Mental health

There is a rare agreement amidst the noise of this election. All parties agree we need to spend more on mental health services and need to do more to help those with mental health problems.

So let me pose a couple of  questions today. What initiatives nationally would make best use of additional money?  And for those of you living in the Thames Valley, what additional local facilities and staff do we most need?

There are a range of therapies that are used for differing conditions, where experience and practice can refine the approaches to seek to improve the success rate. There are drug treatments for things like depression, where the medics need to be careful not to create a dependence on drugs which becomes a problem in its own right.

I find in many of the unsatisfactory debates about public service it is often nothing other than a bidding war where £1bn is good and £2bn is much better.  Spending the money wisely should be a bigger part of the debate. Indeed we should start with what we need, and then cost it to see when and how we can afford it.

130 Comments

  1. Mark B
    November 24, 2019

    Good morning.

    Difficult question to answer unless one works in this field and has first hand knowledge. But giving more money to various charities is not what I would consider a wise move. It will not benefit those most in need and only enrich those who seek to profit from others problems.

    Our kind host is right, politicians and parties need to come with workable policy after detailed research. From that the level of funding can be determined and ‘feedback’ mechanisms put in place to monitor the effect of such policies and spending.

    People are sick of the usual knee jerk reaction of politicians, especially in an election, to just say; “More money !” without proper scrutiny. No wonder the country is in a mess.

    1. agricola
      November 24, 2019

      True Mark, charities can cover the downside of the effects of lack of good mental health, like lack of housing or sustenance, but that can only be part of the answer. As you imply too many charities are businesses, preying on the good nature of donors to the benefit of directors.

      1. Lifelogic
        November 24, 2019

        The favourite activity of most charities is to exaggerate the problem is larger than it is and to demand more money, more regulations, more rights more government action. When do you hear of a charity saying “we have now solved the problem of X and have decided we are no longer needed and so are disbanding the outfit!

        Look at all the mad climate alarmist “charities” – these are really massive businesses, propaganda outfit and religions!

        1. hefner
          November 24, 2019

          If you had ever been curious enough you might have realised that a lot of what you call environmental charities are not charities but have a small, sometimes very small charitable, ‘division’ and really are so called non-profit organisations (like the CBI) with members paying an annual subscription, and acting as pressure groups and/or think tanks allowing them to get some money from members and occasional individuals, yes, but mainly from other organised groups. The information on ‘charities’ like Friends of the Earth, Greenpeace, WWF and other similarly inclined is not that difficult to find (for anybody curious enough, but such a qualificative might not cover your type, better preferring bellowing day in day out half-baked statements). I do not salute you.

          1. Edward2
            November 24, 2019

            Back to sarcasm again Hefner I notice.
            Poor substitute for a well made argument.

          2. NickC
            November 24, 2019

            Hefner, It is one of the defining characteristics of Remains that they apparently cannot help but engage in ad hominem attacks. With your sneers about Lifelogic not being “curious”, engaging in “bellowing” and making “half-baked statements”, you fit the bill.

      2. oldwulf
        November 24, 2019

        To most of us, “mental health” is a nebulous concept. We all have good days and bad days. How many bad days does one need to have before a “mental health” issue is diagnosed. What constitutes a “bad day” and who has the responsibility of diagnosing it – or at least recognising the possibility of an issue. Family, friends and work colleagues have a part to play andso perhaps money should be spent in providing general education and one central contact point.
        It maybe that one designated charity such as MIND could be the focal point but there would have to be some ground rules as to the use of public money including the rates of executive pay, which is touched on by agricola.

        When a mental health issue is identified then presumably something can be done for the individual. This is likely to bring the NHS into the equation.

        For my own part, I have no professional involvement in mental health issues. My thoughts are the result of the suicide in 2017, of a young friend. He had served in the armed forces and was employed as an armed police officer. I believe that he had personal issues and had received some counselling a few months prior to his death. Unfortunately, the counselling was not enough. It may be that my friend’s extreme solution was influenced by his army background, who knows.

        There are probably similar tragedies up and down the UK.

        1. Iain Gill
          November 24, 2019

          I follow the twitter feed of one of the train companies, one which is immediately honest if disruption is caused by suicide by walking in front of a train. Sadly it seems every few days, and never a week goes by without this happening.

          Whatever money is spent should be marked against reducing this.

          1. Iain Gill
            November 24, 2019

            I wonder if the lack of safety net for men is partly to blame. relationship breakdown often leads to the man having no roof over his head, no money, etc. whereas the female is generally given a B & B at least (which is often not ideal, especially if moved frequently and trying to get kids to school). maybe a simple respite place for blokes to go and relax, be warm, have a roof, etc, would help. much of the support network which used to provide this has disappeared as folk have moved around so much now.

  2. agricola
    November 24, 2019

    I come to this with no personal experiece and no medical knowledge. My starting point would be to identify the causes and these must be many and varied. I would then try to eliminate, alleviate, or treat those causes. Only the medical professionals can define all the causes. They could be post natal, battle stress, deriving from drug dependency past or present, depression, grief, and a hundred and one things I have not even heard of.

    It would then help to define the extent of each cause in our population of 70 million. Having done that you might be able to calculate the cost of treatment be it short term or life long. Only then can you have any idea of cost. Without the above knowledge, banding about figures of ÂŁ1 million or any politically contrived sum is totally meaningless.

    If government is intent on tackling mental health it has to be a national programme with facilities everywhere not just Wokingham, much as it may be symptomatic and dear to our hosts heart. If you fail to do it nationally, as in rubbish collection and recycling, you can witness the shambles that ensues.

    1. Mark B
      November 24, 2019

      Agreed. It must also be non-political and cross party. No matter who is voted into office, the policy must be the same and sensibly funded and administered.

    2. Fred H
      November 24, 2019

      Sir John asks about the region of Thames Valley not just one town – Wokingham.

      1. agricola
        November 24, 2019

        Pedantic.

        1. Fred H
          November 24, 2019

          no, just putting you right. Wokingham is a small town in a great big area – Thames Valley. Maybe you don’t know that?

  3. Shirley
    November 24, 2019

    Let’s get to the nub of this problem. Why such a massive increase in mental health problems?

    Is it because the pressures of life are so hard that many cannot cope, or is it that people now expect an easy life and cannot cope with the reality? Not all sufferers are dug addicts, or come from poor families. How do they cope in genuinely poor countries?

    If we can, it’s a better use of money to solve the problem that causes it, rather than just treat the symptoms.

    1. Shirley
      November 24, 2019

      Apologies for the typo: I intended to type ‘drug addicts’, but it applies equally to other addictions.

      1. IanT
        November 24, 2019

        I just assumed a “Dug” addict was some one who couldn’t stay away from their allotment Shirley!

        It does seem though that any issue within Society is immediately met with cries of “We are not spending enough on this!”. The problems are endless & the money supply is not – something most of our politicians seem determined to ignore at the moment.

        Throwing more money at the NHS is rather pointless unless it is well spent and that requires good management, something I’m not convinced we can assume is always there.

    2. agricola
      November 24, 2019

      You are right about the pressures of life. I would maintain that an almost doubling of the population in my lifetime does not help. You would be agreeably surprised at what a sense of relief can be experienced from living in a country twice the size of the UK but with approaching half the number of people. Driving can be enjoyed at 1960s levels, road rage is none existent.

      It would be interesting to see comparative figures for all the different forms of mental health in the UK and Spain. Such figures might offer a few clues and solutions.

      1. Iain Gill
        November 24, 2019

        it cannot help that justice is missing in our society, eg the bias in the financial ombudsman service, that the streets are not safe, policing has collapsed upon itself into a politically correct fantasy land, jobs are transitory, females are rewarded for having kids (why work when you can stop taking the pill without the agreement of the male, and get his money for life or benefits), people are forced to move often for work so dont have a support network around them, and others are forced to stay in places they hate by the way social housing works. a lot of it is to do with the manipulation of society by our political class, in general we would be all better off if people were making their own decisions rather than having them forced on them by the state.

    3. Fred H
      November 24, 2019

      Shirley….I think you are on the right track talking about not being able to cope. Children are exposed to societal ‘norms’ and pressures which develop into expectations often wildly unreasonable. This disappointment shifts towards loss of self-worth and encourages seeking solace in unwise and potentially dangerous behaviours. At the other end of age grouping, people have celebrity and ‘success’ thrown at them at every turn, and this can lead to inward reflection of life ‘not working’ for them. Seeking comfort in unwise and potentially dangerous behaviours is attractive. Television, film and magazines, and worst of all social media feeds this expectation.

