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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The rise of the green mayor – Sadiq Khan and the politics of clean energy

At an event at Tate Modern, Sadiq Khan pledged to clean up London's act.

On Thursday night, deep in the bowls of Tate Modern’s turbine hall, London Mayor Sadiq Khan renewed his promise to make the capital a world leader in clean energy and air. Yet his focus was as much on people as power plants – in particular, the need for local authorities to lead where central governments will not.

Khan was there to introduce the screening of a new documentary, From the Ashes, about the demise of the American coal industry. As he noted, Britain continues to battle against the legacy of fossil fuels: “In London today we burn very little coal but we are facing new air pollution challenges brought about for different reasons." 

At a time when the world's leaders are struggling to keep international agreements on climate change afloat, what can mayors do? Khan has pledged to buy only hybrid and zero-emissions buses from next year, and is working towards London becoming a zero carbon city.

Khan has, of course, also gained heroic status for being a bête noire of climate-change-denier-in-chief Donald Trump. On the US president's withdrawal from the Paris Agreement, Khan quipped: “If only he had withdrawn from Twitter.” He had more favourable things to say about the former mayor of New York and climate change activist Michael Bloomberg, who Khan said hailed from “the second greatest city in the world.”

Yet behind his humour was a serious point. Local authorities are having to pick up where both countries' central governments are leaving a void – in improving our air and supporting renewable technology and jobs. Most concerning of all, perhaps, is the way that interest groups representing business are slashing away at the regulations which protect public health, and claiming it as a virtue.

In the UK, documents leaked to Greenpeace’s energy desk show that a government-backed initiative considered proposals for reducing EU rules on fire-safety on the very day of the Grenfell Tower fire. The director of this Red Tape Initiative, Nick Tyrone, told the Guardian that these proposals were rejected. Yet government attempts to water down other EU regulations, such as the energy efficiency directive, still stand.

In America, this blame-game is even more highly charged. Republicans have sworn to replace what they describe as Obama’s “war on coal” with a war on regulation. “I am taking historic steps to lift the restrictions on American energy, to reverse government intrusion, and to cancel job-killing regulations,” Trump announced in March. While he has vowed “to promote clean air and clear water,” he has almost simultaneously signed an order to unravel the Clean Water Rule.

This rhetoric is hurting the very people it claims to protect: miners. From the Ashes shows the many ways that the industry harms wider public health, from water contamination, to air pollution. It also makes a strong case that the American coal industry is in terminal decline, regardless of possibile interventions from government or carbon capture.

Charities like Bloomberg can only do so much to pick up the pieces. The foundation, which helped fund the film, now not only helps support job training programs in coal communities after the Trump administration pulled their funding, but in recent weeks it also promised $15m to UN efforts to tackle climate change – again to help cover Trump's withdrawal from Paris Agreement. “I'm a bit worried about how many cards we're going to have to keep adding to the end of the film”, joked Antha Williams, a Bloomberg representative at the screening, with gallows humour.

Hope also lies with local governments and mayors. The publication of the mayor’s own environment strategy is coming “soon”. Speaking in panel discussion after the film, his deputy mayor for environment and energy, Shirley Rodrigues, described the move to a cleaner future as "an inevitable transition".

Confronting the troubled legacies of our fossil fuel past will not be easy. "We have our own experiences here of our coal mining communities being devastated by the closure of their mines," said Khan. But clean air begins with clean politics; maintaining old ways at the price of health is not one any government must pay. 

'From The Ashes' will premiere on National Geograhpic in the United Kingdom at 9pm on Tuesday, June 27th.

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

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