“1 in 4 people have a mental health problem. I want the NHS to work for people with a broken spirit as much as those with broken bones.”
Those words belong to Jim Murphy, leader of the Scottish Labour party, speaking at the televised Leaders’ Debate – Scotland. He went on to say that we need to remove the stigma attached to mental illness. Patrick Harvie of the Scottish Green Party agreed with him. (If you watch the Leader’s Debate video I’ve linked to, you’ll find the relevant part 53 minutes in.)
I was watching the debate with one eye on Twitter and within seconds of his words, several people tweeted their delight at hearing them, including supporters of different parties. We don’t hear much about mental health from politicians, and Jim Murphy started by saying he thinks politicians in all parties need to focus more on it.
I agree, and judging from my Twitter timeline, so do many others. So what do the political parties have to say about it?
Murphy is not the only UK politician to talk about the need to remove stigma around mental health. Nick Clegg, the current Deputy Prime minister, has placed mental health as a core policy for the Liberal Democrats.
Healthy Minds and Healthy Bodies
Mental Health is probably the most important issue of our time:
- With healthy minds we can achieve so much more than when we are broken in spirit.
- With healthy minds we are more likely to be physically healthy, since some mental illnesses, such as depression put you at far higher risk of contracting some physical illnesses – heart disease and diabetes being just two. And prolonged physical illnesses make you more at risk of mental health problems.
So, it makes sense to approach mental and physical health as integral, rather than as separate entities. Do any of the parties have this approach?
I decided to investigate the policies of all the main political parties standing in the UK, and the SNP, which is the party in power in Scotland’s parliament and so in charge of our NHS. (In the UK, healthcare is devolved, so the UK government in Westminster only legislates for England on Health. The parliaments in Scotland, Wales and Northern Ireland receive a block grant for public services, with an allocation for Health Care. Each of these parliaments then make their own decisions on Health Care, including how the funding is allocated.)
Four of the main parties I investigated have easy to find policies on Mental Health. Two parties have commissioned research and developed strategies based on that research.
Here is what I found:
The Conservative Party
The first policy I tried to find was the Conservative party’s, since they have been the main party in government for the last five years. Typing “Conservative party mental health policy” into Google, brought up an article by Dr Liam Fox MP: The neglect of mental health in the NHS is a national disgrace
Dr Liam Fox is a Conservative MP, and is clearly concerned about mental health provision, but in spite of trying a variety of related searches, I have not been able to find a Conservative Policy document on Mental Health. The closest I found was this article from last year, by Nicky Morgan, the education minister. I’ve also tried to search the Conservative Party Website, but to no avail.
If the Conservatives have a policy on mental health, it’s well hidden. Even after the launch of their manifesto I have not been able to find a policy.
It was not easy to find the SNP’s policy on Mental Health. Their Vision statement for Health doesn’t mention mental health. Neither does their page on Health and Wellbeing progress. It is not mentioned on their launch page for their Families Manifesto. I did eventually find a paragraph in their 2015 manifesto that relates to mental health, and further research brought more information about their track record so far. (In Scotland, as the party in power in the Scottish Parliament since 2007, the SNP have been responsible for Health, including Mental Health.) The manifesto says that the Scottish Government has invested £15 million in a Mental Health innovation fund, and that they would seek increase this to £100 million over the next five years – so on average £20 million per year. Most of this is to be directed towards “projects that will improve mental health treatments in the primary care sector.” (This means it will be directed towards GPs.) This money is also intended to “enable further investment in child and adolescent Mental Health services.”
However, according to Jamie Hepburn, Scottish Parliament minister for Sport, Health Improvement and Mental Health, expenditure on mental health in Scotland is around £896 million. This makes an increase of £15 million look considerably less of a commitment, especially when you take account of inflation, which even at the current 0.5% would require an increase of around £4.5 million just to maintain current spending levels. Furthermore, according to the LibDems, there are “883 fewer staffed mental health beds since 2009, hundreds of young people face waits of over six months to begin treatment and our hospitals have lost 64 specialist mental health nurses.”
