The profile of mental health has been raised significantly in the past few years, partly due to campaigning from mental health charities and partly due to high-profile people – from Prince Harry to Professor Green – speaking publicly and candidly about their own mental health problems. All of this should be welcomed as it removes the stigma around mental health and encourages people who are suffering in silence to seek help.
However, the awareness movement is not without its pitfalls. It is sometimes co-opted by people to advance their own agenda, such as increasing a fanbase or grabbing media attention.
YouTube celebrity, Logan Paul, recently caused outrage when he uploaded a video of a dead person in Aokigahara forest in Japan – a place known to be a frequent site for suicides. The video was viewed more than 9m times before Paul took it down. The YouTube “vlogger” apologised, saying he “intended to raise awareness for suicide and suicide prevention”. Judging by the response on Twitter, many people weren’t convinced by his excuse.
The awareness movement has also, at times, been hijacked by politicians and bureaucrats. They publicly declare their commitment to raising awareness – drawing plaudits for their sensitivity and bravery – while simultaneously under-investing in mental health services.
Late last year, it was revealed that half of all Clinical Commissioning Groups – NHS bodies responsible for commissioning healthcare services for their local area – are not planning on spending more on mental health services this financial year, despite a huge increase in demand for these services. Speaking to The Independent, Labour MP Luciana Berger said: “Theresa May claims to be committed to improving mental health but her cuts are harming mental health services.”
A few months earlier, a BBC Radio 5 Live investigation found that, out of 39 mental health trusts that provided figures for their crisis teams, 27 had seen their workload massively increase, “but without a comparable rise in funding”.
Not ‘either-or’ but ‘both’
Mental health stigma is of course very real, affecting the lives of people with mental health problems as well as those close to them. Research has shown that fear of being labelled and stigmatised affects people’s willingness to disclose their illness and seek treatment, so it is laudable that ignorance about the causes of mental ill health and treatment options are being discussed.
But the debate around awareness shouldn’t cover up the very serious problems mental health services face. It is all very well to tell people that it is okay to have a mental health problem and that they should seek the necessary treatment, but if the healthcare system isn’t functioning as it should, awareness campaigns ring hollow.
Public education on mental health problems, and on how to find help, needs to go hand-in-hand with making improvements to mental health services. While politicians speak about mental health awareness and the importance of seeking mental health treatment, further cuts to NHS mental health services are hanging over the fate of those afflicted by mental ill health.
Those in charge of the mental healthcare system should be held accountable and not be allowed to hide behind the sometimes nebulous awareness debate. People with mental health problems not only need public awareness and understanding, but a functioning mental health service.
Health chiefs in Tayside have stated having two centres of excellence is the only safe way forward for inpatient mental health services.
The decision was taken at a meeting of Perth and Kinross Integration Joint Board following months of consultation, campaigning and protest.
It will see general adult psychiatry acute admissions centralised at the Carseview Centre at Dundee’s Ninewells Hospital.
Learning disability inpatient services will be provided at Murray Royal Hospital in Perth alongside other specialist services, including rehabilitation and substance misuse.
The decision will see services relocated from the outdated Strathmartine Hospital and the Mulberry unit at Stracathro Hospital in Angus.
The board voted five to one (an abstention) in favour of the preferred option.
Clinicians believe the steps will secure the future of inpatient services, improve the quality of service and environment available to patients and make services more attractive to potential staff.
Individual health and social care partnerships in Angus, Dundee and Perth and Kinross will be working to enhance mental and health and learning disability services in local communities, where 94% of mental health care is delivered.
More than 100,000 people took part in an often-criticised consultation process and more than 57% of those who responded said they were against the proposals.
NHS Tayside’s medical director Andy Russell, however, said the present model of care could not continue, with the redesign proposed “the only safe option”.
The Government accepts it was wrong to prevent higher levels of claims being made for mental health conditions.