    4. Iain Gill
      November 24, 2019

      I think a lot of it is to do with the breakdown of the old support networks. I look back and my dad had his brother in the next town, my brother is in Australia. My dad worked within a 50 mile radius different jobs his entire life. I have worked in tens and tens of countries all around the world, and probably every single county in the UK. The old support network that could see you were stressed, and intervene in simple ways, is simply not there for many people. And is not there when things get extreme. Not helped by the cliff face that you go over if you have financial or work problems, its not a gradual slope its completely vertical.

      So on the whole I think its stuff like this.

      1. Al
        November 25, 2019

        Agree completely. The other problem is the lack of entry level jobs, due to mechanisation, the disappearance of factory work, and the increasing degree requirements even for roles like receptionist. It is very easy for someone, once rendered incapable of performing their own role through age injury or illness to find it impossible to find any form of income.

        And with the current standards for benefits being reported as declining terminal cancer patients, those who are in genuine need (and haven’t learned how to game the system because they’ve been working) have no safety net at all.

        1. Iain Gill
          November 25, 2019

          yes

          not just that a lot of people have been displaced from the workforce by political social manipulation, for instance in some lines of work work visas are being printed, despite market already being saturated, and the incomers just undercut and displace locals

  4. margaret
    November 24, 2019

    I refer many to our fairly new service in our local town . I have somewhere to refer them to at last rather than directly to hospital psychiatrists. There a few medications which can be prescribed and are used more often. A couple of these change behaviour , sometimes and only sometimes for the better, Remember mental health is a far bigger problem than simply being depressed . It includes many congenital and ideopathic derivations.The problem of mental health needs to be triaged effectively.
    Since our town has had this service it is taken off and unfortunately the waiting list is too long . The way of referral is predominantly self -referral; by telephone , filling forms, either by paper or IT. As you can imagine sufferers cannot always physically do this . It needs will power , a positive slant and the skills to be able to self help. Even sufferers who make an appointment to see their clinicians ;- the Nurses and Dr’s, have enough optimism to see a beneficial outcome, but many don’t get there.
    The second solution would be to have a walk in centre for mental health needs , strongly triaged at point of entry to stop the inebriated and trouble causers being disruptive.Mental Health is now more openly talked about but still difficult to easily be accessed and slightly out of sight.

    1. Iain Gill
      November 24, 2019

      often its unrealistic for medics to know, or be able to judge. it was better in the old family doctor days, when the doc genuinely knew the extended family and friends and could spot things early. sometimes it takes a friend or relative to go see the doc and tell them how bad it is for one of their patients.

      like severe drug problems, it can be possible to be a fully functional member of society while hiding serious problems.

      1. margaret
        November 25, 2019

        I reiterate Iain ,Mental health is a far bigger problem than those who suddenly go off the scales of the accepted normal or dive into cycle of unhappiness. A comment down below points out the difficulties of autism . Special needs children have many mental health issues.
        Many for some unknown reason think that Dr’s and Medics treat all health matters . They obviously don’t know much about the NHS where the majority of health matters are in fact helped by the Nurses in investigation diagnosis , and treatment. They are obsessed with the word Dr, the labelling of who they think is a cure all but actually does not themselves cure all. They say they are going to see the Dr , when they actually see other types of professions who are more capable. This reliance on a profession in name who cannot do everything is foolish.I go to many courses: the Drs simply do not have enough training or knowledge. Other professions work hard accumulating knowledge all their life whilst 6 years , which in actual fact does not expose medics to the necessary training for everything and is not long and does not equip them, yet the public seems to think the Dr’s are quasi gods. We need to really break down this dependence on a snob -like category and treat people accordingly.

  5. margaret
    November 24, 2019

    It ‘has’ taken off ..usual too quickly typed error for which I apologise but don’t have the time to keep checking.

  6. Nig l
    November 24, 2019

    I agree with Mark B.

    Two things, firstly the classification and treatment of Dementia is shocking with Local Authorities seemingly doing everything they can to ‘avoid’ their financial responsibilities. It is a mental illness. My mother suffered from it and with me and my sister living a distance away only getting to her in the evenings and that needed a 100 mile round trip, we had to rely on one set of retired neighbours. Without them……….?

    As part of that and a broader topic money grabbing care homes need to be sorted with the State building and running them. No money? Cut the overseas aid budget.

    Families should not have to rely on newspaper advice columns to find out what financial support is legally theirs. HMG should prepare a simple advice document that is binding on the LAs.

    Secondly, and this is a thread from all ‘public’ enquiries namely that one agency does not speak to another with fragmentation, whose responsibility, budgets and worst of all Data Protection used as excuses.

    I don’t like additional bureaucracy but we have ‘useless’ Police Commissioners, what about a Mental Health/Social Service Tsar with legal enforcement powers.

    And finally I know, and many others who raise this, are wasting our breath, but there needs to be real accountability of the work force through performance management.

  7. Everhopeful
    November 24, 2019

    I would suggest that mental health issues are largely down to what governments have done to people.
    We are like scattering ants under a shower of boiling water. It is not good.
    LOOK AT THESE PAST THREE YEARS…just one example.
    At grassroots level there is very little available help for mental troubles and what there is is frankly damaging. Abysmal.
    What is it when govts seek to destroy society and family and then apply their “solution”? Communism? Where dissidents are branded mad?
    Not far off!

    1. Everhopeful
      November 24, 2019

      Not to mention the fact that wonderful Mental Hospitals, having been destroyed by vile propaganda and undermining of professionals, were closed and torn down for housing. Care in the Community!!!
      No politician had to witness the devastation caused by all that. IT MADE VULNERABLE PEOPLE HOMELESS!
      There was a really good system…so what did the govt do? Rip it up for their long term, no doubt EU driven agenda.

      1. Alan Jutson
        November 24, 2019

        Everhopeful

        Tend to agree with much of what you say.

        Care in the community is a great strap line, but in effect it does not happen, far too many people are just left to their own devices to try and cope as best as they can, and from experience, very many fail and require ever more help, support and finance to try and cover up the failure of the system which in many cases is simply totally unfit for purpose..

        Not suggesting we should keep them in special hospitals but certainly they would benefit from proper and suitable establishments which are properly staffed with professionals and funded accordingly

      2. sm
        November 24, 2019

        To the best of my knowledge, asylums were closed on the recommendation of the psychiatric profession. The treatment and care of patients had been pretty awful in some cases, but instead of reform, the professionals insisted on bringing in Care in the Community, which is both expensive and poor in outcome.

        As to the rising need of mental health care, there are surely many causes, among which I would suggest the additional number of the elderly who are ‘kept alive’ (rather than living), the blanket dosing of the elderly with statins which can impair mental function, and the huge increase in illegal drug use over the past 50 years.

        1. tim
          November 24, 2019

          I believe there is a surge in adult mental ill health, along with male suicide. Things will get worse. It is mainly caused by pressures of living. Children are not allowed to be children today. My ten year olds school work seems more advanced than mine was at age 16 {leaving school in my day}. There is an increase in child mental heath illness, and they are getting this at a younger age.
          The big pressures are lack of job security, living costs. Most people will have to private rent for a lifetime.
          What can be done? For children reduce the amount testing, sats at foundation age! For adults, get rid of zero hours contracts. e.g. tonight I gave my neighbour a lift home from work, I noticed she was staggering, could hardly walk, but mentally she is extremely stressed. Her cruciate ligament has “gone” her knee is full of fluid and it could go into her blood “sepsis”. Can you not have time off sick? No sick pay, can not pay mortgage if do not work. Answer to this: If work place does not help, then a government sick pay scheme.

        2. tim
          November 24, 2019

          sm– the blanket dosing of the elderly with statins which can impair mental function. I can attest to that! Just had well man visit to doctors, they wanted to get me on these and some of these. I have no health problems, it is crazy! like visiting a drug dealer!

          1. Iain Gill
            November 25, 2019

            Proven to reduce your risk of dying from cardiovascular problems in the next ten years by twenty percent. If you don’t get on with one type try another. Statins are a game changer, even the NHS struggles to mess up the improvement they bring.

  8. Lifelogic
    November 24, 2019

    My only experience is in relation to two different people living near tenants of mine watching the various arms of government doing nothing or any value with violent patients with severe mental health issues. The police saying we cannot do anything as it is a “mental health issue”, social service doing virtually nothing and then it all repeats a few weeks later. One of my tenants moved out due to fear of this person.

    Perhaps I have been unluckily but the state seems only to be interest in people they thing they can extract money from. Never from people who cost them money. Please the various arms of government try to evade responsibility, push patients from pillar to post and try to do nothing whenever they can get away wit it.