I also found documents relating to a Mental Health Bill introduced to the Scottish Parliament in December 2014. Early documents state that one aim of the bill is “to ensure that people with a mental health disorder can access effective treatment quickly and easily,” and includes reference to a “named person” who would look after a patient’s interests. It also includes reference to detention, compulsory treatment orders and criminal procedures. Later documents, including the Mental Health Bill, mostly refer to the legal aspects.
I’m really not sure what to conclude about the SNP’s mental health policy. For instance I’m not convinced that the primary care sector is the best place for investment – though this depends on how that investment would be made, and this is not clear. Overall their policies seem to take a piecemeal approach to an extremely important issue. This is echoed by the SAMH (Scottish Association for Mental Health) in a response to Scottish Government’s 2012 – 2015 Strategy for Mental Health. SAMH say, “While there are many excellent actions within this draft strategy, there is no sense of an overall vision or strategic direction to guide systems and services development.”
The Liberal Democrats
In contrast to the other two parties currently in power, the Liberal Democrat’s mental health policy, Serious about Mental Health, was easy to find. As I’ve already mentioned, they have for some time been talking about Mental Health issues, so this is as you would expect.
Their website states they are “using £400 million to help people with mental health problems get the right support early on.”
They also have plans to improve services. The main points are
- Crisis Care Concordat – ensuring nobody is turned away who needs support.
- Choice – the same choice as in physical health care
- Liaison and Diversion – identify health issues of offenders entering criminal justice system
- Restrain – train staff to reduce harmful practices
- IAPT – invest in psychological services
- Children’s mental health – £54 million more investment
- Time to Change – a campaign to change attitudes and reduce stigma.
However, the Liberal Democrats have been part of the Coalition government for the past 5 years, so I also looked at their record. This makes the picture less clear. For instance, when I searched for “increased spending on mental health England” the top two results are contradictory. In March Nick Clegg announced a £1.25 billion boost to Mental Health funding – over five years, with most of this to be targeted towards helping young people. This report also shows that £7 million extra was spent on psychiatric beds this year. However, in December 2014, NHS England revealed that funding for children’s mental health services had fallen in real terms by 6% since 2010. Another report suggests that in England, in real terms the overall mental health service budget has fallen by 8%.
On the other hand, the in the autumn of 2014 Nick Clegg set up a Mental Health Taskforce to discuss ways to improve services for young people, welfare and employment issues as well as how to improve crisis care.
The Liberal Democrats Care Minister Norman Lamb has today outlined a plan to integrate Mental Health care with GP services, as part of a general plan to integrate health and care services, and improve efficiency. (The plan includes using technology more frequently so in some cases patients would consult GPs by phone or Skype.)
Of the three parties currently in power in either the UK as a whole or in Scotland, the Liberal Democrats are only one with an easy to find Mental Health policy. They have been the much smaller partner in the coalition government with the Conservatives, who appear to have no Mental Health policy. This makes it hard to say exactly what they might have achieved with a different partner, and also makes it hard to know what their commitment is for the future. For example, it would have been useful if their website had given more detail of what the Taskforce achieved.
The Green Party
The *Green Party’s Health Values and Principles contain a lengthy section on Mental Health.
I’m not sure of the difference between a policy and “values and principles” – but I have heard Natalie Bennett, the Green’s leader, say that things in the “principles” section of their document are “long term aims” rather than matters they would anticipate being dealt with in the next parliamentary term. This probably means that some of the points outlined here would be long term aims. Sometimes the document says the Green party “would” (which I take to mean a policy) and other times they say something “should” happen – which possibly indicates a long term aim.
That said, the Greens have certainly thought in depth about mental health and its links to other areas of our lives. For example, the Green Party sees mental health as linked to economic, social, psychological and biological factors. (I agree that all of these need to be considered.) They also see the high incidence of unmet mental health needs in young offenders as an indication of a need for their social justice and early intervention policies.
Some of the main points the Green Party say they would adopt are:
- a range of readily available evidence-based therapies and treatments, based on the NICE guidelines.
- ensure increased funding for research.
