Mental Health: More must be done

Caveat accompanies BMHUK’s welcome of the new cross-government national mental health strategy writes Matilda MacAttram.

While welcoming the new national strategy that sets out the plan for the future of mental health care in England, equality groups recognise that real progress will not be achieved unless the enduring discrimination faced by black patients is properly addressed.

 ‘No Health Without Mental Health’ a cross-government strategy for the first time gives mental health the same importance as physical health, and outlines how an emphasis on early intervention and prevention will help tackle the underlying causes of mental ill-health.

Hailed as both a public mental health and social justice document, this report is underpinned by the coalition’s three main guiding principles of freedom, fairness and responsibility.

Health campaigners have welcomed the pledge to ensure patients are protected from avoidable harm and treated in a caring a safe environment. They see the moves to make the Cabinet sub-Committee on Public Health oversee the implementation of this strategy a commitment from the highest levels, to take this issue seriously.

There are many aspects of this new strategy, which if implemented properly will greatly improve the experience of many people who are languishing on secure wards up and down the country, but without a clear commitment to see the numbers of black patients who are detained under the Mental Health Act come down health experts working on the front line say that there is a danger that this new strategy could merely remain another paper exercise.

This document shows that the costs of mental health problems to the economy is a staggering £105 billion, and treatment costs are expected to double in the  next 20 years.

A significant portion of the is spend in mental health care is on high and medium secure units where large numbers of black patients are locked  up,  even when they are well enough to be out in the community. The absence of the support services to help patients out of the system needs to be addressed.

This is just one of the many of the issues that need to be tackled if this new strategy, which has been hailed as a strategy for social justice is going to work.

After the DRE programme what the community expected to see some real change in the experience of African Caribbean patients, but  five years on the experience is poorer and the numbers of people who are ending up in the system has doubled.   

Speaking about the report other campaigners such as Alicia Spence services director of the African Caribbean Community Iniative in Wolverhampton said; “We hope that this strategy is not just another papers exercise, because while this is happening lives are being destroyed and communities are being torn apart.  Failing to do the right thing is not cheap, locked wards are one of the most expensive parts of the system.  We hope that with this new strategy commissioners will have the courage and commitment to resource community led services that have and can make a positive difference to people’s lives.”

Frederick Clarke, the director of Mighty Men of Valour told me; “The commission of services by GPs is a major development, but there would be nothing worse than for people to be given the power to commission for client group that they do not know anything about.  It would be a good idea to for GP consortia that will be responsible for commissioning to engage with the community organisations who have a good track record in supporting people and find out what the needs are, especially in regard to mental health,”

And expressing her view Rachel Barclay director of The Two Way Street community mental health service said; “The title of this strategy is excellent as is breaks down the discrimination that exists between mental and physical health as we all know that the way service users are perceived and treated is completely different from anyone who has a physical health condition. But it is delusional to think that this strategy will make things better unless we actually start to address the real problem of the over population of black people in mental health hospitals,”

Failing those who don't have a voice in the system is not cheap. Without accountability for when things do go wrong the fundamental cultural change that is needed within many of the institutions that make up this services there is a danger that this latest strategy could remain just a pipe dream.

Main picture: Matilda MacAttram is founder and director of Black Mental Health UK, a human rights campaigns group. They work to empower African Caribbean to engage with key stakeholders with a view to improving the experience and reduce the over representation of people from these communities at the coercive end of psychiatric care, in custodial settings and on the National DNA Database.