    I am not sure that doctors have very many long term, satisfactory treatments that do actually work. They tend just to prescribe and push them out again. They may or may or often may not take the prescription.

    1. Lifelogic
      November 24, 2019

      “Plus” not please

  9. Everhopeful
    November 24, 2019

    Off topic …or possibly not come to think of it.
    I note reports of plans to “ shrink army” ( again) and to lend an aircraft carrier to our “allies”!!

  10. Bryan Harris
    November 24, 2019

    Where the establishment starts from the position that man is just mud, and not a spiritual being, they will never get it right.

    Drugs and psychiatric abuse are certainly not the answer, unless we want ever more people on the streets, reduced to psychotics, brain damaged or simply dead in spirit.

    There are solutions out there JR but nobody is brave or willing enough to go against current inward and fixed thinking to take advantage of them.

  11. James Bertram
    November 24, 2019

    Again, no expert on this – but I’ve heard that working outdoors, and being outdoors in Nature, is of some help to some mental health issues.
    Which brings me to my favourite rant – When we Leave the EU and CAP, we need to re-direct government support for farming away from large industrialised farms to small farms working with natural processes – which will considerably increase farm employment (pre-war, a farm would employ maybe 5 to 10 times the number of people it does today) bring back life to village communities, and restore wildlife habitats.
    Too, the resulting improvement from better food in human nutrition, and less bad health, will have a knock-on effect of less mental health issues.

  12. Chris Dark
    November 24, 2019

    There are certain mental health conditions that are not possible to treat through touchy-feely therapy or sending people to charities for support. Schizophrenia, for example, is often found in highly intelligent people whose parents are also very bright and in many cases employed in the maths, physics/engineering or scientific fields. It is said that the brain’s dopamine levels are high and these can need controlling with anti-psychotic meds. I have had first-hand experience of this condition with family members and it can be quite terrifying to see it manifesting; an intelligent person suddenly descending into being a jibbering idiot. Not all GPs are up to scratch on these issues but thankfully my relative acquired good support from the area’s mental health authority and is now supplied with adequate meds, AND is holding down a good job in computer programming. I think it is essential that mental health support is available for ALL ages and not just the young 16-25 age group; mental health problems don’t miraculously cease at 25.

    1. anon
      December 1, 2019

      I would add that a universal basic income for all would help and banks should be mandated to run and manage special products & banks facilities for them at no charge.

      An incentive to work, if you are able, but a basic income above, if you are not able. irrespective of your potential assets status at time of claim or working NI stamps.

      We should then have a flat tax (abolish NI) and a local flat tax, with income and capital gains set a the same level. VAT or similar would remain.

      Reduce housing costs and the net inward people pressure on housing.

      The NHS should become more patient centric.
      It should examine all practices clinical and support processes to see if they are best for patient rather than the NHS or its staff.

      I have read heard rumours about the NHS / councils working together to ensure services which potentially should be NHS and free are charged for.

      All involuntary care should be directly funded by the NHS and all other parties should be legally prohibited from charging for involuntary services, including charges on assets, unless those assets exceed the cost of care grossed up by current rates of interest.

      The state mostly will get its pound of flesh in the round, as funds privately get spent down, so whats the hurry. If the person recovers wonderful.

  13. Kenneth
    November 24, 2019

    It’s a big subject but I think we should put resource into the root causes.

    A big one is loneliness.

    Too many families have been atomised. I believe the welfare system is the main culprit since it has stepped in to look after individuals, making family members, friends and neighbours with no role to play.

    We also nowadays seem to expect students to move far away from their families. The danger here is that they fall in love with someone miles away creating more atomisation.

    And then there are the “borderless world” brigade who seem to encourage migration. There are plenty of immigrants who are lonely and abandoned.

    I have no objection to adding more money to mental health budgets but I do object to a welfare system, an immigration policy and other activities that are making the problem worse.

  14. Simeon
    November 24, 2019

    Well obviously the solution is to spend ÂŁ1.6 billion funding an attempt to find a cure for dementia. No dementia tax. Just a massive spending commitment to cure dementia that in no way will require a rise in taxes. Job done.

  15. Javelin
    November 24, 2019

    Just like physical health, mental health is also sometimes genetic and sometimes environmental.

    Stress, frustration, social pressures and social media have a large (50%) of a cause of poor mental health.

    Contrast social media causing mental health in teenagers with Nietzsche’s observation that life without struggle becomes meaningless.

    I take the view that you CANNOT help environmental mental problems with drugs and talking alone. You need to fix the cause of mental health in the environment.

    It appears that creating a healthy mental environment is important to happiness.

    Stress from social media, marketing, losing jobs, unfair Governments, crime etc are all negative.

    The struggle to create, improve lives and help others are all positive.

    A clever Government would ask themselves how can they engineer the environment to keep voters happy.

  16. Dominic
    November 24, 2019

    Please stop pandering to the public sector vested interest. It’s undignified and unnecessary.

    Maybe you should compose an article about how the vile BBC will be privatised should you achieve power in early December? Or maybe an article about voting fraud and how the Electoral Commission turn a blind eye to it to protect their party of choice? That would more useful than articles that do nothing other than help to finance the public sector gravy train at our continual expense

    Reply Many of us wish to see good public services in health and education.

    1. Lifelogic
      November 24, 2019

      We should, as far as possible, get the state out of health care, education and most other things they are fairly dreadful at it and it is hugely inefficient to do it this way. They are killing thousands, failing millions and leaving a lot of people in ÂŁ50K of debt and with worthless degrees with three years plus loss of earnings too.

      The state should just pay for the proportion of people who really need help to pay for these things. With lower taxes this would be far fewer people.

    2. Mark B
      November 24, 2019

      Reply to reply

      But the Conservative Party has been in office for neatly 10 years, how much longer do you need ?

      Dominic raises some good questions that readers are as equally interested in.

  17. Lifelogic
    November 24, 2019

    We have the highest tax levels for 40+ years and even higher government expenditure plus fairly appalling and declining public service. Yet all we get is a promise by Boris/Javid not to increase NI, VAT and Income Tax “rates” (not even thresholds). A bit like saying we will lock the front door but leave all the windows and back door wide open.

    The Conservatives promised an inheritance tax threshold of ÂŁ1m each about 8 years back (about the only sensible thing Osborne did) but it was never delivered (still just a pathetic ÂŁ325K). Only the other day they promised to increase stamp duty yet again to the absurdly high top rate of up to 18% for some.

    Tax (and government spending) as a % of GDP in the UK is about double what is should be. It is killing economic growth & driving people overseas. The way to get more from the rich is to cut taxes and encourage people to provide more for themselves in healthcare, schools, housing, universities etc. The State should only raise what they need to provide the very few things that the State can actually do better than individuals, charities and private companies. Mainly defence & law and order. Just stop the state pissing money down the drain which is the main thing it does.

    Much of it is even spend doing positive harm.

    1. Lifelogic
      November 24, 2019

      Any promise should be of the form we will lower taxation and expenditure as a % of GDP from X% to X/2%.

    2. Lifelogic
      November 24, 2019

      A simple choice – high tax socialism and a fairly fake leave from Boris & the Conservatives or Venezuelan, let go bankrupt lunacy from Communist Corbyn/Mc Donnall/SNP/Libdim remainers, plus potentially breaking the union with Scotland and putting the country a dire risk on the defence front too.

      The people will surely choose the former and by some margin. Even though it is very far from ideal.

  18. Iain Gill
    November 24, 2019

    Well for a start let’s look at what happens if you attempt suicide, that should be the basics.
    Take an overdose, end up in A & E, its crowded, staff overworked, dealing with car crash victims coming in as well as lots of other complex stuff, you are stuck in a corner on your own while they wait for blood test results, nobody talking to you.
    In the best-case scenario, i.e. you happen to have not taken enough to kill or incapacitate you (which is often a surprise to you), then you will be there a very long time with nobody having the time to talk to you. The psychiatric team may well have been informed, but unlikely any will come especially out of hours, they are already maxed out elsewhere.
    In this same best-case scenario, quite often, eventually you will be sent home having seen nobody from the psychiatric team, nobody will have sat down and talked about why you did this, nobody had the time.
    In the same best-case scenario quite a high chance of after sitting in a cubicle on your own for hours and hours, they will get the test results then send you home to an empty flat with no immediate support. Possibly a referral to a psychiatric team sometime in the future.
    None of this is good enough. This person has been sent home to sit in tears of despair, in complete breakdown, and quite a number go onto further self-harm.
    Really the immediate face time from people able to spend the time to help is needed when people are in a crisis like this. This is the basics.
    I have seen all the above happen to a friend of mine. This is not good enough.

