are wards being shuttered; patients are being forced to travel hundreds of miles to get treatment in wards often well over-capacity, incidents of violence against mental health workers is increasing, police officers are becoming de facto frontline mental health crisis teams, and cuts to community services’ budgets are piling the pressure on sufferers and staff alike.

It’s particularly twisted when you think back to solemn promises from on high to work towards “parity of esteem” for mental health – i.e. that it should be held in equal regard as, say, cancer in terms of seriousness and resources. But that’s becoming one of those useful hollow axioms somehow totally disconnected from reality.

NHS England boss Simon Stevens hails the plan of “injecting purchasing power into mental health services to support the move to parity of esteem”; Jeremy Hunt believes “nothing less than true parity of esteem must be our goal”; and in the House of Commons nearly 18 months ago David Cameron went as far as to say “In terms of whether mental health should have parity of esteem with other forms of health care, yes it should, and we have legislated to make that the case”. 

Odd then, that the president of the British Association of Counselling & Psychotherapy (BACP), Dr Michael Shooter, unveiling a major report, “Psychological therapies and parity of esteem: from commitment to reality” nine months later, should say that the gulf between mental and physical health treatment “must be urgently addressed”.  Could there be some disparity at work, between medical reality and government healthtalk?

One of the rhetorical justifications for closures is the fact that surveys show patients preferring to be treated at home, and that with proper early intervention pressure can be reduced on hospital beds. But with overall bed occupancy rates at their highest ever level and the average occupancy in acute admissions wards at 104 per cent - the RCP’s recommended rate is 85 per cent - somehow these ideas don’t seem as important as straight funding and capacity arguments.

Not to say the home-treatment, early-intervention arguments aren’t valid. Integrated community and hospital care has long been the goal, not least in mental health with its multifarious fragments. Indeed, former senior policy advisor at the Department of Health and founder of the Centre for Applied Research and Evaluation International Foundation (Careif) Dr Albert Persaud tells me as early as 2000 there were policies in place for bringing together the various crisis, home, hospital and community services, but much of that work is now unravelling.

“We were on the right path,” he says. “These are people with complex problems who need complex treatment and there were policies for what this should look like. We were creating a movement in mental health which was going to become as powerful as in cancer. We should be building on that now, not looking at what’s been cut”.

But looking at cuts is an unavoidable fact of life in 2015. After a peak of funding for Child and Adolescent Mental Health Service (CAMHS) in 2010, spending fell in real terms by £50 million in the first three years of the Coalition. And in July this year ITV News and children’s mental health charity YoungMinds revealed a total funding cut of £85 million from trusts’ and local authorities’ mental health budgets for children and teenagers since 2010 - a drop of £35 million last year alone. Is it just me, or given all this, and with 75 per cent of the trusts surveyed revealing they had frozen or cut their mental health budgets between 2013-14 and 2014-15, does Stevens’ talk of purchasing “power” sound like a bit of a sick joke?

Not least when you look at figures uncovered by Labour over the weekend, which show the trend is continuing in all areas of mental health. Responses from 130 CCGs revealed a fall in the average proportion of total budgets allocated to mental health, from 11 per cent last year to 10 per cent in 2015/16. Which might not sound a lot in austerity era Britain, but Dr Persaud says this is a major blow after five years of squeezed budgets. “A change of 1 per cent in mental health is big money,” he says. “We’re into the realms of having less staff and having whole services removed. The more you cut and the longer you cut for, the impact is that it will cost more to reinstate these services”.

Mohsin Khan, trainee psychiatrist and founding member of pressure group NHS Survival, says the disparity in funding is now of critical importance. He says: “As a psychiatrist, I've seen the pressures we face, for instance bed pressures or longer waits for children to be seen in clinic. 92 per cent of people with physical health problems receive the care they need - compared to only 36 per cent of those with mental health problems. Yet there are more people with mental health problems than with heart problems”.

The funding picture in NHS trusts is alarming enough. But it sits in yet a wider context: the drastic belt-tightening local authorities and by extension, community mental health services have endured and will continue to endure. And this certainly cannot be ignored: in its interim report this July, the Commission on acute adult psychiatric care in England cited cuts to community services and discharge delays as the number one debilitating factor in finding beds for mental health patients.

And last but not least, there’s the role of the DWP. First there’s what the Wellcome Trust describes as “humiliating and pointless” - and I’ll add, draconian - psychological conditioning on jobseekers, championed by Iain Duncan Smith, which Wellcome Trusts says far from helping people back to work in fact perpetuate “notions of psychological failure”. Not only have vulnerable people been humiliated into proving their mental health conditions in order to draw benefits, figures released earlier in the year, featured in a Radio 4 File on Four special, show that in the first quarter of 2014 out of 15,955 people sanctioned by the DWP, 9,851 had mental health problems – more than 100 a day. And the mental distress attached to the latest proposals - for a woman who has been raped to then potentially have to prove it at a Jobcentre - is almost too sinister to contemplate.

Precarious times to be mentally ill. I found a post on care feedback site Patient Opinion when I was researching this article, by the daughter of a man being moved on from a Mental Health Services for Older People (MHSOP) centre set for closure, who had no idea what was happening next. Under the ‘Initial feelings’ section she had clicked ‘angry, anxious, disappointed, isolated, let down and worried’. The usual reasons were given for the confusion. “Patients and carers tell us that they would prefer to stay at home rather than come into hospital”, the responder said at one point. After four months of this it fizzled out and the daughter, presumably, gave up. But her final post said it all.

“There is no future for my dad just a slow decline before our eyes. We are without doubt powerless – there is no closure just grief”.

Benedict Cooper is a freelance journalist who covers medical politics and the NHS. He tweets @Ben_JS_Cooper.