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From: The Socialist issue 822, 20 August 2014: We can't live on poverty pay!

Search site for keywords: Mental health - Health - NHS - Depression

Scandal of underfunded mental health services

A NHS mental health worker

The shocking death of actor Robin Williams starkly highlights the fact that depression is a dangerous and life threatening clinical condition.

In 2013, 5,900 clinically depressed people took their own lives. This contrasts with 1,700 people killed in road accidents in the same year. Of these suicides, 76% were men.

Yet according to the professor Simon Wessley, the new president of the Royal College of Psychiatrists, a staggering two-thirds of people with depression get no treatment. "Some children with depression and other mental health problems are getting no treatment at all", he added.

Mental health services have long been the poor relation when it comes to NHS funding. Even between 1990 and 1995 when the overall spending in the NHS was growing, spending on mental health fell.

Tory health secretary Jeremy Hunt has pledged "parity of esteem" between mental health and physical health services.

However, while 65% of people with psychosis are getting treatment, sufferers can wait for up to two years to access services. As a direct comparison, in the physical health sector, 90% of patients get treatment and wait 18 weeks.

Health and cuts

In addition, the range of NHS treatments available to mental health patients is diminishing. Long term Psychodynamic Psychotherapy is increasingly difficult to get on the NHS but is widely available privately. But at more than 30 a session it is out of reach of anyone trying to live on employment support allowance (ESA).

There has been a rise in the availability of Cognitive Behaviour Therapy which is short term (12 sessions) and therefore cheaper. However, psychologist Dr Tamara McClintock Greenberg writing in the Huffington Post (2011) stated that CBT only helps 20% of patients.

Many more of our patients are being forced into insecure, substandard housing in the private sector as the availability of council flats has been depleted. Cuts to benefit payments increase stress which exacerbates mental illness.

Evidence shows that sustained or chronic stress, in particular, leads to elevated hormones such as cortisol, the "stress hormone", and reduced serotonin and other neurotransmitters in the brain, which has been linked to depression.

Those patients who may recover sufficiently to consider employment face the frustration of being expected to work for free in volunteering roles or to take low paid work.

Mental illness strikes all people from every social class. However, the experiences of our patients suggests that increasingly limited access to the material basics, imposed on working class people in particular, impede recovery and increase relapse rates.

In December 2005 the social work magazine, Community Care, reported that black and ethnic minority groups are over-represented in mental health services and that they are more likely to experience seclusion and physical restraint. This is a damning indictment on the way society operates.

Effectively dealing with mental illness means additional investment in mental health services and stopping the creep of the 'one size fits all approach' in treatment provision.

It also involves taking steps to address the poverty and inequality at the root of much ill health - "...the more equally wealth is distributed the better the health of that society" ('The Spirit Level' - Wilkinson and Pickett 2010).

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