Is Government policy a major contributor to mental illness?
The recent Report to the NHS in England by the Mental Health Taskforce has led to a sudden flurry of interest in mental illness by both the media and politicians, and the interest is to be warmly welcomed. While serious psychotic conditions such as schizophrenia are relatively rare, few of us are exempt from such mental illnesses as anxiety and depression. These obviously vary in seriousness, but for thousands of people they mean being plunged into a dark, bottomless despair from which, no matter how hard they try, no effort of their own can bring deliverance. The mood lies beyond the reach of reason and argument, disables from all activity and in too many cases takes away even the will to live.
Yet, while the recent publicity is welcome, particularly in attacking the stigma still attached to mental illness, it carries its own dangers. It is all too easy to delude ourselves that once we drag the problem out into the open a solution will quickly follow.
The publicity will certainly help, but we still have a long way to go. The last hundred years have seen breath-taking advances in both medicine and surgery. Antibiotics have revolutionised the treatment of infections, open-heart surgery has prolonged countless lives, and even potential pandemics such as AIDS have been knocked back by a well-targeted medical response.
But there have been no comparable advances in psychiatry. While understanding of the human brain has advanced rapidly, it has not yet led to any major breakthrough in the treatment of mental illness. Eating-disorders still baffle us; such medications as are available for depression and anxiety take a month to act, and in the meantime can make the symptoms even worse; and while counselling and related therapies can give support, and help us ‘confront our demons’, they cannot provide the first-aid that many sufferers desperately need.
Behind these failings lies the fact that our understanding of mental illness has advanced only slowly. This may be due in part to the complexity of the problems, but it also reflects the fact that, compared to the resources we have poured into cancer, coronary disease and AIDS, few resources have been focused on mental illness, due to the mistaken perception that it affects only a tiny minority of the population. Any publicity which helps to correct this complacency is welcome.
In the meantime, our understanding of mental illness remains severely limited. We know that it is influenced by genetics, but the extent of that influence is increasingly being called in question. We also know that mental illness is influenced by biochemical factors, which is why medication can help, at the same time there is no certainty that two people with similar biochemistry will develop the same psychiatric symptoms. Much depends on the individual’s environment, including the weather, the sort of community we live in and our personal circumstances.
But much also depends on the individual’s economic environment, and this is where the Government’s new enthusiasm to tackle mental illness begins to sound like humbug. With one breath it speaks of its determination to promote mental health; with the other it speaks of cut-backs, squeezes and greater ‘efficiencies’.
These are but cruel euphemisms for sackings, redundancies and pay-offs, each of which immediately transforms the environment in which people live, and in too many cases triggers-off a descent into mental illness. Job-cuts cost politicians nothing. They can cost the victims everything. Overnight they find themselves forced into the ranks of those viewed (even by government) as work-shy scroungers; and at the same time they find themselves income-less, crippled with debt and even threatened with homelessness.
Is it any surprise that those with any propensity to mental illness sink under such circumstances? You read that as a result of the economies forced on local councils, hundreds of librarians will lose their jobs. Do you simply read, and pass by? Or do you think, How will these human beings, these librarians, cope? If mental health really matters to government, why does it boast of an economic regime which by its very nature is bound to plunge thousands of people into clinical depression?
Of course, private-sector cut-backs can have exactly the same effect, but the private sector does not trade under the slogan ‘Caring’. Government does, yet it pursues a ruthless economic policy, and one of the clearest foreseeable consequences of that policy is a serious impact on mental health. The resulting cost to the NHS may well be greater than any savings achieved by the ‘efficiencies’.
More is needed than merely raising awareness of mental illness. The problem needs new levels of research and a huge hike in investment. But it also needs a level of political honesty which recognises that government policy itself is already a major contributor to mental illness.