To: Luciana Berger
CC: Jeremy Corbyn
CC: Heidi Alexander
CC: Owen Smith
RE: The impact on mental health due to austerity measures.
Dear Ms Luciana Berger et al,
Congratulations on your post, and may we all thank you, for taking this ministerial position on an area that has been gravely ignored.
We at #uniteandight (which is a collaboration of 24 groups) wish to raise some concerns we have, and highlight immediate changes that are required.
1- Mr Duncan Smith insisted that the “most vulnerable people in our society” will be protected under his latest reforms. “Nearly 11 million adults in the UK have a common mental health condition …We also know that being out of work for four weeks or more can actually effect people’s mental health, even if the original reason for ill health was a physical one.” Yet the DWP has said that it only includes physical disabilities as making a person “vulnerable”. Having a mental health condition, no matter how serious, does not count. However, poor mental health is fatal in 2013, figures released by the Office for National Statistics (ONS) show that 6,233 suicides of people over the age of 15 were registered, 252 more than in 2012, which represents a 4% increase. I am not suggesting that 6,233 people have prematurely died due to welfare reform, but I wish to stress how vulnerable this group is.
2- Under DSM5 the latest directory of mental health conditions, it exhibits the diversity of what counts as mental health conditions. Examples of such diversity are Autism spectrum disorder, Tourette syndrome, and other Neurodevelopmental disorders, Schizophrenia spectrum and other psychotic disorders including delusion disorder, bipolar I disorder, bipolar II disorder, Depressive, anxiety and OCD related disorders, Trauma- and stressor-related disorders, Dissociative disorders, Dementia, In 2012, 29873 women and 13984 men died from dementia. This is one of the conditions under the banner of mental health, but exactly how can we collectively pigeonhole people whose needs and conditions are multifarious?
3- To suggest that people who sit at home wallowing in self pity would feel better once they are employed is indicative of their ignorance. This only loosely alludes to depression, which incidentally is not a condition caused entirely by environmental factors, this is too deterministic and generalistic. Researchers have noted differences in the brains of people who are depressed as compared to people who are not. For instance, the hippocampus, a small part of the brain that is vital to the storage of memories, appears to be smaller in some people with a history of depression than in those who’ve never been depressed. A smaller hippocampus has fewer serotonin receptors. There are many people with depression who could possibly have everything in life to be content, yet they are depressed. It is not a choice, nor can it be solved by incentivising the person. If they are depressed, then nothing will matter, they are lost in a bleak hole of despair. Withdraw their welfare, withdraw their support, and they will not be motivated to improve their lives, for the already believe that life is too painful to endure, they have no hope, and are one prod away from suicide.
4-This ignorance is what had caused stigma. Stigma is not isolated to the public, but to the media portrayal of people with mental health conditions, professionals judgment of clients including therapists, the Department of Work and Pensions, the NHS, the Government and the sufferer themselves. If everyone is not exposed to the truth about mental health conditions, and understands the facts not the stereotypes, then no legislation will change. Time to Change has started the ball rolling, but this is something only known about by clients. We are not targeting those who do not understand mental health conditions, and so prejudice prevails.
5- Due to austerity measure, all health services have been cut. Since mental health has NEVER been on a par with physical health, these cuts have resulted in the service entirely existing for crisis care only such as hospitalisation via sectioning. There are no preventative measure, there are no provisions for care, treatment, or therapy for those who require regular living support with professionals. CPNs have been reduced to giving clients (clients) medicines, and ensuring they are taken. Psychologists do not have the funds to take on clients who need long term therapy which by the very nature of their paradigm treatment is long term for years.
