A cautious welcome for Mr Clegg’s mental health challenge
Authors: Stephen Bevan
Professor Stephen Bevan
22 January 2014
Some people in the room had waited 30 years or more to hear a senior politician speak up for people living with mental illness. Not only did Deputy Prime Minister speak up, he also argued for ‘parity of esteem’ with physical illnesses which get the lion’s share of airtime and resources. The occasion was the launch this week of the government’s ‘Closing the Gap’ report in which it set out 25 challenges to improve services and outcomes for people with mental illness.
The audience gave the speech a largely enthusiastic welcome, grateful that Mr Clegg recognised that, while plenty has been achieved, that much more action was needed. Indeed, most of the questions from the floor reflected this gratitude but also urged tangible implementation. My own slightly self-interested thoughts were that the plight of people or working age was given only a low profile in the speech, which is a shame given that:
- Right now, 1 in 6 workers is experiencing depression, anxiety or stress, at a cost of £26 billion to the UK economy, or around £1,035 per employee
- Among people in work, mental illness accounts for nearly a half of all absenteeism. And among people out of work, mental illness again accounts for nearly half of all people on incapacity benefits
- A third of people in the UK say they would not be willing to work with someone who has a mental health problem
- Only 8% of people living with serious mental illnesses such as schizophrenia are employed;
- Over half of people with mental illness report that the stigma associated with their condition is as difficult to live with as the illness itself
These figures emphasise that provision for working age people with depression or anxiety especially is often woefully poor. Indeed, from my perspective, the far more significant report published yesterday was that produced by our colleagues at RAND Europe for both the DWP and the DH. Conducted in collaboration with Turning Point, the Centre for Mental Health and The Work Foundation, the report sets out a series of recommendations for government which we hope will improve the psychological wellbeing of the workforce and the kinds of support to which they can get access. These include proposals to integrate employment support much more closely with clinical services – building on some of the good practice which The Work Foundation found in its study of the employment challenges facing people with schizophrenia.
We will have another chance to build momentum behind the arguments for more consistent and early interventions for working age people with mental illness when the OECD launches its report on Mental Health and Work at an event at The Work Foundation on 10 February. The OECD has carried out research in nine countries and I will be speaking at the launch of the Swiss report in Berne this week and at the event in London in February. I think we can expect some candid reflections on what the UK does well – and less well – compared with other developed economies.
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Some of the statistics you reference Stephen are very disappointing to read. As you allude to whilst positive steps are being made around the stigma of mental health we still have a long way to go.
It will be very interesting to see the comparisons between the UK and other countries in terms of what we do and don't do well in this field.
At a meeting of Patient Group Chairs today, it was reported that 85% of those covered by our CCG and needing talking therapy did not have access to it. Similarly, a crisis centre operated by the charity Mind had to close last year as a consequence of Government funding cuts.
On the other hand, Tuesday's You & Yours phone-in provided instances where multi-agency (= expensive) support for (severe?) mental illness had brought excellent results, but the general pattern was rather unsatisfactory.
Two aspects that may help to explain the blog's dire data seem to me to be a) public understanding of terminology is very poor (the implication of a broken leg is readily recognised, but schizophrenia?) and b) the media frenzy aroused by the release of mentally ill patients into society who go on to kill, hardly encourages empathy for others, whatever their problem.
Improving the outcomes for those with mental illness will require education, serious long term funding plus political will (and not just at the top level). I'm not holding my breath...
It is encouraging to read Mr.Clegg's comments Steve. One would hope funding can be found for major public education campaigns to assist with stigma reduction. In Australia we found a very successful approach was to conduct training in the workplace on common mental health conditions (specifically depression and anxiety) in an effort to open up discussion and build acceptance of these conditions within a workplace. We found that this approach broke stigma to some degree and enabled acceptance of these conditions as part of every day life.
As noted by Jim K it requires significant funding and even greater political will. Hopefully lobbying of politicians in the lead up to elections can begin to start the process.
Thanks for your comments. The OECD has been looking at this in a 9-country study. The UK report is being launched on 10 Feb and the Australian report will be published later in the year. When I present these disappointing stats at conferences I say that the UK has a much better 'handle' on the extent of our problems than many countries - but having good data is just the start. The OECD says that policy in the UK runs somewhat ahead of our capacity to deliver joined-up practice. Quite a diplomatic way of putting it! Nonetheless, I remain optimistic that we are making headway. With the Deputy PM arguing for 'parity of esteem' and with much more enlightened practice among employers, I think we are nearing an important breakthrough. Rest assured, The Work Foundation will be at the forefront of efforts to change the mental health landscape.
The suggestion above regarding workplace education is excellent. Reducing stigma requires not just learning more about mental illness, but understanding that it can happen to anyone and that these people are not to be feared. Rather than marginalize those with mental health issues, involve them in discussions and keep them at the forefront of a mission to educate. It's only when everyone is willing to talk as openly about schizophrenia as they do about heart disease and diabetes that progress will be made.
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