All 1.6 million disability benefit claims are to be reviewed after the Government decided not to contest a High Court ruling on personal independence payment.
The review follows the Government’s acceptance of a ruling against a policy that excluded people with mental health conditions from claiming a higher level of personal independence payment (PIP).
Ministers previously said it could see 220,000 PIP claimants awarded higher payments.
“This will be a complex exercise and of considerable scale, as we will be reconsidering approximately 1.6 million claims,” disabilities minister Sarah Newton said.
Government regulations introduced in March prevented the award of a higher PIP mobility rate if someone was unable to take a familiar journey on their own unless it was “for reasons other than psychological distress”.
The rules, which overruled the decision of an independent 2016 tribunal, meant people incapacitated because of a mental health condition would not be able to receive higher rates of support.
The judgment made in December ruled the policy “blatantly discriminatory” against people with mental health conditions.
Ministers at the time said the decision would affect 164,000 people’s benefits and would cost £3.7bn by 2022.
Work and Pensions Secretary Esther McVey confirmed earlier this month that she would not appeal the verdict but would implement it with payments backdated to the original 2016 tribunal.
Philip Connolly, policy manager at Disability Rights UK, welcomed the announcement.
“This review highlights the ongoing and persistent failures of the assessment process, which is badly designed and implemented,” he said.
“Huge amounts of taxpayers’ money is being wasted on poor quality assessments which deny disabled people benefits that they qualify for.
“We hope this doesn’t mean that some disabled people are going to have to attend yet more assessments.”
It is currently unclear what the timetable for the review will be.
Shadow work and pensions secretary Debbie Abrahams said: “The disabilities minister has refused to publish a timetable of how many months or even years it will take for this ‘complex exercise’ to be completed.
“The Government was wrong to cut PIP benefits in the first place, wrong to bring in the PIP regulations last year and it was wrong to repeatedly ignore the views of the courts.”
SAMH, on the announcement of its findings of a major new study is calling on the Scottish Government to mark the Year of Young People by creating a programme to train all school staff in mental health.
The survey of over 3,000 school staff respondents in Scotland found that more than two-thirds of teachers do not feel they have received sufficient training in mental health to allow them to carry out their role properly; and that only a third of school staff say their school has an effective way of responding to pupils experiencing mental health problems.
SAMH’s Going To Be campaign is drawing attention to the three children in every classroom who experience a mental health problem, but who too often struggle to get the help they need. SAMH would like to see all school staff trained in mental health as part of a whole-school approach, and the survey was carried out to find out more about the experiences of school staff in this area.
The full report of the survey findings, ‘Going To Be… Well-Trained’, is available to download here.
Billy Watson, Chief Executive of SAMH said:
“Although health and wellbeing is a core area of the Curriculum for Excellence, this survey shows clearly that unlike almost all other subject areas teachers have had insufficient or no training on mental health to allow them to do their job.
“Yet our mental health impacts on everything we do. Improving the self-esteem, resilience and wellbeing of all our young people must be a priority if we want them to learn.
“While we know that work on mental health training is underway as part of the Mental Health Strategy, we think more needs to be done – at a quicker pace, and on a national level.
“The situation is urgent and school staff and pupils can’t wait any longer. It’s got to change. We want the Scottish Government to commit to establishing a national programme of mental health training that is consistent to meet the needs of school staff.”
The report was launched at Wallace High School in Stirling, where mental health has been a priority issue for the last two years.
Mr Scott Pennock, Head Teacher at Wallace High School said:
“Wallace High has been incredibly proud to develop pupil and staff mental and emotional wellbeing over the last session. This has included working with See Me to train a number of staff as Scottish Mental Health First Aiders; and utilising Scottish Attainment Challenge funding and dedicated resources to sustain a staff team that has adequate training to support with personalised issues in school day-to-day.
“Training staff has been key to ensuring that we have a staff group with the confidence and skills to support young people with mental health issues – essentially providing a front-line resource. It is vital, in our experience, in the modern world, to create a culture where young people feel they can talk about mental health, and where staff have the necessary training to provide support.”
