The state is still failing schizophrenia sufferers

Rethink's Schizophrenia Commission shows how a technocratic system is letting patients down.

Hundreds of thousands of carers will be delighted to hear of the publication today of the report of Rethink’s Schizophrenia Commission. Let me explain why.

The other month my friend was sectioned under the Mental Health Act. In anguish after redundancy and a double bereavement, she had begun to see dead bodies through car windows and threatening connections in all she read from the pavement, to the label on a tin of beans to the front page of the FT. She was terrified because constantly, just out her sight, she could sense the presence of someone who was going to do grave harm to her tiny children. Experiencing difficulties on the schizophrenic range of illnesses her family called the "emergency team". They arrived three days later. In the meantime she was admitted to a "specialist unit" having been taken in by her frantic husband after she’d sought to jump in front of a moving vehicle. Soon he got a phone call at home only to realise that the doctor at the other end of the line was talking about a different patient.  Placed on "constant observation" she was twice - and unmissed by the NHS  - found, mud covered, wandering barefoot near home some miles away.  My friend is just one of hundreds who have experienced poor care.

Rethink's report records that 250,000 of us will experience illnesses in the schizophrenic range. In practice that includes the rape victim whose auditory hallucinations mean her attacker will always be with her. It encompasses the lad who screams to his father in fear "are you really my Dad?" as he tries to make sense of the faces, colours and lights that he sees all about him. Not to mention the large number of kids from poorer backgrounds who seem to be disproportionately impacted by this particular form of severe mental ill health. They are not alone of course. Severe mental ill health affects 700,000 citizens and their families.  And in seeking to address their needs the exhaustion of the technocratic, inflexible welfare state is perhaps nowhere better demonstrated.

In city after city, there is now no out of hours social work if your child needs urgent help. Social services advise that you ring the police instead. And so you may soon find you are among the many parents who have ended up sleeping on a police cell floor alongside a family member with, say,  severe  Obsessive Compulsive Disorder while a drunken brawler crashes around next door.  That, or your employer may take to designing redundancy selection to remove you because you need to leave work early for a good while. Why? Well, the only place they could find for your son was a three hour drive away. And when he is in streams of tears from the unit’s phone you just know that you will have to find the petrol money from somewhere to make the six hour return drive for the one hour of visiting time that the nurses allow.  And even there you may encounter a row of doctors advising you that your child will be discharged weeks before you think it is safe to do so. What they cannot tell you is that their new Clinical Commissioning Group has demanded a "faster average churn rate". No wonder the state reaches for the mass produced response of life shortening, menstruation stopping, bone drying, heart pressure inducing, sight blurring, memory stealing, weight adding, medication with the gentle words "there will be some side effects".

Mental ill-health should be a defining political question of our times. It breaches the ramparts of houses, flats and castles in every class and region. It shatters even the strongest of families who set out to stand by their loved one who has become unwell.  And those who face it are the objects of the last respectable form of vicious discrimination: Watch the faces of A&E staff as they turn to admissions that have attempted suicide. Note that it is only this February that it became legal for someone who had been severely ill, and been long recovered, to become a school governor. Register that for eighteen months until last month a large local radio station ran a jingle "you’d have to be mad to work here but if you do we’ll section you" and thought that it was hysterically funny when I rang to ask "why?" Imagine a jingle that offered to lock up black, gay, Jewish or female listeners for being themselves?

And the hundreds of thousands of carers know exactly what I mean.

Francis Davis is a fellow at ResPublica and this week has contributed to Jon Cruddas MP’s Labour List series on One Nation politics.

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Why the Liberal Democrats by-election surge is not all it seems

The Lib Dems chalked up impressive results in Stoke and Copeland. But just how much of a fight back is it?

By the now conventional post-Brexit logic, Stoke and Copeland ought to have been uniquely inhospitable for the Lib Dems. 

