The UK’s mental health care is in crisis – the next government must act urgently

Mentally ill patients forced to travel hundreds of miles for treatment, forcible sectioning in order to get beds and medical students begging for greater teaching on psychiatry: we’re not getting it right

Just last week, data obtained from freedom of information requests led to claims that the NHS treated mental health care as a “second-class service”. Indeed, thousands of mentally ill patients have been forced to travel “hundreds of miles” for treatment in recent years. Extreme cases have seen patients being forcibly sectioned so that they can receive care in overcrowded wards. Even medical students have resorted to asking for greater teaching on psychiatry, highlighting the derisory attention that mental health issues receive. Yet the state of mental health services is unsurprising considering that they receive only 13 per cent of the NHS budget, despite mental illness affecting around a quarter of the UK population.

Worse still, national spending on mental health has consistently decreased over the past three years. And the trend isn’t limited to adult care; mental health services for children and adolescents have also seen a fall in funding. This decline seems even more irrational considering adolescence is the period when many mental illnesses first manifest, and that hospitals are recording a rise in hospital admissions for conditions such as eating disorders.

The budget cuts have had a noticeable impact, with doctors citing the changes as a cause of “avoidable deaths and suicides,” while mental health organisations claimed that the cuts “put lives at risk”. Mental illness also has a significant impact on a patient’s quality of life, and is thought to contribute to poor physical health, having been associated with diabetes, cancer and cardiovascular disease. As well as the ethical concerns of these cases, such neglect of the mentally ill also has practical implications; a report by the London School of Economics found that the NHS could save over £50m a year by reversing budget cuts to preventative and early intervention therapies.

Yet perhaps the most striking aspect of the decrease in funding comes from the comparison with other areas of health care. The government, for instance, took great pride in announcing that the Cancer Drugs Fund would be ring-fenced until 2016. While it would be wrong to question the severity of diseases such as cancer, it is worth considering that this budget is reserved for treatments that aren’t ordinarily commissioned because they are not cost-effective. Given the nature of the NHS’s funding crisis, it seems unfair to fund relatively inefficient treatments, while the NHS’s most vulnerable patients are left without basic care.

This is the problem. Eager to brand their “reform” of the NHS as good for patients, the coalition has protected the emotive areas of health care that already benefit from public awareness. Aware that severely cutting the budget for paediatrics or cancer care would result in public outrage, the government are cynically withdrawing care from those most lacking a voice in society: the mentally ill.

Although this current crisis is alarming, such disregard of mental health isn’t a recent phenomenon. Plagued by a history of taboo and prejudice, mental health care has historically been chronically underfunded. With a media happy to brand mentally ill people as “psychos” and a threat to society, it has been relatively easy for politicians to excuse this injustice. But public perceptions are changing; a report by the charity Rethink Mental Illness found that public understanding and tolerance of mentally ill people is improving, while 63 per cent were aware of a close friend having a mental health problem.

This is important; for a politician to stand up for mental health care now wouldn’t just be a principled action, it’d be a popular one. With time, and the excellent work of campaign groups, this positive trend in public attitudes will only continue, allowing society to grow in confidence to discuss one of our greatest health challenges. The mental health charity Mind suggests that the next government commits to a 10 per cent rise in the NHS’s mental health budget over the next five years. Considering the state of mental health care and the current funding disparity between health services, this is not an unreasonable request.

Past governments have chosen an area of health care to focus on, in order to target voter demographics. In 1999, Blair announced his “crusade against cancer”. Seeking the “grey vote”, David Cameron called for a “national challenge” to beat neurological diseases such as dementia. But the disgrace of the NHS’s mental health provision goes beyond party politics. Regardless of who wins the general election, the next government must embrace bold reform to end our longstanding neglect of the mentally ill.



HIP HOP PSYCH Event 21st November


21st November 2013, 7pm – 9pm. ORTUS learning & events centre, 82-96 Grove Lane, Denmark Hill, London, SE5 8SN

Co-Founded by Dr Akeem Sule & Dr Becky Inkster

“Demystifying mental illness through authentic beats and lyrics”

HHP Screens

Hip-hop culture is a powerful vehicle for raising awareness about mental health. It is rich with references to psychiatric illnesses that have not been explored, dissected and documented until now. HIP HOP PSYCH, co-founded by Dr Akeem Sule & Dr Becky Inkster, is the interface that links hip-hop with mental health.  Their medical credibility and authentic passion for hip-hop enables them to bridge this gap. They understand the culture, speak the language and want to share their knowledge in order to cultivate awareness and remove stigma surrounding mental health and hip-hop.