6-Whilst David Cameron and Jeremy Hunt gloat at stating CBT has increased and more people now have access to this service, they fail to realise this this therapy is a basic therapy. It works by uniting two paradigms, Behavioural and cognitive. The assumptions of behaviourism is that all behaviour is learnt and can therefore be unlearnt. The cognitive assumption is that our brains are like a computer. The programmes we run are the ones we are given. We cannot do something we do not have a programme for. Therefore we have to re-programme our thinking. There is not one Cognitive Behavioural therapist with ethics that would touch anyone with complex mental health conditions. These type of therapy would not help the client recover, it would not offer the client what they need and it potentially could open Pandora’s box without the means to support client’s emotional and mental torment. Therefore, CBT must be understood, and its limitations must be recognised. A posting on the governments’ Contracts Finder website reveals that the DWP intend to spend £21 million on the online CBT. Which incidentally is already free via Get.gg, Beating the blues, and Fear fighter. So why they are investing in services that are already free is foolhardy. It is not clear how much they intend to spend on human therapists, where they think they can get them, or whether they will actually have training and experience to do the job. Counsellors intend to offer “integrated employment and mental health support to claimants with common mental health conditions”. Yet, Prof Glenys Parry, chief investigator of the government-funded AdEPT (Adverse Effects of Psychological Therapies) study, said that there needs to be greater recognition of the potential for counselling to make people worse. Additionally since these sessions will be run via JCP it will be based on slots of 6-12 sessions maximum, which is the limited slots available to all NHS clients. Mental health practitioners have an ethical responsibility to protect and maintain the confidentiality of their clients. With online therapy the security of the client’s records and information could be jeopardised and confidentiality is at greater risk of being inappropriately breached given the written nature of the medium. Online therapy is currently deemed inappropriate for diagnosis of clinical issues such as chronic depression and psychotic. A disadvantage is that counselling typically takes longer to produce benefits that are noticeable to the person receiving treatment. Another problem is that counselling is not about giving advice, but can be about enabling the client to consider various options. For a client who needs guidance, tools to cope, direction, techniques, etc due to complex mental health conditions they will find they are pouring out their heart to a blank wall, and getting nothing back. Counsellor’s are a sounding board, but most people with complex mental health conditions are very open, and talk incessantly about their issues because they want to be told how to remedy this. They do not need a sounding board. Lastly, the aim of this support is not to empower the client, and help them manage their conditions to live life more skilful, but it is entirely aimed at getting the client into employment. The objectives of many clients suffering from mental health is more extensive than employment. Clients desire and need life skills, coping skills, to obtain a full life with relations, academia, socialising, self care, finances, even being able to go on holiday! To limit the focus to ensuring the client is suitable for work, rejects the exhaustive matters of contention.
7-Mental health cuts are costing the NHS millions long-term as reduced preventive measures mean more people are ending up in hospital. A report by the London School of Economics and Political Science (LSE), commissioned by the Care and Support Alliance, has revealed that since 2005, 30,000 people with mental health problems have lost their social care support, following a £90m shortfall in funding due to cuts to local authority budgets. The research also shows that people with mental health problems have been disproportionately affected compared with older people or those with physical disabilities. Charities which had been the safety net for clients due to NHS cuts, now have had their funding also cut. Mind’s support workers have now had their remit changed to housing related support work only due the findings at homeless.org where 80% of those homeless reported some form of mental health issue, 45% had been diagnosed with a mental health issue. Rethink Mental Illness, has found that services that help young people recover from psychosis, are struggling to survive in the face of major funding cuts. All charities have been hit by austerity. Their funding has been cut, just as more people than ever needs them. All mental health clients deserve access to a support worker, who they can see regular, talk out issues, practice exposure therapies, gain access to justice through advocates, get support with form filling such as council housing and welfare. Someone who is in regular contact with clients will notice when someone is behaving differently to their own norm, and are heading towards crisis. The support worker can intervene before the client hits crisis, and help them through particularly fragile episodes. However, charities funding cuts should not be the ‘last straw on the camels back’. Mental health clients should be protected by NHS services who are obliged to comply with the recommendations in the Francis Report to improve care and safety for clients. NHS England have funded the additional costs of implementing these recommendations in the acute trusts but have withheld equivalent funding from mental health services, creating a significant gap in the budget.
8- We are all aware of the potential DWP deaths. We have read the names, we have seen their pictures, we have laid flowers on the lawn outside Westminster for every human being who has prematurely died due to sanctions and the mental turmoil of Work Capability assessments. UK Government’s reforms now, for the first time, has officially been blamed for his death of Michael O’Sullivan, a 60-year-old, after a coroner found that the “trigger” for his suicide was “his recent assessment by a Department of Work and Pensions (DWP) doctor as being fit for work”. The inquest heard that the Atos Healthcare-employed doctor assessing O’Sullivan for the DWP, a former orthopaedic surgeon, had not taken the views of other doctors treating him that he was not fit for work. The coroner was told that the doctor had not asked O’Sullivan if he had any suicidal thoughts during the 90-minute assessment which would have been so incredibly unbearable for him, that many would have said anything to escape the room, even though he had mentioned them in a DWP questionnaire.
Like many with mental health conditions he was a father with serious mental health problems, who killed himself after being hounded back to work by the DWP. It is incomprehensibly to someone who has never suffered mental health, but it is the most consuming, overwhelming and painful, emotional, mental and physical torture. When pushed, the only escape is to jump, and whilst we believe Michael represents the tip of the iceberg, we are terrified that many more will follow him.
All those with mental health conditions are terrified. Terrified of the mental torture they live with day to day. Terrified of prejudice and stigma. Terrified of welfare reforms, and assessments akin to mentally abusive interrogations. But most of all they are terrified that they simply cannot hold on any longer. That all this pressure from ‘fit for work’, the scrounger rhetoric, the failing services that now rely on the medical model and dope clients up to be compliant, and the loss of support are all pushing this vulnerable group of human beings to the edge and they are terrified that they too will die. On behalf of all those with mental health conditions, a beacon of hope has been ignited by your party. Please do not extinguish that beacon.
I apologise for the length of this letter. This area in particular has been swept under the carpet, and so now that we have a beacon to turn to, we are flooding you with all our concerns!!!