1142 GMT September 22, 2019
The average wait for treatment to begin is 19 weeks. One in six people wait longer than six months. Parking the human beings for a second, it makes no sense as a system: physical and mental health are not equivalent, and having a psychotic episode is not the same as breaking your leg. But in the broadest possible terms, this is like fast-streaming people with arthritis while leaving cancer sufferers in a half-year limbo. It’s not a system anyone would design; it’s hard to fathom how it could simply evolve, wrote The Guardian.
Reading the report from the charity Rethink Mental Illness, though, you cannot park the human beings for very long. Heartbreaking testimonies leap off the page: “These answers were on behalf of my husband, who sadly took his own life six weeks ago. I truly believe that, if he had received therapy sooner, he would still be here.” “I was left for months at a time with no contact from my community psychiatric nurse. Following a suicide attempt, I did not hear from them for a month.”
All the determination in the world cannot make more hours in the day, magic more staff on to community psychiatric teams
The perception of the health service from the outside is of a system left threadbare by nearly a decade of underspending and restructuring, held together by the determination of the people working in it. This is wishful thinking: all the determination in the world cannot make more hours in the day, magic more staff on to community psychiatric teams. What’s really going on is a huge amount of suffering, for want of a plan.
Mental health, bear in mind, has been at the center of the government’s rhetoric since 2012, when the Health and Social Care Act specifically brought up ‘parity of esteem’. Its failure to enact or, for that matter, define it notwithstanding, there didn’t appear to be any shortage of intention. There are civic catastrophes going on that seem to be part of a deliberate approach: universal credit is the striking example.
It is a failure as a social safety net, but if your plan is to destroy security as a duty of the state then it’s working quite well. Mental illness is not such a case: David Cameron made a specific pledge to bridge not just the esteem gap but also that of funding. Theresa May made what was, in retrospect, an astonishing speech nearly two years ago, in which she undertook to “employ the power of government as a force for good to transform the way we deal with mental health problems”; it was a ‘historic opportunity’, she said; it would sweep away the years of injustice, the ‘completely unacceptable stigma’. Sure, she said a lot of things that don’t transpire. Yet the failures in this area speak of something more significant than insincerity.
May has been unable to employ that ‘power of government’ because government has, effectively, ceased. It’s disappeared down a rabbit hole in which it has somehow managed to trap us all: when Brexit is all it can talk about, that is all any of us talk about.
Meanwhile, in the spheres where life is lived, where crises occur and professionals wrestle with them, everyone is forced to proceed as though normal service will resume shortly. The long-term plan for the NHS — slated to consider, among many other things, how to spend the extra £2 billion on mental health that the chancellor of the exchequer, Philip Hammond, promised in last month’s budget — was due on 10 December. Two days later, the independent review of the Mental Health Act 1983 was set to deliver, and two days after that, the green paper on adult social care.