The party lost its deposit in both seats in 2015, and has no representation on either council. So too were the referendum odds stacked against it: in Stoke, the so-called Brexit capital of Britain, 70 per cent of voters backed Leave last June, as did 62 per cent in Copeland. And, as Stephen has written before, the Lib Dems’ mini-revival has so far been most pronounced in affluent, Conservative-leaning areas which swung for remain. 

So what explains the modest – but impressive – surges in their vote share in yesterday’s contests? In Stoke, where they finished fifth in 2015, the party won 9.8 per cent of the vote, up 5.7 percentage points. They also more than doubled their vote share in Copeland, where they beat Ukip for third with 7.3 per cent share of the vote.

The Brexit explanation is a tempting and not entirely invalid one. Each seat’s not insignificant pro-EU minority was more or less ignored by most of the national media, for whom the existence of remainers in what we’re now obliged to call “left-behind Britain” is often a nuance too far. With the Prime Minister Theresa May pushing for a hard Brexit and Labour leader Jeremy Corbyn waving it through, Lib Dem leader Tim Farron has made the pro-EU narrative his own. As was the case for Charles Kennedy in the Iraq War years, this confers upon the Lib Dems a status and platform they were denied as the junior partners in coalition. 

While their stance on Europe is slowly but surely helping the Lib Dems rebuild their pre-2015 demographic core - students, graduates and middle-class professionals employed in the public sector – last night’s results, particularly in Stoke, also give them reason for mild disappointment. 

In Stoke, campaign staffers privately predicted they might manage to beat Ukip for second or third place. The party ran a full campaign for the first time in several years, and canvassing returns suggested significant numbers of Labour voters, mainly public sector workers disenchanted with Corbyn’s stance on Europe, were set to vote Lib Dem. Nor were they intimidated by the Brexit factor: recent council by-elections in Sunderland and Rotheram, which both voted decisively to leave, saw the Lib Dems win seats for the first time on massive swings. 

So it could well be argued that their candidate, local cardiologist Zulfiqar Ali, ought to have done better. Staffordshire University’s campus, which Tim Farron visited as part of a voter registration drive, falls within the seat’s boundaries. Ali, unlike his Labour competitor Gareth Snell and Ukip leader Paul Nuttall, didn’t have his campaign derailed or disrupted by negative media attention. Unlike the Tory candidate Jack Brereton, he had the benefit of being older than 25. And, like 15 per cent of the electorate, he is of Kashmiri origin.  

In public and in private, Lib Dems say the fact that Stoke was a two-horse race between Labour and Ukip ultimately worked to their disadvantage. The prospect of Nuttall as their MP may well have been enough to convince a good number of the Labour waverers mentioned earlier to back Snell. 

With his party hovering at around 10 per cent in national polls, last night’s results give Farron cause for optimism – especially after their near-wipeout in 2015. But it’s easy to forget the bigger picture in all of this. The party have chalked up a string of impressive parliamentary by-election results – second in Witney, a spectacular win in Richmond Park, third in Sleaford and Copeland, and a strong fourth in Stoke. 

However, most of these results represent a reversion to, or indeed an underperformance compared to, the party’s pre-2015 norm. With the notable exception of Richmond’s Sarah Olney, who only joined the Lib Dems after the last general election, these candidates haven’t - or the Lib Dem vote - come from nowhere. Zulfiqar Ali previously sat on the council in Stoke and had fought the seat before, and Witney’s Liz Leffman and Sleaford’s Ross Pepper are both popular local councillors. And for all the excited commentary about Richmond, it was, of course, held by the Lib Dems for 13 years before Zac Goldsmith won it for the Tories in 2010. 

The EU referendum may have given the Lib Dems a new lease of life, but, as their #LibDemFightback trope suggests, they’re best understood as a revanchist, and not insurgent, force. Much has been said about Brexit realigning our politics, but, for now at least, the party’s new normal is looking quite a lot like the old one.