It has, on the surface, been a good week for the campaign to get better understanding and services for mental health and mental illness. The long-awaited NHS Taskforce Report gave a strong analysis of the dreadful problems we face, and some good ideas of how they might be addressed, and the government indicated a willingness (I don’t think we can put it much stronger than that) to fund them.
The other good thing happening is that the BBC are covering mental health in depth all week as part of their season of programming on the issue. Amid my many criticisms of the media down the years, I have often said that mental health is one area where I think the coverage has been broadly good, and has steadily improved. One thing is for sure: the volume of coverage in recent years has increased, and the BBC focus is another welcome step in that direction.
These two things – the Taskforce Report and the BBC mental health week – came together last night when David Cameron appeared on the main bulletins, interviewed by Fiona Bruce. Now given everything else he has on – he left for Paris almost immediately the interview was over on the next stage of his European “strategy” (sic) adventure – I suspect he could have done without the interview. He may even have thought it would be a nice interlude amid all his other problems, a chance to show his touchy-feely side on an issue that he knows is a growing concern for the public.
If so, he got something of a rude awakening. Fiona Bruce was not really in cuddly touchy-feely mode, and unsurprisingly wanted to know exactly what the PM intended to do to meet the demands set out in the report. Cameron was classic Cameron, hoping the warm words and the top level message of broad support would do. But there were some very clear specific demands in there, and he seemed vague at best, evasive at worst.
Added to which the figures – a billion pounds extra spending, a million more people to be treated – were just too rounded to be convincing. Then on that old question – “is this new money?” – it all got a bit vaguer, and as the day wore on it became clearer we were in any event talking mainly about the era when Cameron is going to be a former PM.
The good news is that in Cameron allying himseld to the cause, and his likeliest successor George Osborne having done so in the spending review, the issue gets further up the agenda and it becomes harder for them not to deliver in future. But we have seen in plenty of other areas promises of action, promises of funding, which then evaporate as he moves on to another “top priority.” I felt when he was promising his prisons revolution last week, for example, that it was all very well to talk about improving prison conditions, and moving from incarceration to rehabilitation as a philosophy, and giving more powers to Governors. But if those Governors are having to cut their budgets, how can they deliver on these new priorities?
On mental health, we have seen the government talk the talk, but when some of the responsibilities have shifted to local government, whose budgets have been slashed, how can we expect the same levels of service to be offered? We can’t. Cameron and Osborne are allying themselves with a campaign, rather than delivering a plan to see the campaign goals being met.
There was one part of his interview that really struck me, namely when he talked about the need for a two-week maximum waiting time for someone with psychosis. The talk is all about parity between mental and physical health. Having had psychosis back in the mid-80s, I can tell you what the physical equivalent of a psychotic attack is – you’ve gone through the windscreen of your car in a multiple motorway pile up, and you’re lying on the tarmac not sure if you’re going to see the day out.
Just think on that. It shows how far we are from genuine parity between physical and mental health. Would the police, fire and ambulance service tell the car crash victim to wait two weeks to see someone? I don’t think so.
As Jeremy Hunt wages war on the junior doctors over his plans for a “seven-day NHS” (a version of which we already have, and which was in any event an election promise they didn’t think they were going to have to deliver), the one area where we do need it is in mental health and mental illness. With most operations whether it they happen on a Monday or a Sunday does not make that much difference. Mental health crisis does not differentiate between weekdays and weekends. But to deliver the kind of weekend service that is required demands genuine extra investment.
I think both Cameron and Osborne do want to see better services. But I am far from convinced they are willing the means to deliver them. So the campaigning has to go on, and we have to keep on generating the sense of outrage there surely ought to be that mental health services are so far behind the kind of level of support and service we take for granted for physical health.
And we have to watch like hawks to see what all this talk of an extra billion pounds means, where it is coming from, over what period, and what it is actually delivering.
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