Staff at Selly Oak Hospital in Birmingham. Photo: Christopher Furlong/Getty Images
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The UK’s mental health care is in crisis – the next government must act urgently

Mentally ill patients forced to travel hundreds of miles for treatment, forcible sectioning in order to get beds and medical students begging for greater teaching on psychiatry: we're not getting it right

A report this week was grim reading for those involved in mental health care. The survey of GPs revealed that one in five had seen patients harmed as a result of “delays or a lack of support” from mental health services, while shortfalls had forced 82 per cent of doctors to act “outside of their competence”. While this news is shocking, it is just another example of the UK’s mental health care crisis.

Just last week, data obtained from freedom of information requests led to claims that the NHS treated mental health care as a “second-class service”. Indeed, thousands of mentally ill patients have been forced to travel “hundreds of miles” for treatment in recent years. Extreme cases have seen patients being forcibly sectioned so that they can receive care in overcrowded wards. Even medical students have resorted to asking for greater teaching on psychiatry, highlighting the derisory attention that mental health issues receive. Yet the state of mental health services is unsurprising considering that they receive only 13 per cent of the NHS budget, despite mental illness affecting around a quarter of the UK population.

Worse still, national spending on mental health has consistently decreased over the past three years. And the trend isn’t limited to adult care; mental health services for children and adolescents have also seen a fall in funding. This decline seems even more irrational considering adolescence is the period when many mental illnesses first manifest, and that hospitals are recording a rise in hospital admissions for conditions such as eating disorders.

The budget cuts have had a noticeable impact, with doctors citing the changes as a cause of “avoidable deaths and suicides,” while mental health organisations claimed that the cuts “put lives at risk”. Mental illness also has a significant impact on a patient’s quality of life, and is thought to contribute to poor physical health, having been associated with diabetes, cancer and cardiovascular disease. As well as the ethical concerns of these cases, such neglect of the mentally ill also has practical implications; a report by the London School of Economics found that the NHS could save over £50m a year by reversing budget cuts to preventative and early intervention therapies.

Yet perhaps the most striking aspect of the decrease in funding comes from the comparison with other areas of health care. The government, for instance, took great pride in announcing that the Cancer Drugs Fund would be ring-fenced until 2016. While it would be wrong to question the severity of diseases such as cancer, it is worth considering that this budget is reserved for treatments that aren’t ordinarily commissioned because they are not cost-effective. Given the nature of the NHS’s funding crisis, it seems unfair to fund relatively inefficient treatments, while the NHS’s most vulnerable patients are left without basic care.

This is the problem. Eager to brand their “reform” of the NHS as good for patients, the coalition has protected the emotive areas of health care that already benefit from public awareness. Aware that severely cutting the budget for paediatrics or cancer care would result in public outrage, the government are cynically withdrawing care from those most lacking a voice in society: the mentally ill.

Although this current crisis is alarming, such disregard of mental health isn’t a recent phenomenon. Plagued by a history of taboo and prejudice, mental health care has historically been chronically underfunded. With a media happy to brand mentally ill people as “psychos” and a threat to society, it has been relatively easy for politicians to excuse this injustice. But public perceptions are changing; a report by the charity Rethink Mental Illness found that public understanding and tolerance of mentally ill people is improving, while 63 per cent were aware of a close friend having a mental health problem.

This is important; for a politician to stand up for mental health care now wouldn’t just be a principled action, it’d be a popular one. With time, and the excellent work of campaign groups, this positive trend in public attitudes will only continue, allowing society to grow in confidence to discuss one of our greatest health challenges. The mental health charity Mind suggests that the next government commits to a 10 per cent rise in the NHS’s mental health budget over the next five years. Considering the state of mental health care and the current funding disparity between health services, this is not an unreasonable request.

Past governments have chosen an area of health care to focus on, in order to target voter demographics. In 1999, Blair announced his “crusade against cancer”. Seeking the “grey vote”, David Cameron called for a “national challenge” to beat neurological diseases such as dementia. But the disgrace of the NHS’s mental health provision goes beyond party politics. Regardless of who wins the general election, the next government must embrace bold reform to end our longstanding neglect of the mentally ill. 

George Gillett is a freelance journalist and medical student. He is on Twitter @george_gillett and blogs here.

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Northern Ireland election results: a shift beneath the status quo

The power of the largest parties has been maintained, while newer parties running on nicher subjects with no connection to Northern Ireland’s traditional religious divide are rapidly rising.

After a long day of counting and tinkering with the region’s complex PR vote transfer sytem, Northern Irish election results are slowly starting to trickle in. Overall, the status quo of the largest parties has been maintained with Sinn Fein and the Democratic Unionist Party returning as the largest nationalist and unionist party respectively. However, beyond the immediate scope of the biggest parties, interesting changes are taking place. The two smaller nationalist and unionist parties appear to be losing support, while newer parties running on nicher subjects with no connection to Northern Ireland’s traditional religious divide are rapidly rising.

The most significant win of the night so far has been Gerry Carroll from People Before Profit who topped polls in the Republican heartland of West Belfast. Traditionally a Sinn Fein safe constituency and a former seat of party leader Gerry Adams, Carroll has won hearts at a local level after years of community work and anti-austerity activism. A second People Before Profit candidate Eamon McCann also holds a strong chance of winning a seat in Foyle. The hard-left party’s passionate defence of public services and anti-austerity politics have held sway with working class families in the Republican constituencies which both feature high unemployment levels and which are increasingly finding Republicanism’s focus on the constitutional question limiting in strained economic times.

The Green party is another smaller party which is slowly edging further into the mainstream. As one of the only pro-choice parties at Stormont which advocates for abortion to be legalised on a level with Great Britain’s 1967 Abortion Act, the party has found itself thrust into the spotlight in recent months following the prosecution of a number of women on abortion related offences.

The mixed-religion, cross-community Alliance party has experienced mixed results. Although it looks set to increase its result overall, one of the best known faces of the party, party leader David Ford, faces the real possibility of losing his seat in South Antrim following a poor performance as Justice Minister. Naomi Long, who sensationally beat First Minister Peter Robinson to take his East Belfast seat at the 2011 Westminster election before losing it again to a pan-unionist candidate, has been elected as Stormont MLA for the same constituency. Following her competent performance as MP and efforts to reach out to both Protestant and Catholic voters, she has been seen by many as a rising star in the party and could now represent a more appealing leader to Ford.

As these smaller parties slowly gain a foothold in Northern Ireland’s long-established and stagnant political landscape, it appears to be the smaller two nationalist and unionist parties which are losing out to them. The moderate nationalist party the SDLP risks losing previously safe seats such as well-known former minister Alex Attwood’s West Belfast seat. The party’s traditional, conservative values such as upholding the abortion ban and failing to embrace the campaign for same-sex marriage has alienated younger voters who instead may be drawn to Alliance, the Greens or People Before Profit. Local commentators have speculate that the party may fail to get enough support to qualify for a minister at the executive table.

The UUP are in a similar position on the unionist side of the spectrum. While popular with older voters, they lack the charismatic force of the DUP and progressive policies of the newer parties. Over the course of the last parliament, the party has aired the possibility of forming an official opposition rather than propping up the mandatory power-sharing coalition set out by the peace process. A few months ago, legislation will finally past to allow such an opposition to form. The UUP would not commit to saying whether they are planning on being the first party to take up that position. However, lacklustre election results may increase the appeal. As the SDLP suffers similar circumstances, they might well also see themselves attracted to the role and form a Stormont’s first official opposition together as a way of regaining relevance and esteem in a system where smaller parties are increasingly jostling for space.