This is a joint piece with Labour councillor Mick Bowman, who is a UNISON shop steward, and Mental health social worker.
In the North East, one in four have a mental illness ranging from bi-polar disorder, clinical depression and severe anxiety. And in a report released last month by the mental health charity MIND two out of three people have experienced a panic attack or a bout of depression in the last year!
In Newcastle 45,845 young adults under 24 have short and long-term mental health conditions. Both universities in the city record a steady increase in the number of students who have been sectioned under the 1983 Mental Health Act.
The notion and underlying causes of mental ill-health remains a contested idea. The dictionary defines it as a ‘’state of mind which affects the person’s thinking, perceiving or judgement to the extent that he/she requires care or medical treatment.’’ Given the level of discourse on the issue we must avoid sweeping generalisations or labels.
Disclosure of the condition is normally only identified when a person is at crisis point. Most don’t come to doctor’s surgeries with a history of the illness. The absence of a support network in the wider community plays an important role in this. Mental health issues, which have a number of manifestations, have displaced unemployment as our region’s biggest social problem. Mental ill-health is the largest cause of disability in the UK.
Making sense of it all remains problematic. In Victorian times it was seen as the work of the devil or evil spirits which resulted in thousands of Britons being incarcerated large purpose built Asylums normally located well outside towns or cities. By the (20th century the ‘bio-medical’ approach to the condition was widely adopted by psychologists which saw the saw the cause as primarily biological – the brain – treated by drugs or ECT to ‘cure’ the illness.
With the closure of mental hospitals in the 1970s coupled with ‘care in the community’ some scholars adopted a social model – there was a social pattern to mental ill-health.
Mental illness was a symptom of social inequalities with working class men and women and ethnic minority groups affected. The figures reveal that people from the lower socio-economic groups are more likely to show signs of depression, anxiety and stress brought on by deprivation, bad housing and long-term unemployment. According to the teachers’ union, UCU, the increased stress levels in colleges and universities, with more lecturers on insecure ‘uber-style’ employment contracts remains a permanent feature of the post-16 sector.
Women, it’s argued, are more likely to experience post-natal depression. Jobless men are more likely to commit suicide. As the charity Time for Change, notes: ‘’mental health is just not on the radar for many men.’’ With regard to the link between ethnicity and mental illness research has noted that Afro-Caribbean people are more likely to be diagnosed as schizophrenic and committed to psychiatric hospitals.
The Government has recognised the endemic racism within mental health services and has pledged reform.
Controversially, the radical psychiatrist Oliver James in his book ‘Affluenza’ argues that free market capitalism marked by the ethic of competition and self-promotion has spawned materialism with its premium on money, ‘’conspicous consumption’’, fame and selfies. Inequality has led to spiralling rates of mental illness in Britain.
Wilkinson and Pickett in their book ‘The Spirit Level’ reached similar conclusions. The UK, alongside North America, is the most unequal country in the developed world yet has the highest rate of mental ill-health. A lot of mental illness is a product of inequality with more egalitarian societies such as Japan and Scandinavia having better rates of social well-being.
To some writers mental illness is nothing more than a ‘social construct’ – label applied by others to people’s behaviour. For Szasz and Goffman, who advised on the film ‘One Flew Over the Cuckoo’s Nest’ in 1975, mental illness isn’t a disease. Rather it’s a label used by the powerful to control those seen as socially disruptive. The reactions of others leads to the mental illness badge being applied, and not the ‘’abnormal’’ behaviour itself which makes people ‘’mad’’! In short ‘’patients’’ have become stigmatised by others and the system itself.
Yet the psychologist David Gove points out that labelling theory is inadequate in explaining the cause of mental illness. For many people mental illness is real -causing distress to themselves, their families, friends and employers. The World Health Organisation argues that depression will be the second most common health condition in the western world by 2020.
It costs some £135b each year in England alone. Depression is not only bad for happiness, it’s bad for the economy too. People with a severe mental health condition die up to 15 years younger than their peers in the UK. There’s a clear link between mental ill-health, poor housing, under-achievement at school, alcohol dependency and loneliness. Three out of 4 people with long-term mental health conditions are excluded from the paid labour market according to a TUC report released in June this year. Sufferers of panic attacks earn less than 42% than their peers in the workplace. Men’s suicide rates have been soaring in the last half decade, running at 6,000 a year: all compounded by stigma and discrimination.
Negative stereotypes still persist. It’s argued that people who are mentally unwell are more likely to commit crime and harm others. But as Alistair Campbell, Tony Blair’s former chief spin-doctor, a sufferer of depression himself notes, nothing more could be further from the truth. Victims of street crime are more likely to be those with mental health issues.
Much has been achieved by charities like ‘Re-Think Mental Illness’ to break down taboo. Yet more work is required to support people ,men in particular, to be open about their health .More employers need to open up to mental health as an HR issue. Mental health champions need to be appointed at the workplace.
But arguably the best attempts to bring the issue to the top of the public policy agenda was the decision of four parliamentarians, including Durham North MP Kevan Jones, to describe their own experiences of depression in 2012. More recently, Prince Harry did the same in front of millions of viewers. All this has raised awareness of what has become the greatest health challenge facing British society in the second decade of the 21st century.
Mental health services under the Government are at breaking point. True, large scale ‘’total institutions’ with barrack like dormitories for in-patients have gone. Yet community based services are patchy and under-resourced.
For Campbell, only a quarter of those suffering are getting any type of treatment or support- and that usually means pills like diazepam or anti-depressants. In Newcastle there’s an 18 week waiting list for youngsters to access relevant child and adolescent mental health services.
Richard Layard has recommended training an extra 10,000 clinical psychiatrists and therapists to deliver CBT for those who have depression, through 250 centres, providing courses costing £750. This, he argues would save government millions of pounds in lost productivity, PIP payments and lost tax receipts.
Local authorities and Trusts across the region are leading the policy agenda by pledging to give good mental health the same priority as good physical health. Nationally, measures to challenge discrimination at work and toughen up the 2010 Equality Act to give better protection for employees and learners suffering a mental health problem are required.
Investment is needed in community based services and mental health nursing. The controversial universal credit programme which has brought distress and potential destitution to out of work claimants needs to be abandoned. And insensitive PIP assessment procedures need to be revamped with a more holistic, compassionate approach being adopted to meet the needs of service users. The time is long overdue.