    1. Stred
      November 24, 2019

      A pastor near us who acts as an unpaid social worker took a man who had attempted suicide into the A and E in London. He could not find a parking space and so pulled in beside the ambulance area and rushed in to the desk. He was told to take his place in the queue and explained that he needed help to bring the unconscious patient in. He eas told that the ambulance staff could not carry anyone who had not arrived in an ambulance anf so he went back to his car and carried the patient in himself. The sight of an unconscious customer was not enough to elicit a response and he had to stay with him. When, after half an hour, he was able to hand over, he went to move the car and found that he had been given a parking ticket. The hospital has dismissed his excuse.

    2. tim
      November 27, 2019

      Iain Gill– i agree people need to TALK and get off their chests their problems.
      I can recognise mental illness very quickly, and the ones putting it on. I am a Plumber. I worked on social housing, I came across hundreds of mentally ill people. More of my time was spent Listening/counselling mentally ill people, than fixing the plumbing. These people, left alone drugged up, shells. My main advice was: Please you have to set foot outside this flat, there are birds singing, sunshine, flowers. Put a hat on, no one can see you, and walk. The more fresh air, and exercise the better you will feel. Try to cut down on the medication, the longer you take it the more you need. I am sure Doctors will be horrified.

  19. Iain Gill
    November 24, 2019

    As an anecdotal aside, I am friends with a number of psychiatric nurses. They mostly all work now for one of the outsourcers doing the benefits assessments of people claiming sickness benefits from the DWP. For the nurses it’s a far better job. They work constant day shifts, get good travel and overtime allowance, bonus payments, better basic pay. No pressure if they need to take time off at short notice to help their family, their shifts are easily swapped. No real pressure of life and death decisions. On their own mostly with no management breathing down their necks constantly, they just get out in the community and get on with it, management is far lower key.
    If my experience is more widespread then significant numbers of our best psychiatric nurses have been taken out of the front line and turned into benefits police. I doubt this is the best use of their time when looked at holistically for the whole country.
    Another example of unintended consequences of the social manipulation carried out by our political class.

    1. dixie
      November 24, 2019

      This agrees with my experience in Berkshire, the last PIP review we had to attande with our child was given by an ex-pychiatric nurse. He fully understood the circumstances and accomodated the situation when our child had a panic attack.

      Berkshire does have a very good Community Mental Health Team though there is a lot of call on their resources

    2. Alan Jutson
      November 25, 2019

      Ian

      I also understand that the staff you speak of have had a massive, and I mean massive increase in earnings, way, way, above what they used to earn, simply for completing assessments.

      The system needs to change.

  20. Stred
    November 24, 2019

    In the few cases that I know, the patient had genetic reasons for their condition and they went from psychiatrist to psychiatrist, who did not bother to read the patient’s notes and made different diagnoses, which required different medication. Sometimes a change had nearly disastrous results. In others the use of strong cannabis appears to have lead to psychosis in young people. It is interesting that the leader of the Libdums smoked and enjoyed dope and now wants a law to make us all use the words that she approves of, while making skunk legal.

    Some psychiatrists seemed to favour the Laing school and believed that there is no such thing as insanity but that it is just an unusual attitude. Others use recovered memory techniques to unearth deep problems of abuse and hope to cure the problem. This is in spite of their own professional body warning that this is unreliable and leads to false memories. This has lead to much damage in families falsely accused. Some psychiatrists are level headed and professional but many are only there because it is the easiest branch of medicine, the number of conditions being few. Until the quality of the professional treatment is improved, there is little point in throwing money at the problem.

  21. Frances Truscott
    November 24, 2019

    I did work in the field of child and adolescent mental health. I also have a child who was in the first cohort of children tested all the time. Even being tested on entry to school and then says etc etc. The upsurge of poor mental health exactly mirrors the increase in testing. We should never have been chasing the abusive regimes of the tiger economies. That’s not where our strengths lie in any case.
    So back off from the testing. Let children and teachers have time and encouragement for joy and creativity.
    Then we could put senior gyms in parks just as kids have playgrounds.
    Tackle pressure and tackle isolation. In schools have friendship benches. There are a great many more ideas.

    1. NickC
      November 24, 2019

      Frances, “first cohort of children tested all the time”??!? What are you talking about? When I was at secondary school (1960s) we were tested continuously. There were consolidated results every half term. What’s more the form teacher read out the results and told off those who were at the bottom in front of the class. This was perfectly normal. Testing at school is not the cause of mental health issues.

      1. Frances
        November 26, 2019

        School league tables put a lot of pressure on everyone to get results. Teachers have to teach to the test. The result is constant pressure which even the smallest children understand. It also narrows the curriculum to
        things to be learned by rote. Ind schools do well because students are able to be passionate about something .
        Testing takes away the joy of teaching and learning. We need to be able to raise people capable of enthusiasms , creativity, and flexibility.
        We are not training people to just work in factories or as lawyers and doctors. Jobs are vanishing because of technology. We need education for the jobs there will be and also not outsource jobs abroad.

  22. alastair harris
    November 24, 2019

    I am not sure this is the problem it is hyped up to be. For the most part it seems to be based on the unproven claim that anxiety is a medical condition. Personally I would prefer the vast sums poured into the NHS went on providing a better service, and improving outcomes for some of the more nasty conditions, like cancer, where we lag behind many other countries.

  23. Dave Andrews
    November 24, 2019

    Those trying to deliver mental care find their resources consumed by juggling shifts in response to flaky staff, and fill their hours with administration demanded by a top-heavy management structure.
    In the NHS, someone is entitled to 6 months full pay and 6 months half pay on sick. There are a large number that exploit this entitlement to the full.

  24. Kevin
    November 24, 2019

    I have two questions on this subject:
    1) If a person is medically diagnosed as having a condition that may prevent them from knowing where they are at any particular moment, can they, by virtue of that medical diagnosis alone, automatically obtain a disabled parking badge (so that their carer can take them out etc.) without having to pass a bureaucratic “triage” process?
    2) Will a future Conservative government undertake to review the statute book for any legislation that subjects people to possible legal consequences, including loss of employment or liberty, if they state what they believe to be the objective truth on a subject (having presented grounds for that belief, reasonable or otherwise), if the effect of that legislation is to prevent them, by means of economic or physical coercion, from entertaining the thought that they may be right?

  25. dixie
    November 24, 2019

    My experience is of raising and caring for an autistic child, now nominally an adult, with learning difficulties.

    1. Autism is a life-long condition so why the repeated demands for reviews and form filling, is it simply to keep the outsourced functionaries employed? What it does do is add significant, unnecessary demands and stress to the carers mad individual who can’t understand a map let alone get themselves safely to an address. Reduce the frequency of interviews and paperwork for life-long conditions to save money and stress.

    2. If you have not cared for an mentally disabled person, especially a child, you have absolutely no conception or understanding of the impact on parents/carers. We are treated as unpaid government servants with no accommodation or true respite from responsibility and stress. I have never seen any concern or accommodation whatsoever for the needs and mental health of carers.

    3. Autism and learning difficulties do not magically change or disappear at 18 yet procedures and support alter radically.

    4. Because of where we live we have found local transport services to be very good, Reading buses especially, but links to Wokingham and radially around Reading are poor to non-existent which limits access. For the last 30+ years housing estates have been designed on the assumption of a family car with no consideration for those who must take the bus. Stop designing dormitory estates for commuters.

    5. Local educational provision has been very good once the need has been recognised and statemented. Addington School and the LDD programme at Reading college have been truly excellent. But nationally it’s a postcode lottery.

    6. Beyond full time education opportunities look really dire. Everyone should be able to contribute purposefully, yet the Conservatives closed down Remploy sites which provided at least some opportunity to not just sit in a room. These people are not able to compete in the job market but they can contribute and need to operate as independently as they are able. Spectrum Designs in Port Washington, NY is a good example of a profitable business employing autistic people. This does not mean government must fund things but it definitely requires a government more adaptive and supportive of entrepreneurial activities and much less regulatory and bureaucratic mindsets.

    7. Housing is a major issue, provision needs to accommodate the degree of capability and needs of the individual and I am aware of some good initiatives in Wokingham but know nothing about Reading which is really where we live. There needs to be a more universal approach and much more flexibility in taxation around inheritance when leaving property to disabled people.

    PS I tried to engage with Wokingham CP association on these matters when the CPF topic came up a year ago but there was zero interest or response, one reason I left the CP.

