Twitter is rarely the kindest or most compassionate place to share your opinions. As a mental health advocate who is open about my diagnoses, it is no surprise that people online use them as a weapon against me. The most common put-down I receive is that I am not entitled to have an opinion on politics – and any opinion I do have cannot be trusted – because I have multiple mental health conditions.
These people are entirely wrong. Mental health and mental healthcare are political and it’s more important than ever that people with mental ill health are politically engaged and their opinions taken seriously. After all, we know better than anyone how the government is failing us.
Mental health services in Britain have been severely underfunded since the coalition government introduced austerity measures in 2010. Let’s be clear, austerity was an ideological decision rather than an inevitability. It did not have to happen. David Cameron’s party made a conscious choice to balance the budget on the backs of vital services, at the expense of some of the most vulnerable people in our society. This choice has hugely affected the lives of people with mental health problems, from those with mild conditions to others suffering from chronic issues.
In 2017-18, the government spent around £12bn on mental health services in England. But despite soundbites about parity between mental and physical health problems, almost half of England’s 60 NHS mental health trusts have seen their cash budgets decrease since 2012. Despite population growth and an increase in the number of people needing services, the government still spends less on mental healthcare now than it did nearly a decade ago. In 2017, there were 5000 fewer mental health nurses than when the Conservative party came to office.
Overall funding levels also disguise changes in the way mental health funding is allocated, with more money going to talking therapy services aimed at people with less severe problems, and less going to more specialised staff and facilities.
Under a government led by Boris Johnson – who has suggested that “hard work” can cure depression – mental health services are likely to be further cut or co-opted. At the same time, mental health conditions may start to affect more people than ever before as inequality increases and life, for many, gets harder. People like me have already suffered as a direct result of Tory mental health policies – not only do we deserve to be listened to, but we can offer valuable insight into what isn’t working.
While people often try to shut me down when I speak about politics, a flurry of recent initiatives have encouraged people like me to be open about their conditions in order to reduce stigma. Doing so is posited as something radical that will, in itself, bring about change. While it is, of course, crucial we address the stigma that surrounds mental illness, talking about our individual conditions and ignoring the political context in which we are suffering is not enough.
It is no wonder the government, which is behind schemes like the Time to Talk Day, is encouraging us to chat and eat biscuits, but not to discuss the policy decisions that have made things so much harder for us.
According to NHS Digital, since the Tories gained office, the number of people detained under the Mental Health Act has nearly doubled from 26,481 in 2008-09 to 49,998 in 2018-19. This shows how poorly equipped the current infrastructure is to cope with the number of people needing mental health support.
While people suffer on dangerously long waiting lists, their illnesses are likely to become more severe. This includes hundreds of children each year who have to wait months for eating disorder treatment – an issue that is made all the more serious because eating disorders are progressive illnesses – they get worse over time. The more quickly someone with an eating disorder receives treatment, the more likely they are to recover.
The Tories and their empty promises cannot be trusted. If the current trends continue, mental health services will get worse over the next five years, while demand increases, as growing inequality plunges more people into debt and poverty. Changes to the benefits system are already exacerbating mental health problems, as people are put under immense stress as they are forced to jump through hoops to receive support.
Government initiatives like Time to Talk seek to shift the focus away from underfunded and inadequate mental health services and place the onus on sufferers to talk to others in an attempt to ‘feel better’. This individualisation of mental health puts undue responsibility on to people who need appropriate professional intervention, rather than a conversation with their friends.
While talking to others about your condition might provide a little relief, it’s more important that mental health sufferers are given the opportunity to discuss and examine the political choices that have compounded their problems and made inaccessible many of the services that could have helped them. By doing this, we can at least keep mental healthcare on the agenda.
Harriet Williamson is a freelance journalist and mental health activist.