Shortly after the Labour party conference in October, Ed Miliband gave a speech about a ‘one nation’ approach to mental health.
He talked of mental health as a challenge that affects us all, no matter who we are. Given that one in four people (constituents, voters…) experiences a mental health problem in any given year, you might think that politicians would, as he put it, be “falling over each other” to do something about it. Yet until recently this hasn’t been the case. Miliband quite rightly acknowledged that “for far too long leading politicians from all parties […] have maintained an almost complete silence about mental health”.
He said that mental health is an “economic challenge holding back prosperity” and the first thing we must do is break down the taboos surrounding it. Most importantly, he appeared to really understand what Mind and other mental health charities have been emphasising for years – that mental health is everyone’s business.
Miliband’s one nation is one in which everybody prospers and everybody plays their part. Responsibility for mental health, as he points out, goes way beyond the NHS. It impacts on, and can be affected by, every aspect of our lives and, as such, we need a coordinated approach from all areas of our society. Employers, schools, communities, local authorities, criminal justice, the benefits system, the media and all of us as individuals have a part to play in improving everyone’s mental health. In every capacity we can help to break down stigma, tackle discrimination, support those with known mental health problems and improve the general mental health and resilience of us all.
While a joined-up approach to mental health is more common sense than radical thinking, it is indisputably good news that mental health is on Miliband’s radar and that it fits the one nation brief so neatly. And his speech is timely. There is a real sense that the tide may be starting to turn for mental health.
Earlier this year, the implementation framework that accompanies the government’s mental health strategy, No Health Without Mental Health, was published. One of the most important features is that this is a cross-departmental framework rather than a Department of Health one, an ambitious plan for improving mental health across several areas of government and society. It involves bodies that don’t necessarily have mental health on their radar but should.
Another important recent development has been commitment from government to giving mental health parity of esteem with physical health. The Health and Social Care Act enshrines this principle in law and the NHS mandate, launched in November, means the NHS commissioning board is held accountable in ensuring these words are turned into actions.
Mind has fought for parity for many years. Mental health services have always been underfunded and overlooked, and the people using those services have lost out as a result. In many parts of the country waiting times treatment are far longer than would be accepted in physical health care. There is no right to choose a secondary mental health provider, as there is for people using physical health services do. And perhaps most shockingly, people the life expectancy of people with mental health problems is up to 20 years shorter than those without.
Miliband is not alone in his efforts to change parliament’s attitude to mental health. The mental health discrimination bill is making its way through the Commons with support from all sides and, last June, several MPs unexpectedly, and for the first time, opened up about their own mental health problems during a debate about services. The debate triggered a huge amount of mental health discussion in the media and it made for an exciting and emotional day in Mind’s offices. Mind, together with Rethink Mental Illness, runs an anti-stigma campaign called Time to Change, and key to the success of the campaign is having high-profile individuals willing to speak out about their own mental health.
Since its launch in 2007, Time to Change campaigning has reached millions of people across England and has seen a four per cent reduction in discrimination as reported by people with mental health problems. There is a long way to go – we cannot expect to remove deep-seated prejudice overnight – but we are making progress. Breaking down stigma also underpins the one nation approach, with Miliband going as far as to say “we cannot build One Nation unless we all speak out about mental health”.
Miliband concluded his speech with:
“We can’t prevent all mental ill-health. There are not cures for all conditions. But we can help change the culture in our country. We can ensure that everyone counts, that everyone matters, and that no one dealing with any form of illness should ever feel ashamed.”
Whatever you think of Miliband’s politics, nobody can argue with that.