    Reply Thank you for your response and important comments based on experience. I would appreciate more guidance on how additional funds could best be spent to improve the support available to families.

    1. dixie
      November 24, 2019

      We are probably atypical in that we adjusted our lifestyle and life goals some time ago and funding is not the primary issue, for other families there will be clearer funding needs. That said, the social services person who comes to see our child changes every time and autistic people have difficulties dealing with change let alone understanding and interacting with people. As a consequence we have to be in every meeting to mediate for our youngster and interpret both ways, even with medical and education professionals. How would family with less flexibility in working hours cope? What happens when we are not around? Is funding an issue here?

      A more tangible example – get someone to use a bus on their own rather than taxi’s or require a travel companion. The outcome would be savings in staff, time and cost as well as increased independence for the individual.

      It sounds a simple task yet it took our youngster 18 months to be able to take one bus route including learning to use a mobile phone. This competence does not translate to other bus routes and does not guarantee they react properly to breakdowns, timetable changes, re-routing etc.

      From this a couple of funding recommendations might be;

      1. a resourced travel training service
      2. a register of DBS checked taxi providers because buses don’t always go where the vulnerable person needs to. Why doesn’t this already exist ! I have been involved in school activities and am always asked if I am DBS checked.

      Not necessarily the best example and different families will have different needs. There are many other situations that are not a problem for neurotypicals but can be insurmountable for the autistic and mentally disabled people, eg visiting a dentist, where extended similar “training”/familiarisation can help enormously. Again there is a funding element in terms of resourcing but the main aspect is accommodation of the individuals need for repeated practice visits.

      Reply Thank you for the further helpful contribution.

    2. Alan Jutson
      November 25, 2019

      dixie

      Agree Addington School seems to offer excellent support for its pupils, aware it has a number of its own buses, as a member of the local Lions Club we have part funded the most recent one, but clearly they do not have enough transport for all of their students.

      Whilst I have little knowledge of how the support system works, given Addington is an approved Special needs School, are taxi/transport fares for students covered as part of any support package, if not would this help at all.

      Would Ready Bus help at all ?

      Again Our Lions Club purchased one of these a few years ago, and we know that is a well used service, although I am given to understand that Local Government have recently withdrawn, or are about to withdraw, some of its funding !

      Likewise some organisations, MacMillan being one, have a pool of volunteer drivers who use their own cars to transport patients around so that patients can meet an appointments schedule, the complication here is drivers need to be fully covered by additional insurance, as well as being vetted as approved.
      Whilst I am all in favour of making sure drivers are fully insured or vetted to protect the most vulnerable, sometimes approval is complicated, lengthy and costly to all concerned, could there not be a more simple and speedy way of approval ?

      Reply Yes, there are issues over volunteer drivers which I have been pursuing with government.

      1. dixie
        November 26, 2019

        Thanks Alan,

        Readibus provided a regular and excellent door-to-door service whilst our youngster was at Addington and the school made full use of the generously donated buses. The question is what happens once they have left education and need to be able to travel independently.

        Part of the issue with public transport is that these people are not just vulnerable but can react to change or disruptions in an unpredicatable way that can put themselves in danger. Awareness of surroundings and risks is not good at the best of times and any anxiety simply overwhelms even that small awareness.

        Ideally people providing transport would have some awareness of how to avoid making situations worse – bare in mind even the police and medical professionals can screw things up with autistic individuals.

        In my view DBS is a minimum, A question here might be is the assessment process efficient and charged at true cost.

  26. Philip Stephens
    November 24, 2019

    I cannot speak for what Thames Valley or Wokingham residents need for their mental health provision. I cannot even speak for what my own area needs. But I can tell you what my family needs: financial help with social care of a patient diagnosed with dementia four years ago and now paying entirely for his own residential social care (ÂŁ3,300 per month).

    It appears that the NHS does not regard Alzheimer’s as an illness because it cannot treat it. My 85-year old brother-in-law was twice discharged after several months in hospital because he was no longer “ill”. Equally he could not live in his own home because he could not reach the bathroom unaided. So he is being well-looked after in a residential care home.

    I understand that, at present, the NHS does not have the competence to treat Alzheimer’s. The NHS is right to concentrate help on those it can treat. To tell a patient’s family, however, that those suffering from Alzheimer’s are not ill is an insult.

    In Wales the state pays ÂŁ600+ per week for those needing social care whose assets (including their home) are less than ÂŁ50,000. Those with assets more than ÂŁ50,000 have to fend for themselves – no help at all.

    My brother-in-law has never had a foreign holiday. The only period when he has been abroad was when he was doing National Service with the RAF in the fifties. His job was as a salesman at a wholesaler’s. He scrimped and saved to buy his own home. He would be shocked if he understood what he is having to pay for his care or that he will shortly have to sell his home. That he doesn’t is one, single benefit of Alzheimer’s.

    As a postscript, his next-door-neighbour (the wife of a hospital doctor) has for the past year had expensive cancer treatment paid for by the NHS. Fortunately it seems to be working.

    Imagine the outcry if patients were obliged to pay for NHS treatment if their assets were more than ÂŁ50K. One can only hope that the playing field becomes more level.

  27. Ian terry
    November 24, 2019

    Sir John

    Short, sharp and straight to the point, very good post. Last paragraph said it all.

    “Spending the money wisely should be a bigger part of the debate”

    It should be the major agenda item, also with addressing the waste. One typical example:-

    How much did the Smoke Free Grounds in every NHS Hospital and grounds cost? As noble as it was there is no point in wasting money on such schemes unless they are enforced. Every visit to different hospitals one can always see patients and staff have a quick fag around the corner from the building entrances or in the car parks.

  28. Bob
    November 24, 2019

    “we should start with what we need, and then cost it to see when and how we can afford it.”

    What a good idea!
    Why has no one thought of it before?
    It should be applied to all areas of government spending, both at national and local.

  29. Oliver
    November 24, 2019

    1. Social media isn’t good for mental health. What might we do about that?

    2. Medicalising unhappiness or simple inadequacy [see 1.] doesn’t help anyone.

    Can there be a reason other than a failure to manage expectations, and instagram type induced stress for the explosion in alleged mental health issues?

    How can it be other than societally induced?

    How sure are we it’s a medical problem at all?

    For the avoidance of doubt, I’m not trying, at all, to belittle or sneer at, genuine MH issues.

  30. SecretPeople
    November 24, 2019

    We need to tackle the root causes of mental ill health, not just provide more counselling.

    Overcrowding, long stressful commutes, diminishing green spaces, money worries, our home country changing beyond recognition, machetes teens descending on family cinemas, being forced to keep quiet about what is most disquieting.

    1. Alan Jutson
      November 24, 2019

      SecretPeople

      Do not forget the elephant in the room which is a reliance by too many people on drugs, both illegal, and prescription.

      In many cases the NHS, and local GP’s have destroyed lives of many, with what was regarded as the simple solution of prescribing drugs that deadened the mind, and then became addictive to take, turning what perhaps may have been a minor problem at the start, if diagnosed correctly, into a major life changing and mental trauma.

      We also need to agree a proper well thought out solution on what is at the moment illegal drug taking and the selling of such, which also fuels a huge amount of crime.

  31. hefner
    November 24, 2019

    Among all the cases that can be put under a ‘mental health’ heading, there is one usually given a different treatment: mental health of old people with various conditions that often can only be dealt with a family member becoming more or less a 24/7 carer or with the people having to enter a medically-suited retirement home. For what I have seen, whatever the solution taken by the family it is very rarely a simple stress-free one. Furthermore the help supposedly available vary widely from one local authority to the next.

  32. Polly
    November 24, 2019

    I believe the question should not only be ”what do we need ?”…. but also ”why do we need it ?’

    To answer correctly, please think outside the box and not exclude any answers which might be inconvenient.

    Such as what is the effect of the rush towards socialist progressivism and ”new think”, alongside the rolling back of hundreds of years of civilizational evolution ?

    Change can be desirable but it can also be extremely destructive. Such as the downgrading of the family, the downgrading of marriage, the downgrading of personal responsibility, the ease of divorce, the ease of abortion, including the shocking desire of some individuals to legalize late term. Progessive methods of education, prizes for all, no discipline in class, the encouragement generally of an ”anything goes” mentality, the destruction of evolved institutions, the downgrading of Christianity.

    As in the US (until 2016), it seems that in Britain and Europe anything which undermines or destroys self reliance, self determination, and national pride in traditional civilization is seen by governments as desirable and a ”must have”.

    Western governments often seem to want to overturn the apple cart, so what happens then to all the apples ?

    Could so much downgrading of long term evolved human behavioral patterns have an effect on mental health ?

