Tag Archives: Mental health

New Horizons for mental health service users

Continuing the pre-Christmas rush to release big and/or important documents – last week brought us the Social Work Task Force final report and the CQC’s adult social care review – today the government launches its new 10-year strategy for mental health, New Horizons: A Shared Vision for Mental Health.

A quick skim through the 100-page document reveals a few key themes to the strategy, including;

  • Improving the mental wellbeing of the entire population. The inclusive nature of this strategy, to me, will help to bring down the stigma of mental health issues, which still looms large. Also, prevention is easier (and cheaper) than cure
  • Early intervention, including treating mental health problems in children and adolescents, with such things as counsellors in schools. Many children with depression go undiagnosed and often go on to have mental health problems in adulthood, again, prevention is better than cure
  • Getting people with mental health problems back into work – this can really help with self-esteem and bring people back into ‘normal’ society and also reduces the cost to the taxpayer in benefits
  • Linked to this is a campaign to tackle mental health stigma. This is needed to help ensure the other 3 points are successful.

Thus far, the response from mental health organisations has been positive. Paul Jenkins, chief executive of Rethink said it could (note: could) ‘revolutionise the quality of life and care available to people affected by severe mental illness’.

Meanwhile, Mind’s chief executive Paul Farmer has described it as a ‘turning point’ for mental health and welcomed the focus on prevention and wellbeing.

However, Farmer also noted that there is, as yet, no action plan for making the vision of New Horizons become a reality. There are action points in the document, but they are light on detail. He also added that in many areas basic mental health services are still lacking and this should not be ignored.

This hits 2 large nails on the head; government strategies often sound impressive and it’s easy to get carried away and think how good things will be, but ignoring how it will get made into reality, and such documents can also distract from what’s happening (or not) on the ground that needs to be addressed urgently.

So, while the strategy has many of the right elements in it to make genuine strides in improving the care and wellbeing of people with mental health problems, only when the action plan is in place – along with guarantees of funding, or at least no cuts to it – will it be worth getting properly excited about.

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Breaking sport’s mental health stigma

It is the illness that dare not speak its name. Mental health has traditionally been one of sport’s great taboos; nobody talked about it, and those who did risked ridicule and career suicide.

For instance, footballer Stan Collymore was openly ridiculed by his then manager John Gregory and the press when he sought treatment for depression in 1999. When boxer Frank Bruno was sectioned under the Mental Health Act, the ever-sensitive Sun ran the headline ‘Bonkers Bruno locked up’ – although this was changed in later editions.

It’s no wonder sports stars keep things bottled up. Admitting to a perceived weakness in the macho world of sport is just not done; they could be considered unstable or unreliable by managers, and opposition players and fans would ruthlessly use it against them.

The tragic death of German goalkeeper Robert Enke demonstrates an extreme conclusion of this stigma and the fear of its effects.

But Enke’s death may prove to be a turning point in addressing mental health stigma in sport – and more widely. The story was reported around the world and gave people an insight into the mind of someone with depression.

This was followed last night by an Inside Sport special on BBC1. The programme took a considered look at mental health problems in sport – including high-profile cases such as cricketer Marcus Trescothick and Bruno.

The programme eschewed sensationalism and gave them time to explain how they feel when they are suffering problems and – just as importantly – how they manage it and now lead ‘normal’ lives again.

The fact that these two, and others, such as Serena Williams, Neil Lennon and Ronnie O’Sullivan have ‘come out’ and admitted to having mental health problems is helping to slowly break down the stigma.

It shouldn’t be surprising that sportspeople suffer mental health problems, because the pressures must be intense; coping with the expectations of coaches, fans and the media; trying to be the best in the world; dealing with the highs and lows that sport brings; keeping at the peak of physical fitness, for example.

After all, they aren’t superhuman. While some may be fabulously remunerated for, essentially, playing games for a living, it doesn’t change their basic human nature. Money doesn’t make you happy.

While Robert Enke’s death shows how deeply ingrained the stigma of mental health problems – or fear of stigma – still is, people are beginning to understand more about it and that it is an illness and not simply a case of someone ‘pulling themselves together’. Today, Collymore and Bruno would be viewed much more sympathetically, including by the national media.

Programmes like Inside Sport, and idolised sports stars admitting their problems, will help to change attitudes. It may be a long, slow process, but it is changing and hopefully that will mean that there will not be more cases like Enke in the future.

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Big Care Debate – any closer to a solution?

The Big Care Debate closed last Friday (the 13th, ominously, for those of a superstitious bent) ending the consultation on the government’s green paper, Shaping the future of care together , which set out the government’s options for the future funding of adult social care.

Now, the Department of Health will go away and contemplate the results, before, in theory, coming back with a White Paper, possibly in early 2010.

But with an election looming, I wonder if any of it will actually get through and make it into law.  

A spokesperson from the DH told me earlier in the year that if there is no consensus from the Big Care Debate on the best way forward, then it may go to a further period of consultation.

Looking at the reactions to the green paper from various groups, there seems to be little consensus; there have been criticisms, notably from mental health and learning disability groups, that the green paper focused on too much on older people. Indeed, much of the media focus has been on old age care funding and people not having to sell their homes to pay for residential care costs.

But then, older people’s groups, such as the National Pensioners’ Convention, have also voiced dismay over the government’s dismissal of the option to pay for care from direct taxation.

This option also found favour in a Joseph Rowntree Foundation survey. But then other organisations have supported the partnership and comprehensive models of funding the government suggested, which involve insurance and some state provision or the creation of a National Care Service.

If this is reflected among the wider responses, then we could be in for further consultation, which neatly kicks the debate into election time, when nothing concrete will happen because every politician will be scrapping for votes.

So, it seems like the social care industry will be in limbo for some time to come. And all the while the current regime will continue to creak along, and the problems within it will continue to mount, and – crucially – service users will continue to suffer at the hands of a much-disliked and over-complicated funding system.

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