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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Scotland's vast deficit remains an obstacle to independence

Though the country's financial position has improved, independence would still risk severe austerity. 

For the SNP, the annual Scottish public spending figures bring good and bad news. The good news, such as it is, is that Scotland's deficit fell by £1.3bn in 2016/17. The bad news is that it remains £13.3bn or 8.3 per cent of GDP – three times the UK figure of 2.4 per cent (£46.2bn) and vastly higher than the white paper's worst case scenario of £5.5bn. 

These figures, it's important to note, include Scotland's geographic share of North Sea oil and gas revenue. The "oil bonus" that the SNP once boasted of has withered since the collapse in commodity prices. Though revenue rose from £56m the previous year to £208m, this remains a fraction of the £8bn recorded in 2011/12. Total public sector revenue was £312 per person below the UK average, while expenditure was £1,437 higher. Though the SNP is playing down the figures as "a snapshot", the white paper unambiguously stated: "GERS [Government Expenditure and Revenue Scotland] is the authoritative publication on Scotland’s public finances". 

As before, Nicola Sturgeon has warned of the threat posed by Brexit to the Scottish economy. But the country's black hole means the risks of independence remain immense. As a new state, Scotland would be forced to pay a premium on its debt, resulting in an even greater fiscal gap. Were it to use the pound without permission, with no independent central bank and no lender of last resort, borrowing costs would rise still further. To offset a Greek-style crisis, Scotland would be forced to impose dramatic austerity. 

Sturgeon is undoubtedly right to warn of the risks of Brexit (particularly of the "hard" variety). But for a large number of Scots, this is merely cause to avoid the added turmoil of independence. Though eventual EU membership would benefit Scotland, its UK trade is worth four times as much as that with Europe. 

Of course, for a true nationalist, economics is irrelevant. Independence is a good in itself and sovereignty always trumps prosperity (a point on which Scottish nationalists align with English Brexiteers). But if Scotland is to ever depart the UK, the SNP will need to win over pragmatists, too. In that quest, Scotland's deficit remains a vast obstacle. 

George Eaton is political editor of the New Statesman.