Although the lyrics of hip hop music are often associated with swearing, rapping about money and the exploitation of women, there are also rappers whose unfiltered narration goes beyond this by describing the harsh realities of their world and the coping mechanisms employed by some young people.  The music can be rich with references, for example, to addiction, psychosis, bipolar disorder and the effects of urbanicity, poor nutrition and destructive parental influences relating to childhood maltreatment in the absence of positive role models.  

For this event, HIP HOP PSYCH Co-Founders Dr Akeem Sule & Dr Becky Inkster will be focusing on dissecting and analysing a range of hip hop lyrics from different artists – such as Eminem, Tupac, Kendrick Lamar and J Cole – in order to demystify mental health.  In doing this they seek to disarm the boundaries between psychiatry, the humanities and hip-hop culture.  Their approach enables them to gain a deeper awareness into gang culture and allows them to get closer to the reality of the daily struggles and risk factors which people with mental health problems face.

The event will also feature a special performance by Key Changes. Key Changes provides music engagement and recovery services for young people and adults experiencing severe mental illnesses including psychosis, schizophrenia, bi polar and personality disorders. Their innovative approach draws on clinical therapeutic techniques and uses culturally relevant music activities and genres.

Twitter: @hiphopsych / Email:

Price: £15 per person. Booking is essential as spaces are limited. CLICK HERE to buy your tickets.

IMPORTANT INFORMATION: You must be at least 16 to attend this event.

Stigma of mental ill health is ‘worse than the illness’

Sufferers are shunned, taunted and abused, claims an international study of the problem

It is the single biggest cause of disability in the Western world but many sufferers say the stigma attached to it is worse than the illness itself, according to researchers.

While celebrity sufferers who speak out about their depression are hailed as heroes, ordinary citizens are shunned, taunted and abused.

An international study of more than 1,000 sufferers in 35 countries has found that three quarters said they had been ostracised by other people leading them to avoid relationships, applying for jobs and contacting friends.

Discrimination is leading many to put off seeking treatment with a subsequent worsening of their condition.

Drugs and psychotherapy can help 60-80 per cent of people with depression but only half get treatment and only 10 per cent receive treatment that is effective – at the right dose, for long enough and with the right kind of therapy.

The international study published in The Lancet found that levels of discrimination were similar to those for schizophrenia revealed in a similar study three years ago.

Professor Graham Thornicroft, head of health service and population research at the Institute of Psychiatry said: “We have a major problem here. Non-disclosure is an extra barrier – it means people don’t seek treatment and don’t get help.”

While public confessions of depression by well known people including the tennis champion Serena Williams, the US actress Kir-sten Dunst and chat-show host Stephen Fry were increasing, abuse of sufferers was also widespread.

The Norwegian Prime Minister, Kjell Bondevik, attracted worldwide approval when he relinquished power for three weeks to his deputy in 1998 while he recovered from an episode of depression. He was subsequently re-elected.

In contrast, Professor Thornicroft described the case of a woman who had dog faeces posted through her door because neighbours wanted her out and another in which police halted an interview with a man whose flat had been burgled when they learnt that he had been in psychiatric hospital.

“Our findings show discrimination is widespread and almost certainly acts as a barrier to an active social life and having a fair chance to get and keep a job,” he said.

The Government’s Time to Change campaign launched in 2008 aimed at reducing discrimination against people with mental illness had proved to have had a “modest but significant” impact, he added.

In a separate study, researchers have found that the 2008 economic crash led to a deterioration in the mental health of men – but not women.

Anxiety and depression increased markedly among men in the three years following the crash, but women escaped largely unscathed.

Rising unemployment and falling income are not to blame, the researchers say. Instead, job insecurity is thought to be the cause.

Mental ill health among men rose from 13.7 per cent in 2008 to 16.4 per cent in 2009 before falling back to 15.5 per cent in 2010, according to the study published in the journal BMJ Open.

Men derive much of their social status from their occupation and are still the main wage earners in most families. They are becoming more mentally unstable because of the fear of losing their jobs in the recession.

The authors from the Social and Public Health Sciences Unit in Glas-gow, say that while women’s mental health appeared to change little in the period it may have deteriorated since due to job cuts in the public sector.

#RT via Bridget