Tight budgets mean mental healthcare isn’t a possibility for millions in Britain. Photo: Flickr/Lee Haywood
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Austerity is making life unbearable for those with mental health conditions

Strangulation of funds has seen the NHS Mental Health Trusts lose £253m, 2.3 per cent of their funding.

The core ideal of the NHS, that makes it so beloved by British people, is its promise of healthcare free for all. That promise has now become incompatible with the reality of austerity.

By 2020, the NHS will require an extra £30bn just to keep services at their present level. This strangulation of funds has seen the NHS Mental Health Trusts lose £253m, 2.3 per cent of their funding. These cuts translate into a dramatic loss of vital support for those with mental health conditions.

Half of early intervention programmes targeted at young people have been cut. The LSE estimates 30,000 people with mental health conditions have lost their social care, while 1,700 beds have been cut. Over a fifth of doctors said they had sent a child over 200 miles away from their families for treatment, and a similar number admitted sectioning people just to get them a bed. There are huge regional disparities too, as Birmingham City Council reduced its budget for adult mental health by an incredible 94 per cent.

Austerity has left the mental healthcare system in tatters. With all these cuts, universal healthcare at the point of need in Britain is now a myth. Less than a third of people with common mental health conditions get any treatment whatsoever, while only a third of people with illnesses as serious as psychosis and schizophrenia are on treatment.

I suffer from severe and chronic depression. When I moved to Brighton as a student, I suffered a breakdown, and after encouragement from a close friend, sought help. I was told that it would take at least three months to receive any treatment. For me, like millions of other people in Britain, mental healthcare wasn’t a possibility. The charity Mind have called this "a disgrace", while Rethink Mental Illness called it "scandalous", yet austerity is due to continue whoever wins the next general election, with Labour pledging to keep to Tory cuts after 2015.

Much of austerity falls on local government, who spend most of their budgets on social care. As early as 2011, just a year into the coalition, four out of every five councils scrapped care for people with "low" or "moderate" disability needs, an added punishment for people with the most debilitating mental health conditions.

But austerity doesn’t just take away people’s support. It causes poor mental health too. Academics are now coming to the conclusion that austerity translates into a death sentence for some. Stephen Platt, Emeritus Professor of Health Policy Research at Edinburgh University, says, "the rise in suicide in the UK wasn’t inevitable. On the contrary, it was the consequence of a deliberate policy choice: that of austerity." According to research he cites by Samaritans, those in the poorest communities are ten times more likely to take their own life than the affluent. Austerity is at its core a class issue, choosing to privilege the right of the wealthy to pay less tax ahead of the right of poorer communities to a basic standard of mental healthcare.

The slogan of our resistance should be this: austerity kills. We need to make the simple case that policy-makers have a choice: either they clamp down on tax avoidance of £70bn, put banks under democratic control like the TUC demands, or people will continue to suffer mental distress and commit suicide in a Britain where governments prioritise the defence of the wealthy over the rights of those of us with mental health conditions, to receive the treatment we need and deserve.

James Elliott is on the National Executive of the National Union of Students, and represents disabled students in the UK. 

James Elliott is Deputy Editor at Left Futures. He tweets @JFGElliott.

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There is nothing compassionate about Britain’s Dickensian tolerance of begging

I was called “heartless” for urging police to refer beggars to support services. But funding drug habits to salve a liberal conscience is the truly cruel approach.

In Rochdale, like many other towns across the country, we’re working hard to support small businesses and make our high streets inviting places for people to visit. So it doesn’t help when growing numbers of aggressive street beggars are becoming a regular fixture on the streets, accosting shoppers.

I’ve raised this with the police on several occasions now and when I tweeted that they needed to enforce laws preventing begging and refer them to appropriate services, all hell broke loose on social media. I was condemned as heartless, evil and, of course, the favourite insult of all left-wing trolls, “a Tory”.

An article in the Guardian supported this knee-jerk consensus that I was a typically out-of-touch politician who didn’t understand the underlying reasons for begging and accused me of being “misguided” and showing “open disdain” for the poor. 

The problem is, this isn’t true, as I know plenty about begging.

Before I became an MP, I worked as a researcher for The Big Issue and went on to set up a social research company that carried out significant research on street begging, including a major report that was published by the homeless charity, Crisis.

When I worked at The Big Issue, the strapline on the magazine used to say: “Working not Begging”. This encapsulated its philosophy of dignity in work and empowering people to help themselves. I’ve seen many people’s lives transformed through the work of The Big Issue, but I’ve never seen one person’s life transformed by thrusting small change at them as they beg in the street.

The Big Issue’s founder, John Bird, has argued this position very eloquently over the years. Giving to beggars helps no one, he says. “On the contrary, it locks the beggar in a downward spiral of abject dependency and victimhood, where all self-respect, honesty and hope are lost.”

Even though he’s now doing great work in the House of Lords, much of Bird’s transformative zeal is lost on politicians. Too many on the right have no interest in helping the poor, while too many on the left are more interested in easing their conscience than grappling with the hard solutions required to turn chaotic lives around.

But a good starting point is always to examine the facts.

The Labour leader of Manchester City Council, Richard Leese, has cited evidence that suggests that 80 per cent of street beggars in Manchester are not homeless. And national police figures have shown that fewer than one in five people arrested for begging are homeless.

Further research overwhelmingly shows the most powerful motivating force behind begging is to fund drug addiction. The homeless charity, Thames Reach, estimates that 80 per cent of beggars in London do so to support a drug habit, particularly crack cocaine and heroin, while drug-testing figures by the Metropolitan Police on beggars indicated that between 70 and 80 per cent tested positive for Class A drugs.

It’s important to distinguish that homelessness and begging can be very different sets of circumstances. As Thames Reach puts it, “most rough sleepers don’t beg and most beggars aren’t rough sleepers”.

And this is why they often require different solutions.

In the case of begging, breaking a chaotic drug dependency is hard and the important first step is arrest referral – ie. the police referring beggars on to specialised support services.  The police approach to begging is inconsistent – with action often only coming after local pressure. For example, when West Midlands Police received over 1,000 complaints about street begging, a crackdown was launched. This is not the case everywhere, but only the police have the power to pick beggars up and start a process that can turn their lives around.

With drug-related deaths hitting record levels in England and Wales in recent years, combined with cuts to drug addiction services and a nine per cent cut to local authority health budgets over the next three years, all the conditions are in place for things to get a lot worse.

This week there will be an important homelessness debate in Parliament, as Bob Blackman MP's Homelessness Reduction Bill is due to come back before the House of Commons for report stage. This is welcome legislation, but until we start to properly distinguish the unique set of problems and needs that beggars have, I fear begging on the streets will increase.

Eighteen years ago, I was involved in a report called Drugs at the Sharp End, which called on the government to urgently review its drug strategy. Its findings were presented to the government’s drugs czar Keith Hellawell on Newsnight and there was a sense that the penny was finally dropping.

I feel we’ve gone backwards since then. Not just in the progress that has been undone through services being cut, but also in terms of general attitudes towards begging.

A Dickensian tolerance of begging demonstrates an appalling Victorian attitude that has no place in 21st century Britain. Do we really think it’s acceptable for our fellow citizens to live as beggars with no real way out? And well-meaning displays of “compassion” are losing touch with pragmatic policy. This well-intentioned approach is starting to become symptomatic of the shallow, placard-waving gesture politics of the left, which helps no one and has no connection to meaningful action.

If we’re going make sure begging has no place in modern Britain, then we can’t let misguided sentiment get in the way of a genuine drive to transform lives through evidenced-based effective policy.

Simon Danczuk is MP for Rochdale.