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Why aren’t we more shocked that mentally ill people spend time in police cells because we lack beds?

Wanting to care about mental illness is not the same as caring.

A female dormitory at the Broadmoor Asylum in 1867. We haven’t moved on as far from this as we like to think. Photo: Hulton Archive/Getty Images

I supposed I should be horrified that a 16-year old girl suffering from severe mental illness was forced to spend two nights in a police cell while waiting for a hospital bed. I’ve tried to be but I’m not. The whole thing seems so fitting for a country in which the most painful aspects of mental illness remain behind closed doors. Stigma might be talked about in the vaguest of terms – we might even be familiar with the one-in-four statistic – but wanting to care about mental illness is not the same as actually caring.

The truth is, most of us don’t care about those suffering from severe mental illness, at least not when the latter are showing obvious symptoms. We want “the mentally ill” to be witty, insightful, inspired by their torment, or failing that, at least out on the other side (“I have good days and bad…”). That mental illness can be ugly, unremitting, embarrassing, hopeless, is not something for which our standard narrative allows. Is it any wonder, then, that we don’t have resources to cope with the kind of crises in which individuals require full, unconditional support? Is it at all surprising that, according to Mark Winstanley of Rethink, “each year thousands of people with severe mental illness are being held in police cells”? After all, they must be somewhere. We know they exist, if only because of the few occasions when their suffering holds our interest.

The Daily Mail reports on the “Fury as mentally ill girl, 16, is kept in police cells for two nights”. But it’s the same Daily Mail that delights in emphasising severe mental illness as a causal factor in violent crime, and which merrily lists new supposed “causes” for schizophrenia – soil, cat faeces, air pollution – without focusing on the needs of sufferers in the here and now (unless it’s in a foreign country, in which case disapproval of someone else’s brutal approach to treatment is de rigeur).

Last week Deputy Prime Minister Nick Clegg announced the formation of a new mental health taskforce. Buried in amongst the hopeful rhetoric on “turn[ing] a corner on outdated attitudes” and “the whole of society […] providing […] care and support” were some pretty clear expectations:

One in four people in the UK will experience a mental health problem and it costs the country more than £100 billion. This is too big an issue for the NHS to deal with alone.

The whole of Government needs to combine its efforts and pool its resources to help the millions of people whose mental health condition is preventing them from getting on in life.

You get the sense that people with mental illness are seen as a drain. We need to help them “get on in life”. Terrifying them with Work Capability Assessments isn’t working. How do we make them more productive? We’ll “fight stigma” (but in the meantime, let’s not allow those prison cell beds to get cold).

As a recovered anorexic who still suffers from mild depression, I have the kind of mental health background that is easy to sugar-coat. It is not without pain but I am functional. I could tell you all about My Road to Recovery or My Anorexic Hell. I still embarrass people when I mention the worst parts, but at least I now know how to edit the whole sorry tale. I know it’s not like that for everyone. The last time I was in hospital I discharged myself early because I didn’t want to be around “the really mad people”. I was both frightened and disgusted by them. I am ashamed of this – deeply ashamed – but not so much that I don’t forget about them most of the time. Other than for people who are very close to me, my concern for severely ill patients is fragile, easily destroyed by all the things I don’t understand.

Recently I’ve been reading Elaine Showalter’s The Female Malady, a study of madness and English culture between 1830 and 1980. It’s one of those books that allow the reader to look to the past and feel horror – and perhaps a little smugness – at how far we’ve come. Gone are the days of Victorian “moral management”.  Psychiatric Darwinism, with its obsessive focus on eugenics, is no more. We no longer send “difficult” relatives and recalcitrant women to waste away in institutions. It is tempting to think of ourselves as enlightened. But mental illness is still with us, and so too is prejudice and neglect.

What would someone from the future, writing about mental health care in one of the world’s wealthiest countries, say about us? Can you believe they used to lock people with severe mental illness in police cells? Can you believe they used to find a reduced life expectancy of 20 years perfectly okay? Can you believe that schizophrenia patients were characterised as violent and dangerous? Can you believe that politicians used to talk about combatting stigma while allowing anyone who couldn’t be a poster child for mental illness to waste away? If we cannot summon up the empathy to be shocked right now (not just at one news story, but at all the lives being written off every day), then I hope those who come after us will be shocked on our behalf. And I hope they are shocked not because, as ever, it’s easier to judge the past than the present. I hope they are shocked because they’re better people than we are managing to be.

