Am I eligible for free mental health care? How would I know?

Alice O'Keeffe's "Squeezed Middle" column.

‘‘So how long have you been having these irrational thoughts?” I pause to think this through. It’s important to give the correct answer. I have to strike just the right balance with the kind lady from the Mental Health Access Team who has phoned to assess me. If she thinks I’m not mentally unstable enough, she will not refer me for free counselling. If she thinks I’m too mentally unstable, she might call in the social and tell them to take my kids away. Would she actually do that? On balance, probably not. Nevertheless, I must tread carefully.
 
I immediately decide against the honest answer, which is that I don’t think my depression is “irrational” at all. It is based on hard facts, many of them scientifically provable. First, our flat is too small for a family of four. Second, there is now officially no chance of us ever being able to move out. Third, our joint incomings do not match our outgoings and we have no savings or pensions. Fourth, the government has no interest in making things better for families like us – or, indeed, anyone other than their Old Etonian buddies. Fifth, the destruction of the environment continues unchecked, with consequences that are likely to prove utterly disastrous for humanity within my children’s lifetime.
 
I’d argue, on balance, that this is reason enough to feel legitimately less than 100 per cent zip-a-dee-doo-dah. On the other hand, whatever your circumstances, your glass could always be half full. No doubt it is partly the way I am perceiving the difficulties which makes them feel insurmountable. If I were more of a can-do type of personality, I’d be out there doing a jolly tap-dance on the grave of Europe’s bee populations.
 
“It started a couple of months ago. The baby stopped sleeping. We were buying a house and then it fell through . . .” I give her the sorry list of symptoms: the exhaustion, the creeping insomnia, the almost constant snivelling. She sounds pleasingly concerned. This is going well.
 
“Any suicidal feelings?”
 
Gosh. Funnily enough I did catch myself lying in bed the other day, thinking how nice it would be never to have to get up ever again, never to have to deal with another unexpected bill or another broken night . . . but it was more an idle thought than an active planning-to-kill-myself thing. Does that count as suicidal? I’m not sure.
 
“No,” I say firmly. “Not at all.”
 
“Good,” she says briskly. “So what I’m going to do is recommend that you come in for a full assessment session with one of our mental health nurses. You should receive a letter in the post.”
 
“Great. Thank you.” Result! I can’t wait for them to make me better again. “And how long will it take to get the appointment?”
 
“It shouldn’t be more than six weeks.”
 
SIX WEEKS!!! I can’t wait six weeks. Curly is on the brink of disowning me. I’m on the brink of disowning myself. I take a deep breath. “Right. Well, thank you very much for your help.” As I hang up, the tears have already formed a puddle on the keypad.
Alice O'Keeffe's "Squeezed Middle" column appears weekly in the New Statesman.

Alice O'Keeffe is an award-winning journalist and former arts editor of the New Statesman. She now works as a freelance writer and looks after two young children. You can find her on Twitter as @AliceOKeeffe.

This article first appeared in the 19 August 2013 issue of the New Statesman, Why aren’t young people working

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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.

***

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.