In UK politics people with mental health difficulties are the new worthy victims
In the gap between public opinion and lack of public knowledge, tinkering with mental health provides a cheap way for UK governments to show they really care
Taking the opportunity to turn debate away from strife both local and international, Prime Minister Theresa May announced a number new policies aiming to help people who experience mental health difficulties on 9th January 2017. Speaking at The Charity Commission she fleshed out a new direction for her government, ‘The Sharing Society’, that means “government stepping up” and “going further to help those who have been ignored by government for too long.”
According to the PM, the target of this post-Cameron recalibration is to focus upon giving “those who are just getting by a fair chance”; the people that Ed Miliband in what feels increasingly like the distant past might have called ‘the squeezed middle’. This might, it could be argued, look like a doubling down on the effort to avoid addressing inequality unless the announcement could come with an example of a group of people who would also be helped who were, everyone agreed, deserving of some fresh beneficence from this new and an as-yet indistinct Government. Enter people with mental health difficulties. But not all of us.
While it’s certainly true that people with mental health difficulties have been ignored for too long when a Prime Minister takes the opportunity to make their first speech of the year one that features a slew of hitherto unannounced policies there are two questions that immediately come to mind. The first question is ‘Why these policies?’. The second is ‘why these policies now?’
In reality, the PM was accepting the recommendations of the Mental Health Taskforce Five Year Forward View for Mental Health for the NHS in England, as her predecessor David Cameron had also done a year earlier. Thrown into this were some other goodies, most of which were like last years presents rewrapped rather than anything new. These included: a green paper on Children and Young People’s Mental Health Services (CAMHS); mental health first aid train for schools; the reconfirming of a programme to help young people support other young people having a hard time; an extension to digital services mental services mostly already pre-funded; work around employment and mental health and and extra £15m over an undisclosed time period to extend the provision of alternative places of safety so less people have to places to go when they feel distressed and a restatement of the commitment to suicide reduction.
While the overall sentiment of the policies is honourable there’s a distinct whiff of late-night panic about their detail. They resemble very much of the Life Chances strategy of her predecessor. And panic there is: today was the day of a Tube strike, the first working day after the Red Cross announced that the NHS was a humanitarian crisis that needed them to ferry patients home and one where the UK’s position on the world stage has rarely looked more uncertain. In a country increasingly ill-at-ease with itself that is sailing into an unknown brexit future, May needed to announce something that would garner near universal praise without costing too much and which would stand on its own avoiding the contagion spreading from other more combustible policy areas.
Nearly a decade of concerted work, much of it funded by the coalition government and beyond through national campaigns like Time to Change, has driven mental health up the agenda as a social concern. The message that people with mental health difficulties should not be discriminated against has stuck. This is what creates a particular political opportunity for those wishing to be seen to be doing a very public good. Although people with mental health difficulties actually tend to be poorer, more unhealthy and to rely upon public services more, the general public, by and large, has accepted mental health difficulty does not respect demographic boundaries and that doing something to help people with mental health difficulties is ‘a good thing’.
In fact, the new climate of openness has driven home for many just how prevalent mental health difficulty is. To the general public not immersed to any great degree in the detail of what kind of things might actually be good or needed by people with mental health difficulties an extra anything for mental health is seen as a revelatory step forwards.
The major mental health charities have also helped to strengthen this narrative by pursuing an approach for much of the last decade that applauded any slight shift in policy as an incremental step on an ever upwards trajectory that would eventually deliver people with mental health difficulties to a promised land of well resourced social and medical supports. The effect of this has been like everyone applauding the provision of a tiny blanket while shivering in an unheated cell. ‘Shhh!’ the logic has said, ‘Don’t make a fuss or they’ll take away everything for which we fought.’
This policy of applause makes those of us with longer memories, deeper understanding or more personal involvement seem churlish and bitter when we bring up the long term cuts to social security benefits which many people with mental health difficulties rely upon; the erosion of local authority funding leading to closure of local services and the slow decay of funding to the NHS to support those with long term mental health needs.
Once the go-to group for governments wishing to earn humanity points was people with cancer; but it’s difficult to make policy pledges about cancer without it costing the Treasury a lot of money. Mental health, on the other hand, is often embarrassingly grateful for even the smallest of crumbs from the top table.
This gap between public goodwill and detailed knowledge makes mental health the perfect area for a politician who wishes to be seen to be doing unequivocal good. People with mental health difficulties are the new innocent and untainted victims. Or at least the right sort of people with mental helath difficulties are. Where once we may have judged the goodness of our society by our behaviour toward recent migrants or to those with whom we did not share political or religious ideas, now in this age of polarisation it has been harder to find victims to help that do not tread on the political sensibilities of one regressive group or another. Once we might have helped refugees, now we lock them up. Where once we might have looked to help homeless people, now we destroy their tents. So adept have we become at demonising minorities, or in allowing our right wing press to do so, that it has become more and more difficult to find anyone that the majority of the population will agree should be given a hand.
The challenges in the lives of people who experience mental health difficulties are not usually accompanied by mass demonstrations, burning police cars and emergency Whitehall meetings. No barricades are built; no baton charges captured by shaky-handed amateur media makers. People with mental health difficulties don’t talk back, or get bolshy or seem ungrateful.
The idealised vision of people with mental health difficulties; quiet tragic figures wilting for want of a course of CBT or a mental health first aid course in their school has created a kind of victorian urchin analogue; a group of people you can offer a tiny sliver of comfort to and then bask in the glow of their ‘god bless you sir’’s; convinced in your heart that you are both caring and kind.
Conservative social ideas have often been uncomfortable about disruptive or ungrateful beneficiaries. While those who are born with disabilities, or who are unwell from childhood often win the hearts of conservative policy makers; those who acquire their challenges later in life are often considered to be more suspect; somehow less pure in their neediness. Adults with severe mental health difficulties are often people who have had and currently have complicated lives where they are not so obviously victims. This often means that they are treated with a lack of care, subject to control rather than nurturance and made to carry with them a sense that somehow society does not know how to fit them in. People with intense needs who also have autonomy and agency often attract sanction and criticism — witness the current situation with social security benefits in the UK — rather than care and support.
It is no mistake that the policies announced today by The Prime Minister focus on young people, work and digital services heavily. These are the areas where mental health is most filled with hope, where the beneficiaries seem less complex, less disturbing. As with the original publication of the Five Year Forward View, there is little discussion of the lives of those with more severe mental health difficulties., These are those of us with mental health difficulties whom austerity policies have hurt directly, the people who will not ‘get better’ and who will always need support from The State. The nitty-gritty non-shiney lives of people with severe mental health difficulties are seldom discussed in terms of injustice because there are no guaranteed happy endings and exposing them gives no one a rosy glow.
So, while we can be as happy and excited as a poor child being given an orange for christmas, these policy announcements represent potential improvements for some, while other are left high and dry. Even at the birth of ‘the shared society’; some with mental health difficulties already are missing out on their slice of the pie.
@markoneinfour
Elements of this piece appear in a different form in the article “Theresa May’s mental health speech isn’t anything new — she’s fixing problems the Tories created in the first place” published on 9th January 2017
