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The Guardian view on mental health: mind the gap The Guardian view on mental health: mind the gap
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The shocking death of Robin Williams, the depressive who made the whole world laugh, is a reminder of how hard it can be to help people with mental illness. Being able to pick your own rehab clinic or fund your own therapy is no guarantee of getting well. But as many a mental health patient in Britain would testify, it makes it more likely than being reliant on the current lottery that is provided by an NHS which historically has never given mental illness the priority it needs.The shocking death of Robin Williams, the depressive who made the whole world laugh, is a reminder of how hard it can be to help people with mental illness. Being able to pick your own rehab clinic or fund your own therapy is no guarantee of getting well. But as many a mental health patient in Britain would testify, it makes it more likely than being reliant on the current lottery that is provided by an NHS which historically has never given mental illness the priority it needs.
There are changes afoot. In some ways, it is the best of times: people can be more open about their experiences as the stigma of mental illness is reduced. Last week, the deputy prime minister Nick Clegg promised a Lib Dem manifesto commitment to spend £50m more on research funding. The health minister Norman Lamb – also a Lib Dem – was outspoken in his criticism when NHS England and the funding agency Monitor recommended that the tariff for mental health services be cut by 20% more than the tariff for acute medical services. There are changes afoot. In some ways, it is the best of times: people can be more open about their experiences as the stigma of mental illness is reduced. Last week, the deputy prime minister Nick Clegg promised a Lib Dem manifesto commitment to spend £50m more on research funding. The health minister Norman Lamb – also a Lib Dem – was outspoken in his criticism when NHS England and the funding agency Monitor recommended that the tariff for mental health services be cut by 20% more than the tariff for acute medical services.
But the two interventions reveal that it is also the worst of times. The commitment to parity of esteem between attitudes to mental and physical health may now be universally accepted, but the gap is as wide as ever. Mental illness accounts for more than a fifth of the NHS “disease burden”, but gets only a tenth of the cash. In practical terms, the cuts that Mr Lamb attacked mean the axing of the kind of low-cost schemes intended to help people suffering, say, mild or moderate depression. That makes it more likely that they become more ill. It means beds become scarcer and scarcer, and services for under-18s, when most mental health problems begin, reach fewer and fewer of those who need them. But the two interventions reveal that it is also the worst of times. The commitment to parity of esteem between attitudes to mental and physical health may now be universally accepted, but the gap is as wide as ever. Mental illness accounts for more than a fifth of the NHS “disease burden”, but gets only a tenth of the cash. In practical terms, the cuts that Mr Lamb attacked mean the axing of the kind of low-cost schemes intended to help people suffering, say, mild or moderate depression. That makes it more likely that they become more ill. It means beds become scarcer and scarcer, and services for under-18s, when most mental health problems begin, reach fewer and fewer of those who need them.
But funding is only one headline issue. Mentally ill patients have none of the rights available to the physically ill. There is no guaranteed maximum waiting time for treatment and no universal standard of access to care. Last month, freedom of information requests by the shadow health minister Luciana Berger revealed that two-thirds of the clinical commissioning groups who responded were spending less than 10% of their budgets on mental health. That included not just prosperous areas like Surrey or Devon but CCGs in poor inner-city areas where mental health problems tend to be worse, like Bradford and Southport.But funding is only one headline issue. Mentally ill patients have none of the rights available to the physically ill. There is no guaranteed maximum waiting time for treatment and no universal standard of access to care. Last month, freedom of information requests by the shadow health minister Luciana Berger revealed that two-thirds of the clinical commissioning groups who responded were spending less than 10% of their budgets on mental health. That included not just prosperous areas like Surrey or Devon but CCGs in poor inner-city areas where mental health problems tend to be worse, like Bradford and Southport.
Mental health charities welcome the progress that is being made. But at the same time, they warn that every aspect of the system is under unprecedented stress. Patients struggle to get an appointment to see their general practitioner, GPs fight for a referral, and treatment itself becomes harder to access. No health without mental health, said the government two years ago. There is a long way to go.Mental health charities welcome the progress that is being made. But at the same time, they warn that every aspect of the system is under unprecedented stress. Patients struggle to get an appointment to see their general practitioner, GPs fight for a referral, and treatment itself becomes harder to access. No health without mental health, said the government two years ago. There is a long way to go.