    My opinion is a definite Yes.

    Polly

    1. Ghost
      November 24, 2019

      Your questions are good.
      I shall repeat an unoriginal question. If your pc is downed by a trojan, do you

      1/ Use an expensive trojan destroyer which may not rectify the harm done?
      2/ Buy a new pc?
      3/ Restore to an earlier time?

      #It is not a surprise that most trojans and malware in general destroy or disable your computer’s facility to “Restore to an earlier time”

      It could indicate in regard to human beings that if there is a increase in percentage terms of mental behaviour that is awry then the start of the fault may lay in the past at one point. A turning point, of some kind.

    2. NickC
      November 24, 2019

      Polly, Very thoughtful. I agree with much of what you’ve said.

    3. steve
      November 24, 2019

      Polly

      An excellently written post, with which I entirely agree.

      Absolutely bang on.

      My sentiment would include; Rap crap, guns knives, consumerism, lack of sense of value, win by any means, hit below the belt, stitch up, lie, talk with one’s mouthful – obesity epidemic, can’t tell me what to do I’ll report you for abuse, I am the only thing that matters.

      It’s all get, get, get. In fact you might have noticed that certain generations these days will even say to a shop assistant; “can I get” one of such and such.

      I know if it was me serving I’d simply say “yes, it is possible you could get one” and I wouldn’t let up until they asked properly.

      Who teaches kids to go to a shop counter and say “can I get” ? Is it bad parenting ? is it the schools ?

      Bring back National Service, 1950’s style, that’ll sort it.

      1. Fred H
        November 25, 2019

        ‘can I get’ is an Americanism, sadly followed over here.

  33. Narrow Shoulders
    November 24, 2019

    Prevention being better than cure we can start at school by teaching children that life is difficult and there will be ups and downs with very few terminal. Pick yourself up, dust yourself down and start all over again.

    We have real issues with learning difficulties, depression, schizophrenia and PTSD. Anxiety and temporarily stressful situations are part and parcel of being alive.

  34. Iain Gill
    November 24, 2019

    Unfortunately the conservatives will probably win the election, not because they have any vision or joined up purpose, but rather because labour are actively alienating voters, which together with the way the Brexit party has unilaterally handed them seats.

    Any Muppet with a conservative rosette is now a candidate minister.

    The system needs a far bigger shake up.

    1. Fred H
      November 24, 2019

      Winning will not be of any use unless they get an unlikely majority.

  35. forthurst
    November 24, 2019

    At an inquest into the death from suicide of a patient on a mental health ward locally, evidence was submitted that only 50 per cent of staff were permanent with the other half being bank or agency staff who didn’t have sufficient knowledge of patient histories at all times.

    The coroner stated, “This is a tragic case and has raised a number of issues of concern … staffing levels …had reached crisis point. There was no ward manager, no matron and a reliance on bank and agency staff.” “A number of staff gave evidence of how they had raised safety concerns with senior management. The effect on staff morale was hardly surprising.”

    The use of agency staff is appropriate for project based work where the level of staffing can fluctuate very substantially; however, it is hard to see how that applies to a mental health ward. Why are we totally dependent on foreign doctors and nurses? Why are hospitals so reliant on agency staff that cost more than pemanent staff and being hired by the shift know next to nothing about the individual patient cases? Why do graduating doctors in significant numbers leave the country soon after graduating? Why are the majority of GPs, part time females? Why are students who have obtained the necessary A level grades being turned away from medical school from an artificially created shortage of places? What is the point of nurses doing a three year degree course before they start working?

    From the minister down to the ward level there are people in place who could not organise a … in a brewery. Furthermore, there is an agenda at work to multiculturise the medical profession which does not give priority to patient safety or the career aspirations of English people.

  36. glen cullen
    November 24, 2019

    This isn’t really a hard question you either have a mental health issue or you’re a snowflake. The hard question for government is identifying ‘snowflakes’ in this politically correct world with the watchful eye on the media

    My brother is mentally handicapped with epilepsy and autistic 62yrs but still a child

    We all make our own assessment but government constantly dishes out mixed messages, anyone with stress or discomfort in schools, universities etc are offered counselling. Dear I say ‘in the old days’ if you had a bad hair day, problem at work or poor exams you would talk it through with your family and friends. Resource and funding needs to be clearly identified and not secured via the media nor fashion trends

    Call it out for what it is, terrorists are not mentally ill they are bad people, drunks and drug takers aren’t mentally they are just weak people, burglars, muggers etc aren’t mentally ill they are just criminals, the list goes on
..

    Government should stop using the term ‘mental health’ as a catch-all that describes all social ills and imbalances
.it’s a condition for most or whole of life when your view and physical condition of the world is different from what we consider the norm

    My brother is not a socially impaired service user ,,,,he is mentally handicapped for the whole of his life, and I thank our society that he has been well looked after in a charity care home.

    1. Richard1
      November 24, 2019

      Thank you good post

      1. Stred
        November 24, 2019

        Thank for two good posts above.

    2. steve
      November 24, 2019

      Glen

      “Call it out for what it is”

      …..not allowed.

      “drunks and drug takers aren’t mentally they are just weak people”

      Not always. I have a tenant who was targeted by heroin pushers when she was 13 years old. She was of no fixed abode when I found her took her in. She’s been clean for nearly 3 years now. The strength to get sorted out didn’t come from me, or the case workers, it was her effort.

      But you are not wrong to generalise, it is certainly true most of these people are indeed weak souls. In fact a lot of them seem to have lost their souls.

      The problem for them is that they’re seen as a underclass…..which perpetuates their weakness. Last I heard we were a Christian society, we shouldn’t be shunning the weak, we should as Christians be giving them strength. A bit of kindness goes a long way

      I also think it’s a terrible indictment of a society that can, and indeed does, tolerate the weak and less fortunate dying on the streets while designer clothes pass by.

      I remember a while back there was a TV series where soap celebrities lived rough amongst the homeless. The Coronation Street chap, alias Les Battersby….quit half way through and described society as ‘ f^*!ed ‘ He was right, society is broken.

      Our Dad brought us up to never turn a blind eye to a man down on his luck, and to defend the weak. I think he did a good job with us.

      Sometimes I wonder, and sometimes with a tear in the eye over some of the things I’ve seen……where did our country go wrong. But you know what, I will live to my last breath by the virtues our dad bestowed upon us.

  37. Iain Gill
    November 24, 2019

    Take another example. Professional boxer has a mental health crisis. Takes a dozen police to get him to police station. He has done nothing criminal, so desk sergeant refuses admission and tells them to take him to mental health out of hours crisis admission.

    So that dozen police drop this person off to a facility with a single nurse there to admit him, and no secure facilities to gaurd against risks, no rooms with locks etc.

    Would you do that nurses job?

  38. William Long
    November 24, 2019

    One has to be very suspicious of what is clearly at present a bidding war and can only hope, though without a great deal of confidence, that the money that Mr Johnson has promised for mental health, is the result of some considered process to establish what is needed. Of course though, real progress in finding a way of controlling if not curing, the various forms of dementia could only result eventually in considerable savings for the NHS in addition to the obvious benefits for the sufferers.
    It is a huge pity it has to be a political matter. One of the few things on which I agreed with our neighbouring MP, Sarah Wollaston, was her wish for a cross party approach towards the whole question of health funding.
    With regard to dementia treatment in the present situation where there is no medical cure, and only marginal control, in my experience, the pressing need is for more fully trained and competent specialist personel. As with everything to do with the NHS there is huge inconsistency between different geographic areas. We are extremely lucky here with an excellent local team but that is by no means universal. A very important thing that the political leadership of the NHS could do, is to ensure that the achievements of the centres of best practice in any discipline are replicated consistently on a national basis.

    1. steve
      November 24, 2019

      William Long

      “One has to be very suspicious of what is clearly at present a bidding war”

      Yes that’s exactly what it is, and I find it disgusting that political parties seem to assume we’re all so contemptible as to allow ourselves be bought off. They obviously don’t realise that we’re not anywhere near as low as a snake’s backside as to be ‘bribed’

      I believe their cheap tactics will backfire.

      I have yet to see any of the contenders have the honesty to come out and say; ‘I can promise you nothing’ If one did….he’d be the man I’d follow.

  39. Tom Willis
    November 24, 2019

    At a recent conference, a need for some ‘mental health hub’ was identified. A lot of mental-health oriented research and practice is in silos of medication, electrical/magnetic stimulation, psychology and social care. These need to talk to each other, and the needs of carers and recovering sufferers should be included in the treatment plans.