Find out more about our work on young people’s mental health and join our Going To Be campaign here.
Specialist training programmes being closed down because of a lack of graduates.
The crisis in mental health services is likely to be made worse because of a collapse in trainee nurses following the Government’s decision to scrap bursaries for nursing students last year, MPs have warned.
In a report on the nursing workforce the Commons Health Select Committee said ministers must be prepared to “respond swiftly” if the policy, intended to allow more nurses to be trained, keeps driving down numbers.
The committee said it was particularly concerned that specialist courses in mental health, learning disabilities and community nursing have been rendered financially unviable because of a lack of applicants.
Ucas data shows that applicants aged 21 to 25 dropped 13 per cent while those aged over 26 fell 6 per cent last year.
“This is of great concern, given that a significant proportion of trainee nurses are over the age of 25,” the report said.
“Of particular concern is the fact that mature students make up an even larger proportion of students in the shortage areas of mental health nursing and learning disability nursing.”
“We have heard that some universities providing undergraduate courses in mental health and learning disability nursing have struggled to recruit sufficient students this year, threatening the financial viability of these courses.”
This includes London South Bank University, which did not run its learning disabilities course this year, and Sheffield Hallam which recruited just 70 per cent of its target.
Where are nurses most in demand?
Changes in nurse numbers in each sector since 2010:
General, elderly and adult nurses
Learning disabilities settings
Mental health settings
Source: Health Committee
These are also the areas that have suffered the biggest declines in nurse numbers in recent years, with an increase claimed by the Government happening almost exclusively in acute NHS hospitals.
Sean Duggan, chief executive of the Mental Health Network, said: “It is important to recognise that in the short term we are seeing increasing vacancy rates, more nurses leaving than joining the profession, and a sharp reduction in applicants to nursing degree places – particularly among the mature students who have traditionally been most attracted to mental health and whose wealth of life experience truly enriches the care they provide.
He said it was also impacting on prospective students with caring responsibilities, from low income groups, and from black or minority ethnic backgrounds, which meant the workforce could become less representative of the community it serves.
But since 2017 prospective nurses are required to pay £9,000 a year fees or take out student loans for their training, and this resulted 700 fewer nurses starting training, according to Ucas figures.
This could be devastating as qualified nurses are leaving the NHS in droves after eight years of Government-enforced pay restraint and financial pressure in the NHS meaning many services are under significant strain.
Nurses told the committee that the pressures were a risk to their safety, wellbeing, and even their job.
In one interview reported by the committee, a nurse said “every time I walk onto the ward, my PIN (the professional registration number from the Nursing and Midwifery Council that nurses need to practise in the UK) is on the line.”
Scrapping bursaries for nurses will put patients at risk
Janet Davies, chief executive and general secretary of the Royal College of Nursing, said the loss of nurses and drought in the pipeline of the next generation, is a “double whammy”.
She said: “The report should make for sober reading inside Government. Ministers must stem the losses by easing the pressure in the NHS and social care, valuing staff with a pay rise above inflation and increasing training places.”
Ms Davies added that the RCN welcomed the recommendation “that the Government must now ‘be realistic’ in linking pay to supposed productivity gains”.
Unison’s head of health, Sara Gorton, said: “The foolishness of abolishing the NHS bursary for healthcare students is laid bare in the report.
“The government needs to reverse this ill-thought-out decision, as well as provide proper funding for nursing apprenticeships, so that young people are encouraged to join the nursing profession.”
Labour Shadow Health Secretary, Jonathan Ashworth, said: “Labour shares the Committee’s concerns about removing the nursing bursaries and the Government’s on-going failure to guarantee the rights of EU healthcare staff.
“The truth is that the Prime Minister has overseen an unprecedented workforce crisis in our NHS, which has culminated in the number of nurses falling for the first time since 2013.”