Glosswitch is a feminist mother of three who works in publishing.

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Air pollution: 5 steps to vanquishing an invisible killer

A new report looks at the economics of air pollution. 

110, 150, 520... These chilling statistics are the number of deaths attributable to particulate air pollution for the cities of Southampton, Nottingham and Birmingham in 2010 respectively. Or how about 40,000 - that is the total number of UK deaths per year that are attributable the combined effects of particulate matter (PM2.5) and Nitrogen Oxides (NOx).

This situation sucks, to say the very least. But while there are no dramatic images to stir up action, these deaths are preventable and we know their cause. Road traffic is the worst culprit. Traffic is responsible for 80 per cent of NOx on high pollution roads, with diesel engines contributing the bulk of the problem.

Now a new report by ResPublica has compiled a list of ways that city councils around the UK can help. The report argues that: “The onus is on cities to create plans that can meet the health and economic challenge within a short time-frame, and identify what they need from national government to do so.”

This is a diplomatic way of saying that current government action on the subject does not go far enough – and that cities must help prod them into gear. That includes poking holes in the government’s proposed plans for new “Clean Air Zones”.

Here are just five of the ways the report suggests letting the light in and the pollution out:

1. Clean up the draft Clean Air Zones framework

Last October, the government set out its draft plans for new Clean Air Zones in the UK’s five most polluted cities, Birmingham, Derby, Leeds, Nottingham and Southampton (excluding London - where other plans are afoot). These zones will charge “polluting” vehicles to enter and can be implemented with varying levels of intensity, with three options that include cars and one that does not.

But the report argues that there is still too much potential for polluters to play dirty with the rules. Car-charging zones must be mandatory for all cities that breach the current EU standards, the report argues (not just the suggested five). Otherwise national operators who own fleets of vehicles could simply relocate outdated buses or taxis to places where they don’t have to pay.  

Different vehicles should fall under the same rules, the report added. Otherwise, taking your car rather than the bus could suddenly seem like the cost-saving option.

2. Vouchers to vouch-safe the project’s success

The government is exploring a scrappage scheme for diesel cars, to help get the worst and oldest polluting vehicles off the road. But as the report points out, blanket scrappage could simply put a whole load of new fossil-fuel cars on the road.

Instead, ResPublica suggests using the revenue from the Clean Air Zone charges, plus hiked vehicle registration fees, to create “Pollution Reduction Vouchers”.

Low-income households with older cars, that would be liable to charging, could then use the vouchers to help secure alternative transport, buy a new and compliant car, or retrofit their existing vehicle with new technology.

3. Extend Vehicle Excise Duty

Vehicle Excise Duty is currently only tiered by how much CO2 pollution a car creates for the first year. After that it becomes a flat rate for all cars under £40,000. The report suggests changing this so that the most polluting vehicles for CO2, NOx and PM2.5 continue to pay higher rates throughout their life span.

For ClientEarth CEO James Thornton, changes to vehicle excise duty are key to moving people onto cleaner modes of transport: “We need a network of clean air zones to keep the most polluting diesel vehicles from the most polluted parts of our towns and cities and incentives such as a targeted scrappage scheme and changes to vehicle excise duty to move people onto cleaner modes of transport.”

4. Repurposed car parks

You would think city bosses would want less cars in the centre of town. But while less cars is good news for oxygen-breathers, it is bad news for city budgets reliant on parking charges. But using car parks to tap into new revenue from property development and joint ventures could help cities reverse this thinking.

5. Prioritise public awareness

Charge zones can be understandably unpopular. In 2008, a referendum in Manchester defeated the idea of congestion charging. So a big effort is needed to raise public awareness of the health crisis our roads have caused. Metro mayors should outline pollution plans in their manifestos, the report suggests. And cities can take advantage of their existing assets. For example in London there are plans to use electronics in the Underground to update travellers on the air pollution levels.

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Change is already in the air. Southampton has used money from the Local Sustainable Travel Fund to run a successful messaging campaign. And in 2011 Nottingham City Council became the first city to implement a Workplace Parking levy – a scheme which has raised £35.3m to help extend its tram system, upgrade the station and purchase electric buses.

But many more “air necessities” are needed before we can forget about pollution’s worry and its strife.  

 

India Bourke is an environment writer and editorial assistant at the New Statesman.