It is entirely welcome that the Prime Minister should choose mental health as one of her first interventions in domestic policy. We need high-profile figures to speak out on mental health, to tackle the stigma and to bring discussion about mental health into the daylight. It was also welcome when David Cameron made a virtually identical speech when he was in Number Ten almost exactly one year ago to the day, and when his deputy Nick Clegg made the same speech, and when any number of health ministers did the same.
We don’t need Theresa May to play the ‘greatest hits’. We need some concrete action to tackle our nation’s mental health crisis. Listening to the PM’s speech, there was little to cheer. May called for a new focus on child and adolescent mental health. She’s right to highlight the issue. But where is the substance? A Department of Health report ‘Future In Mind’ called for this focus over two years ago. Her government has cut Children’s Centres, school nurses, health visitors, youth clubs and child and adolescent mental health services (CAMHS) across the country. A paltry £15million for ‘crisis cafés’ is no replacement for the panoply of support and provision for young people she has sliced from our communities.
And what of her announcement that more teachers will be trained in spotting the signs of mental illness and poor health in their students? Again, this is welcome. Most teachers I speak to witness the early signs of deteriorating mental health in the classroom. Training for most teachers does not cover how to spot signs of self-harm, depression, anxiety and suicidal thoughts. Extra guidance cannot go amiss.
The issue though surely is what happens once the teacher has identified the pupil at risk. If there are not the support services, from talking therapies, counselling, and psychiatric support to acute care and beds, then what is the use of spotting the signs of mental illness? Identifying the need for services and support is only of value if timely support is available.
Despite May’s warm words, she presides over a system teetering on the edge of collapse. Nothing in her speech suggests she grasps the enormity of the situation, or has the policies to tackle it. At the moment, after seven years of pressures on funding, CAHMS is in crisis, with young people left without adequate care and treatment, and their families left in despair. A Royal College of Psychiatrists survey last month showed that 72% of psychiatrists say the NHS services they provide are ‘inadequate’ or ‘very inadequate’.
If ever there was a case of prevention being better than cure, it is young people’s mental health. One in five children will experience a mental health difficulty at least once during their first 11 years. Mental health problems often start in childhood. Half of young adults with mental health problems first developed symptoms by the age of 15, and three-quarters had symptoms in their late teens.
More than half of all adults with mental health problems were diagnosed in childhood. Less than half were treated appropriately at the time. Research by the Centre for Mental Health shows that children have to wait an average of ten years to get appropriate help after they first suffer mental health problems. The delays in treating them is thought to cost our society more than £105billion a year.
Yet two-thirds of primary school children do not have access to a counsellor at their school. CAMHS are struggling to cope with demand – one in five children referred to CAMHS are denied a service. The average waiting time between referral and assessment ranges from just a week in some areas to more than 26 weeks in others – with an average waiting time of nearly two months. Professionals have reported to the NSPCC that waiting times in some areas are measured in years not months.
As pressure builds on other areas of the NHS, money is not being spent on mental health. Recent research by Young Minds has exposed that at least half of areas are diverting money intended for mental health services towards physical health. The real cost is paid by young patients and their families. One police force detained a child for 42 hours over this Christmas period because there was no mental health bed available. The NHS in England is sending patients who are seriously ill with eating disorders to Scotland for treatment because chronic bed shortages mean they cannot be cared for in England. This is simply unacceptable.
When Theresa May stood up to make her speech today, she had a real opportunity. She could have drawn a line under the Coalition Government’s failings, and announced new money to treat society’s mental health. She could have defined herself as a reforming Prime Minister, addressing head-on one of the biggest health challenges of our times. She could have brought hope to thousands of families waiting for treatment, and denied the care their loved ones need. Instead, she came up with more of the same: a ‘thematic review’, warm words and good intentions, but nothing to end the crisis, and no respite for patients and their families.
Luciana Berger is MP for Liverpool Wavertree, President of the Labour Campaign for Mental Health, and a member of the Health Select Committee