So, first of all, many thanks to The Guardian, who have once more allowed me a platform to argue the basic case that we are light year away from parity between mental and physical health. Here is the piece they have just posted, to coincide with the launch of the MQ charity’s #WeSwear campaign designed to get people fired up about the lack of research that goes into mental illness compared with physical illness.
So thanks to MQ. They are an important new addition to the mental health landscape.
Thanks also – the Republican in me may struggle with this one but my Monarchist Mum would have been thrilled! – to Prince William, his wife Kate and Prince Harry, for the work they are doing in promoting mental health through their Heads Together campaign. I was invited to their event yesterday where all three spoke with a real passion for the cause of parity, and, in their mingling afterwards, a real understanding of the issues. Prince William echoed the hope that 2017 could be a tipping point in changing the way we think about mental health. Harry said that in the military, the importance of physical fitness was a given, but mental good health was vital too; and he said there was nobody who didn’t at some time need support. Kate emphasised the importance of being open about mental health issues, and finding the right person to talk to.
Of course they are limited by their role as to how far they can go, but in a room full of charities and campaigners, given the mingling went on for a long time afterwards, it is pretty clear to me they understand that the stigma campaign cannot be a substitute for services. It was also clear they are in this for the long haul, which is great news for those of us campaigning under the Time to Change banner.
Heads Together has become the official charity partner for the London Marathon, so thanks to the Marathon organisers too. Kate said she hoped it would be remembered as ‘the mental health marathon.’
These are all great signs of change and progress towards the tipping point.
BUT … whether we are talking about services, attitudes or research, mental health remains the poor relation. Another speaker yesterday, Jon Salmon, whose father took his own life and who later became profoundly depressed to the point of attempted suicide himself, explained that he could only get the help he needed – CBT – because his work health insurance covered mental illness. See also the story in my Guardian piece of the young man I advised to get help, and what his GP told him, that frankly ended up making him feel worse.
So there is a lot to be encouraged about, but also a lot to get angry about. And MQ’s We Swear campaign is all about both generating and then using the anger about the reality of mental health services to fight harder for change. We Swear has two meanings – we swear to keep fighting for change … and we swear because we are fucking angry.
MQ having asked me to write a piece for The Guardian, I did so, and vented all the sweary spleen I could muster … only to learn that even The Guardian stops short of allowing full on Malcolm Tucker foul-mouthery. Just one of my many F words made it through.
My thanks for them publishing the edited piece is sincere. But I also thought some of you might want to see the original. If nothing else, journalism students can have an interesting case study in editing. I will feel better, as I often do when I have let off a volley. More importantly, it if fires some of you up to get angry and get involved, it’ll be worth it.
Here goes …. (I particularly enjoyed the pay-off line, so do read to the end)
It is a fucking scandal and it is time to get fucking angry. So fuck fuck fuck fuck. There. I feel better. No, not because I am channelling Malcolm Tucker. But because swearing is just one way both to let off steam and to fire up a bit of anger so that you get out and fight for things that matter. Also, because The Guardian is one of the few media outlets where we are allowed to call a spade a spade without fucking asterisks.
So why the anger this wintry morning? Because, one week on from the latest Prime Ministerial speech full of fine intentions about prioritising mental health, we are light years away from the parity between mental and physical health care that is set out – in law – in the NHS Constitution. Since her speech, I have spoken to a mother at her wits’ end because her daughter is being treated in Scotland when she lives eighty miles south of the border; a young man I persuaded to get help for his anxiety and depression who has been given some pills and told he might get CBT in six months; a student who has dropped out after two failed suicide attempts, one of which followed a long wait in a crowded room waiting to see an overstretched university psychiatrist. I’ve been out on the streets of Camden with my son Calum who spends much of his spare time giving food, clothes and company to the growing army of people – many clearly with mental health problems – who sleep rough.
I recently got a letter too, which really made me fucking angry, from someone who said that my urging people to be open, in a radio interview, had led him to seek help for what he worried was a drink problem, and when he got to his GP was told their alcohol support service had been cut but ‘here is a list of AA meetings.’ It makes you wonder what is the point of winning a fight to change attitudes if the services are not there to help people who, despite the stigma and taboo, make that first step to be open about a mental health problem?
There are of course many people who do get good treatment. But my worry about Mrs May’s speech is that she and other politicians see the battle against stigma as a substitute for the services we need, rather than an accompanying policy goal, and a genuine priority.
Every time there is pressure on health spending, as now, mental illness slips down the priority queue. So for all Mrs May’s fine words, and David Cameron’s before her, they presided over eight percent cuts in spending on mental health, the loss of six thousand mental health nurses and a fall to a lower per capita number of psychiatric beds than France, Germany or the OECD average.
We see the same bias against mental health in research. There too it is the poor relation, which is why I welcome the work of mental health research charity MQ and their ‘WE SWEAR’ campaign launched today.
More than four out of ten people believe that mental illnesses such as anxiety and depression are now an inevitable part of life. Even with more prevalent physical illnesses we don’t have the same expectation, because we just don’t think about mental health in the same way as physical health. That has consequences for care, and the pressures politicians and commissioners feel to provide it.
Sadly, young people seem to be hardest hit; only one in four young people referred to a professional actually gets the treatment they need. When you consider that 75% of mental illness starts before the age of 18, that’s a lot of young people surrounded by their own concerns and the inabilities of others to help them. Yet where is the anger? Suicide is now the biggest killer of young men in Britain … delete ‘suicide’ and insert any physical illness or any other aspect of our national life and you would have political and media outrage aplenty. Walk past all those people living on the streets, as we all do, and imagine they were lying there untreated and unhelped, not with a psychiatric illness but a broken leg or cancer or a violent asthma or heart attack – we would have an ambulance there in no time.
So swear. Support the ‘We Swear’ campaign to raise awareness of the research gulf. Swear to get fired up and don’t take no for an answer. Get fucking angry that politicians talk the talk so silkily while presiding over decline.
The demand for parity must include research. To make progress, we need research which focuses on mental illness in young people and we need to lobby for it. You only need to consider the progress in HIV treatment over the last 20 years to see that research is a huge part of the answer, or the progress on cancer treatments as a result of the standing the cancer research charities have in our national life.
Mrs May is right that it is not all about the money. But a lot of it is. So here is a fact that makes me swear a fuck of a lot. For every person affected by mental ill health in the U.K. we spend just £8 on research. For dementia – £110. For cancer – £178. Good for cancer. A fucking scandal for mental health.
Three children in every class are affected by a diagnosable mental illness, and the impacts can last a lifetime. If we were funding mental health research like we have other physical illnesses, things would look very different. That suicide fact might not exist.
84% of us acknowledge that not enough is being done to tackle mental illness. So give a **** (the campaign needs asterisks alas for broader reach and for advertising in public places) and join the movement for radical change in attitudes, services and research. And if you bump into Mrs May or Jeremy Hunt, point out that by not investing in care, by not investing in research, by not taking seriously the growing mental health needs of younger people in particular, we are storing up greater problems – and costs – for the future. That much, surely, is so fucking obvious, it’s unbefuckinglievable we even have to fucking say it.
For more information, visit www.mqmentalhealth.org
Alastair Campbell is an Ambassador for Time to Change, Mind and Rethink, the co-founder with Norman Lamb and Andrew Mitchell of Equality4MentalHealth and Patron of the Maytree Suicide Sanctuary
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