    Something like a Wellcome Trust, or a <a href="https://www.fraunhofer.de/en.html&quot; Fraunhofer Institute would help.

    There is very little ‘joined up’ thinking about mental health. Most of the treatments today involve inspired guesswork and often just shaking things up in the hope that they will improve. As a worldwide culture, we know very little about diseases of the brain, less about the mind. The current prevalence of mental health problems seems to be worldwide, not specific to any one culture or development level.

    Attempts to address this should indeed be national, if not multi-national. In the UK, there is the start of this at the NHS England level, but the Scottish, Welsh and Northern Irish NHS entities tend not to be included.

    We really could up our game, and it is more organisation than oodles of money that is required.

  40. Andy
    November 24, 2019

    Mental health provision in this country is woeful. A family member of mine has suffered from serious mental health problems throughout her life. Treatment is, well, all but non existent. She has made several attempts on her own life – and yet the matter always seems to end up with the police rather than people who can make her better.

    For too long mental health has been dismissed as a non problem – and yet it is arguably worse than many physical conditions. So many of the other problems in society – crime, homelessness, drug abuse etc – are linked to mental health. We need to fix it.

    1. Tom Willis
      November 24, 2019

      Agreed. However, that is a question more of policy and societal awareness rather than budget, I think.

      I am told that, under the coalition government, there were moves toward different parts of the state working together on this, but they disappeared during the next government.

      The problems, as you say, are not just medical treatment but the whole approach. A person on blood pressure medication (clearly a physical illness) gets free medication; a person on anti-depressants does not unless there is some other condition like age. Someone unable to get out of the house because of depression/anxiety is ‘invisible’ while someone unable to get out because of physical disability is not. A sufferer unable to get out of bed for whatever reason finds it impossible to turn up to benefit assessment appointments.

      There are no known easy solutions. Arguably, in the past, families and communities took care of their own mentally ill people, sometimes compassionately and sometimes not, but that is no longer workable.

    2. Anonymous
      November 24, 2019

      Andy

      So much of what you describe can only be self treated.

      There has to be a will for there to be a way.

      I have tried many a time to help a person breath deeply, release the stale air from the bottom of their lungs, hold a power pose, smile when they don’t feel like it… then get on an brass it out.

      Either way things become self fulfilling.

      For most they need to grow up, be an adult and take full responsibility for themselves.

      (see my later post if published.)

  41. ukretired123
    November 24, 2019

    I believe that mental health issues have grown in recent times due to many coincidences in advanced western countries especially notable in the USA, issues such as:-
    Excess money, excess food, drugs, guns, etc which did not exist years ago.
    Focus on self image, especially young females.
    Confusion about what sex folks are – we only had 2 types when I was young – simple!
    Confusion about everything especially when Hollywood and TV show extreme violence etc.
    I was appalled to see the best reads on scribd were not to give two hoots about anything…
    Young people are given the belief they can be whatever they wish to be and when they either leave school or increasingly “university” they are inevitably sadly disappointed by the shock of reality of work.
    I think education needs overhauling as the reality is there is no “easy street” to succeed and young people need to be taught like De Bono books and teaching skills basically ” how to think” and problem solve more effectively, by doing and not just thinking, the latter of which there is far too much of, as demonstrated by folks on the visual media today.

    1. ukretired123
      November 24, 2019

      Getting to the pith of this is:-

      We all have a role to play in life
      It is up to each person to discover
      What it is exactly.

      Others can help but it is ultimately what we decide along the way.
      When folks get overwhelmed they need help but mental health is invisible and only detected by few unless better understanding becomes wider, as in this topic hosted by Sir John.

    2. ukretired123
      November 25, 2019

      Bullying in schools is a major factor why youngsters have problems with peer pressure exacerbated by the early adoption of social media. Sudden change in a person’s behaviour is often the clue. Sometimes children miss school due to bullying and need a change of environment or holiday to think clearly, which we have witnessed in our teenage niece years ago like a correctional boost in her confidence.
      Changing schools can be a challenge too!

  42. Dominic
    November 24, 2019

    Should the once decent Tory party continue pandering to the left wing BBC your party expose the UK and its people to the existential danger of a Marxist government. Believe me, if that happens we will see a collective mental health epidemic

    Stand up and expose the BBC-Labour-Public sector partnership. Why your party can’t do this defies every Tory voter I speak to. Your party appears too have zero understanding of the real world

    Johnson’s just another liberal left patsy without principle.

    1. Fred H
      November 24, 2019

      Dom….I agree it would appear each successive Tory government has less and less empathy with the people and what they want. They still ‘DO NOT GET IT’.

    2. steve
      November 24, 2019

      Dominic

      “Johnson’s just another liberal left patsy without principle.”

      Yep. Sure is.

      They’re all the same, which is why you might as well vote Labour….just to keep him out of office.

      Either way the country’s buggered. Might as well punish Johnson for letting us down because he’s frightened of his own shadow.

  43. margaret
    November 24, 2019

    John ! you have put a correction of my post , but not the post !!!!

  44. Iain Gill
    November 24, 2019

    Rationed free car parking at hospital is a stupid half way house.

    The beurocracy in doing the rationing will cost vast amounts.

    Spread sheet warriors with no real world experience producing a stupid system again.

    1. Eh?
      November 24, 2019

      How come they are not collecting stuff from food banks? Who are these people with cars?

  45. Iain Gill
    November 24, 2019

    Another funny mental health anecdote. My dad when living with a terminal illness was diagnosed with depression by some of the docs. I told them in no uncertain terms to stop being stupid. He was cheesed off with dying, a perfectly understandable reaction no surprise to me. Not helped by the fact he knew that the NHS had let him get to that stage with none of the early intervention routine in the rest of the world.

  46. Lester Beedell
    November 24, 2019

    My daughter is a mental health nurse in Cambridgeshire and she loves the job, it’s very demanding but she’s dedicated, she visits her patients at home

  47. John Probert
    November 24, 2019

    GP’s do not understand mental health and in many cases the drugs that they use
    do not work and are damaging

    Counselling is what is required with specialist skills like EMDR to cope with more
    serious forms of trauma

  48. Prigger
    November 24, 2019

    If you had a government who aimed its policy on fixing cars and not making better ones you’d know such government was insane.

    1. steve
      November 24, 2019

      Prigger

      Where that falls down is in the fact that governments don’t want us to have better cars. They’re in cahoots with manufacturers who’s aim is to force us to have crappy electric cars at premium prices while they’re piss cheap to make, truth be known.

      1. Prigger
        November 25, 2019

        I feel so alone

  49. Turboterrier.
    November 24, 2019

    Off Topic

    It seems the Labour money tree has just grown another branch. Screaming from the paper stalls this morning in the supermarket another pledge to pay all the women who missed out on the pension age change. When boris was asked about it on the TV with Corbyn he was very negative and highlighted how much it was going to cost and being un affordable. I think the headlines show that someone has stolen a march on the situation. How many women will have a double think about where to put their cross now. I hope that Boris can spike their guns on this one in some way

  50. Anonymous
    November 24, 2019

    Having attempted suicide and having been in the care of a crisis team myself and having a brother who had to be sectioned and have several cycles of electric shock therapy I have had personal experience of this issue.

    Citalopram provided a much needed boost in serotonin but this can be created through healthy living and practice:

    – wholesome foods

    – exercise (particularly involving weights)

    – fresh air

    – work and/or doable projects and goals (hobbies, voluntary work) to give purpose and self esteem

    The mindfulness practices described by Eckhart Tolle (The Power of Now) and Richard Carlson (Stop Thinking Start living) should be on prescription for all mildly afflicted depressives.

    The Western world has produced some of the unhappiest people for one very simple reason.

    Choice.

    This gives rise to being overwhelmed by choices and being overly self critical about making the ‘wrong’ choices and the resultant feelings of inferiority measured against peers who have made the ‘right’ choices.

    It is a fact that the happiest (and often healthiest as regards BMI) peoples can be found where there are the fewest choices.

    I prefer the Western lifestyle but I now understand the burdens that come with it and manage them much better. ‘First World Problems’ (as the modern phrase goes) are all about keeping face among your peers.

  51. BillM
    November 24, 2019

    We all should be concerned over the mental health care in this country.
    We should be very concerned of the lack of firm administration of those bordering on “criminally insane” that are released from secure care into the public arena because a ‘committee’, in their naivety, has deemed them suitable for their freedom from secure units.
    I do not know how many innocents have been slaughtered by such insane people but there is certainly more than one on occasion. And one innocent life is one too many.
    Release must be tightened up in such cases.

