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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 Buried in amongst the hopeful rhetoric on “turn[ing] a corner on outdated attitudes” and “the whole of society […] providing […] care and support” were some pretty clear expectations: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.

Photo: Getty Images
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What's to be done about racial inequality?

David Cameron's words on equal opportunities are to be welcomed - now for some action, says Sunder Katwala.

David Cameron made the strongest, clearest and most high profile statement about ethnic inequalities and the need to tackle discrimination ever yet offered by a British Prime Minister in his leader’s speech to the Conservative Party conference in Manchester.
“Picture this. You’ve graduated with a good degree. You send out your CV far and wide. But you get rejection after rejection. What’s wrong? It’s not the qualifications or the previous experience. It’s just two words at the top: first name, surname. Do you know that in our country today: even if they have exactly the same qualifications, people with white-sounding names are nearly twice as likely to get call backs for jobs than people with ethnic-sounding names? … That, in 21st century Britain, is disgraceful. We can talk all we want about opportunity, but it’s meaningless unless people are really judged equally”, said Cameron.
While the proof of the pudding will be in the eating, this was a powerfully argued Prime Ministerial intervention – and a particularly well-timed one, for three reasons.

Firstly, the Prime Minister was able to root his case in an all-but-universally accepted appeal for equal opportunities. It will always prove more difficult in practice to put political energy and resources behind efforts to remedy discrimination against a minority of the population unless a convincing fairness case is made that values cherished across our whole society are at stake. Cameron’s argument, that any party which tells itself that it is the party of the ‘fair chance’ and ‘the equal shot’ must have a response when there is such clear evidence of discrimination, should prove persuasive to a Conservative Party that has not seen race inequalities as its natural territory. Cameron argued that the same principles should animate responses to discrimination when it comes to race, gender and social class. Put like that, wanting job interviews to be fair – by eradicating conscious and unconscious patterns of bias wherever possible – would strike most Britons as offering as clear a case of the values of fair play as wanting the best baker to win the Great British Bake-Off on television.
Secondly, Cameron’s intervention comes at a potential "tipping point" moment for fair opportunities across ethnic groups. Traditionally, ethnic discrimination has been discussed primarily through the lens of its impact on the most marginalised. Certainly, persistent gaps in the criminal justice system, mental health provision and unemployment rates remain stark for some minority groups. What has been less noticed is the emergence of a much more complex pattern of opportunity and disadvantage – not least as a consequence of significant ethnic minority progress.

Most strikingly of all, in educational outcomes, historic attainment gaps between ethnic minorities and their white British peers have disappeared over the last decade. In the aggregate, ethnic minorities get better GCSE results on average. Ethnic minority Britons are more likely, not less likely, to be university graduates than their fellow citizens. 

As a result of that progress, Cameron’s intervention comes at a moment of significant potential – but significant risk too. Britain’s ethnic minorities are the youngest and fastest-growing sections of British society. If that educational progress translates into economic success, it will make a significant contribution to the "Great British Take-Off" that the Prime Minister envisions. But if that does not happen, with educational convergence combined with current ‘ethnic penalties’ in employment and income persisting, then that potential could well curdle into frustration that the British promise of equal opportunities is not being kept.  Cameron also mirrored his own language in committing himself to both a ‘fight against extremism’ and a ‘fight against discrimination’: while those are distinct challenges and causes, actively pursuing both tracks simultaneously has the potential, at least, depolarise some debates about responses to extremism  - and so to help deepen the broad social coalitions we need for a more cohesive society too.

Thirdly, Cameron’s challenge could mark an important deepening in the political competition between the major parties on race issues. Many have been struck by the increase in political attention on the centre-right to race issues over the last five to ten years. The focus has been on the politics of representation. By increasing the number of non-white Conservative MPs from two to seventeen since 2005, Cameron has sent a powerful signal that Labour’s traditional claim to be ‘the party of ethnic minorities’ would now be contested. Cameron was again able to celebrate in Manchester several ways in which his Cabinet and Parliamentary benches demonstrate many successful journeys of migrant and minority integration in British society. That might perhaps help to ease the fears, about integration being impossible in an era of higher immigration, which the Home Secretary had articulated the previous day.

So symbolism can matter. But facial diversity is not enough. The politics of ethnic minority opportunity needs to be about more than visits to gurdwaras, diversity nights at the party conference fringes and unveiling statues of Mahatma Gandhi in Parliament Square. Jeremy Corbyn’s first speech as Labour leader did include one brief celebratory reference to Britain’s ethnic diversity – “as I travelled the country during the leadership campaign it was wonderful to see the diversity of all the people in our country” – and to Labour bringing in more black, Asian and ethnic minority members - but it did not include any substantial content on discrimination. Tim Farron acknowledged during his leadership campaign that the Liberal Democrats have struggled to get to the starting-line on race and diversity at all. The opposition parties too will no doubt now be challenged to match not just the Prime Minister’s rhetorical commitment to challenging inequalities but also to propose how it could be done in practice.

Non-white Britons expect substance, not just symbolism from all of the parties on race inequalites.  Survation’s large survey of ethnic minority voters for British Future showed the Conservatives winning more ethnic minority support than ever before – but just 29 per cent of non-white respondents were confident that the Conservatives are committed to treating people of every ethnic background equally, while 54 per cent said this of Labour. Respondents were twice as likely to say that the Conservatives needto do more to reach out – and the Prime Minister would seem to be committed to showing that he has got that message.  Moreover, there is evidence that ethnic inclusion could be important in broadening a party’s appeal to other younger, urban and more liberal white voters too – which is why it made sense for this issue to form part of a broader attempt by David Cameron to colonise the broad centre of British politics in his Manchester speech.

But the case for caution is that there has been limited policy attention to ethnic inequalities under the last two governments. Restaurateur Iqbal Wahhab decided to give up his role chairing an ethnic minority taskforce for successive governments, unconvinced there was a political commitment to do much more than convene a talking shop. Lib Dem equalities minister Lynne Featherstone did push the CV discrimination issue – but many Conservatives were sceptical. Cameron’s new commitment may face similar challenges from those whose instinct is to worry that more attention to discrimination or bias in the jobs market will mean more red tape for business.

Labour had a separate race inequalities manifesto in 2015, outside of its main election manifesto, while the Conservative manifesto did not contain significant commitments to racial inequality. The mid-campaign launch in Croydon of a series of race equality pledges showed an increasing awareness of the growing importance of ethnic minority votes - though the fact that they all involved aiming for increases of 20 per cent by 2020 gave them a slightly back-of-the-envelope feel. 

Prime Ministerial commitments have an important agenda-setting function. A generation ago the Stephen Lawrence case opened the eyes of middle England to racist violence and police failures, particularly through the Daily Mail’s persistent challenging of those injustices. A Conservative Prime Minister’s words could similarly make a big difference in the mainstreaming of the issue of inequalities of opportunity. What action should follow words? Between now and next year’s party conference season, that must will now be the test for this Conservative government – and for their political opponents too. 

Sunder Katwala is director of British Future and former general secretary of the Fabian Society.