  52. swampy
    November 24, 2019

    I saw repeats of Sophy and the Marr Shows. Labour just keep talking.
    If their legs had just been cut off they’d say “Let me make this perfectly clear, the top 5 % are the only ones without legs. etc etc etc etc etc
    They are a swamp.

  53. Daniel Boys
    November 24, 2019

    Nobody with influence ever seems to question why so many people have mental health issues. And what aspects of our society could be attributed to the problem.

  54. There it is
    November 24, 2019

    Here’s one seat Tories would have got this 2019 Election but for a horseshoe nail
    Candidates listed in alphabetical order of their surname.

    General election 2019: Penistone and Stocksbridge
    Party Candidate Votes % ±
    Brexit Party John Booker
    Conservative Miriam Cates
    Labour Francyne Johnson
    Liberal Democrats Hannah Kitching
    General election 2017: Penistone and Stocksbridge
    Party Candidate Votes % ±
    Labour Angela Smith 22,807 45.8 +3.8
    Conservative Nicola Wilson 21,485 43.2 +15.5
    UKIP John Booker 3,453 6.9 -16.0
    Liberal Democrats Penny Baker 2,042 4.1 – 2.2
    Majority 1,322 2.6 -11.7
    Turnout 49,787 69.8 +3.9
    Labour hold Swing -5.8

  55. Frances Truscott
    November 24, 2019

    Earlier I commented on the toxic effects on child mental health of the endless testing supposedly to “raise standards”. But preparing people for happy lives and changes of career doesn’t lie in chasing the abusiveness of the tiger economies.
    The abuses of testing continue into the workplace now lousy with short term contracts.
    My daughter has her dream job in a creative industry. 3 months probation in a 6 month contract and now a years contract which may or may not lead to permanent employment.
    People have been dropped and their dreams shattered.
    The industry loses people 2 or 3 years in in large numbers.
    Government can support happy childhoods and find ways to encourage security in the workplace so people can build their lives and drop their shoulders a bit.

  56. Fred H
    November 24, 2019

    OFF TOPIC.
    What should be done about the RMT strike called between Dec 2nd and the New Year?
    Should legal restraints be available to prevent such excessive disruption?
    Should the rail company dismiss drivers/guards after a certain time on strike?

  57. Iain Gill
    November 25, 2019

    Hey John,

    Thanks for taking an interest in this subject.

    Many Thanks

  58. End in sight
    November 25, 2019

    “Hong Kong elections: Pro-democracy groups makes big gains” That’s sorted then.
    We can all comfortably and in good mental health speak of other things.

  59. Frances Truscott
    November 25, 2019

    Heres a really difficult idea. More help for 1 child per adult and then stop paying people to have children they cannot adequately raise because they don’t have adequate resources.
    Mental health starts very early indeed. The brain is formed very early.

  60. Danieljames
    November 25, 2019

    During my time in the military I became what is called a TRiM Manager. TRiM is Trauma Risk Management and has been use by the RN for a few years now and by the RM since 1997. It is based on the premise that people who are suffering will much more readily talk to someone who has experienced similar things. We are trained to identify little things, small changes in personality, actions and so on and is extremely useful on operations and after not only to identify people but also to start a process that could mean more help getting to those who need it quickly but also to prevent what could be a more minor situation becoming a major one. Intervention was and is key. TRiM Management has undoubtedly helped hundreds, if not thousands of serving military personnel deal with situations that would otherwise have spiralled out of control. Perhaps there is a lesson there for the civilians.
    In terms of spending amount, I would suggest that with every department and every budget it is more important how well any money is spent rather than how much.

  61. Gareth Warren
    November 25, 2019

    I do have trouble understanding depression since I believe we are in control of our lives, however it is a real problem. Here I think drugs are a minor element and we need to find ways to get these people interacting with more people.

    For other mental health I would live to see more help offered beyond the medicinal, here a private cleaning firm can be better value than state.

    But this topic touches on the biggest issue that no one wants to talk about, suicide. So many thousand seek to outright kill themselves and no one asks why? How many more seek to drug/drink themselves to an early grave? Here I would suggest communities that were seeking to build a more beautiful future rather that build everything to the minimum price would help – but it is a larger problem.

    I’d also insist on higher minimum standards for housing, the previous labour governments “high density” housing will be the slums of the future.

  62. Here we go
    November 25, 2019

    They’re discussing education on the box.
    I mean this: from 11 to 16 yrs of age I feel my education was only useful in
    A/My English class ( two hours per week with a very strict grammarian teacher ) at 11 years old for one year only.
    B/Thumping into me my arithmetic times tables up to and incl the 12 times table two hours or four hours per week for five years.
    C/ Weekend hiking and camping trips, plus two two-week school camps, hiking, in the Yorkshire dales plus more or less a 10 day 24/7 Outward Bound course when I was 14 for about four of us.
    That’s it. Really.
    Now,lecturers and professors on strike interviewed say “It won’t harm students’ education.” No.

  63. kzb
    November 25, 2019

    Depression is an entirely understandable reaction to the circumstances in which people find themselves. It’s not really an illness, it is a natural reaction.

    “Mental Health spending” really means dishing out Prozac and the like to medicate the population. This is the science fiction dystopia which we now inhabit.

  64. a-tracy
    November 25, 2019

    My mother told me of a young man she knows who succeeded in ending his life recently because of a row that turned violent with a friend, he was arrested and feared being incarcerated.

    A woman she was in hospital with succeeded in ending her life after an operation resulted in an hysterectomy at a young age and she didn’t get any help with the mental issues of not being able to become a mother, fearing her boyfriend would leave her and that she wouldn’t be a good choice for him.

    A young man hung himself at home when his girlfriend ended their relationship.

    An empty nest mother nearby discovered her husbands affair and ended her life and the life of their two dogs in the garage with the engine running.

    A feared cancer illness resulted in a man hanging himself, the autopsy showed he didn’t have cancer.

    A female neighbour feared her husband was going to leave her and went to a tip at night and took an overdose – he wasn’t having an affair.

    Relationship help and advice is woeful, being taught to cope when friendships turn sour is as important as maths and science.

    1. tim
      November 27, 2019

      a-tracy– A feared cancer illness resulted in a man hanging himself, the autopsy showed he didn’t have cancer. Terrible- 4th april 2018 that is exactly what my old mate did. Had been retired 3 months and I think not being busy played a part in this tragedy. I hope one day people who retire will be given retirement help/advice!

  65. adam
    November 26, 2019

    You should not be spending any money on mental health as it is a scam. You should spend money on things that achieve something. Dont give money to people unless they can demonstrate results.

  66. Lindsay McDougall
    November 29, 2019

    The problem is that much mental illness is due to a malfunction of the brain, often due to a chemical imbalance. The majority of mental illnesses are not curable and the question is how we manage those conditions. Is incarceration necessary or is care in the community possible? Care in the community is time consuming, hard work and expensive, which is why the easy option of incarceration is often adopted. Also, the risk of violence – especially by male patients – must be assessed.

    My late father was Medical Superintendent of Moss Side hospital from 1954 to 1978. Moss Side was one of the three ‘Special Hospitals’, the others being Rampton and Broadmoor. By Statute Law, the patients detained were “dangerous, violent or criminal by reason of subnormality”. It was quite explicit (as a rough guide, ‘subnormal’ meant having an IQ of 80 or less). In practice, highly intelligent psychopaths were also admitted because no other hospitals could cope with them. The law has now been changed so that highly intelligent psychopaths may now be admitted officially. Moss Side has subsequently been renamed Ashworth and Ian Brady ended his days there.

    During the early years of my father’s tenure, whether a patient was released was entirely a decision for my father and the other specialist psychiatrist(s) on his staff. The Commons decided that this gave the Medical Superintendent too much power and instituted a system of appeals to tribunals, a tribunal consisting of lawyer, a layman and a non-specialist psychiatrist (whom my father was wont to refer to as the waiter, the porter and the upstairs maid). How did it work out? When my father took the decisions, few patients were released and only one reoffended. After the tribunals were introduced, more patients were released and several reoffended. Make of that what you will.

    Largely due to the initiative of Enoch Powell, who was hostile to institutions like Moss Side, admissions fell for a while. I don’t know what has happened since. It was certainly true in my father’s time that many patients accepted their fate and became institutionalised.

    It ought in theory to perform a value for money audit on the various treatments of mental health. Pound for pound, are the outcomes as good as for money spent on physical health? I wish I knew.

    1. Iain Gill
      November 29, 2019

      This is another thing that Jordan Peterson has done some good youtube talks on.

      He is after all a clinical psychologist with a lot of relevant experience.

      Well worth a watch.

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