- encourage mental health awareness training to reduce stigma
- workplace mentoring
- bring psychotherapists under the governance of the Health Care Professionals Council
- encourage schools to employ suitably trained counsellors
- ensure that LGBTIQ community specific health programs are funded
- fund initiatives to reduce barriers into those from black and minority ethnic groups receiving care
- increased mental health training for GPs
- encourage GP practices to employ a mental health nurse
One policy I found particularly interesting was the “personal budget.” If I’ve understood this correctly, it would mean people would be given a budget to access services of their choice – the Green Party don’t say whether this would include private care. Given that the range of mental health care options currently available on the NHS is fairly limited, and that talking therapies such as CBT are usually available for 6 – 15 weeks, this proposal has potential to allow people time for deeper healing.
The Green Party has clearly given issues a lot of thought, and many of their suggestions would surely enhance life for those with mental health challenges. What is less clear is how many of these suggestions they would push for in the next parliament.
Like the Green Party, UKIP include Mental Health under the umbrella of Health. However, it consists of only a few paragraphs.
The main points are:
£3 billion extra cash for the NHS. £1.7 million of this would be spent on Mental Health each year, to be phased in over 2 years.
Access to specialist mental health treatment for pregnant women and mothers of babies under one.
Ensure “clinicians take a ‘whole person’ approach to physical and mental health.” This would mean people with long-term physical illnesses would have access to local mental health services. Patients “experiencing distress or exhibiting mental health issues” on admittance to hospital should have physical and mental health assessed, with psychiatric liaison services in acute hospitals and A & E. Health and social care would be integrated.
UKIP also intends to increase funding for research and treatment of dementia.
UKIP have considered mental health, and like several of the parties they recognise that mental and physical health are linked. However, their policies do not appear to have much depth, and they focus only on a few aspects. Their emphasis seems to be on providing support for people with physical illnesses. It’s true that long term or serious physical illness can impact mental health so this awareness is welcome. However, there are many other causes of mental health problems – for example, the mental health charity, Mind, lists poor housing as making people more vulnerable to mental health issues.
It is not clear whether the £170 million extra per year is in addition to the £250 million extra already announced by the Lib Dems.
It’s also hard for me to take UKIP’s mental health policy seriously when balanced against their intent to repeal Human Rights legislation.
The Labour Party
The Labour Party launched its manifesto today, and it includes a section on Mental Health. (Page 36)
Some key points are:
- Mental health is to be given equal priority with physical health.
- People will have the same rights to psychological therapies as to drug treatments.
- To reduce undiagnosed mental illness, NHS staff training will include mental health.
- A higher proportion of the mental health budget will be spent on children than at present.
- Teachers will have training to enable them to identify problems and link children with support.
- They will encourage development of children’s social and emotional skills “for example through the use of mindfulness to build resilience.”
- A goal is that all patients will be able to access talking therapies within 28 days, and all children who need it will be able to access school-based counselling.
Labour sees mental health as part of a wider “Whole-Person Care.” Their plan is to integrate health and social care services so that three currently fragmented services become “a single service coordinating all of a person’s needs – physical, mental and social – with preventing illness and promoting good health at its heart.”
This approach is similar to that of the Green Party and to that the Liberal Democrats outlined today.
What I found particularly interesting about the Labour Party, however, is that when I started my search for their policies, I came across document after document, with particular emphasis in child mental health. This is because Ed Miliband set up a Taskforce in 2012, and launched this at the Royal College of Psychiatrists. This Taskforce was asked to find: “how society needs to change to prevent mental health problems and promote good mental health and to look at how we can support fuller integration into the wider community of those affected by or recovering from mental health problems.”
The report concludes: “If we were to act on the logic of the arguments presented here, it would help create a society that looks very different, one where mental health would take centre stage in supporting people across the lifecourse … this is about a cultural shift in how society treats mental health, including politicians and policymakers, the NHS and wider public services, businesses, charities and community groups, and citizens themselves.”
Since they have already commissioned research, it is clear Labour has made mental health a priority. With their policy to introduce “whole-person care” the Labour Party has taken the suggestions of the Taskforce on board. They have clearly thought out objectives and a coherent approach. I really like that they see prevention of difficulties as equally important as treatment. The only criticism I have is that I would like to see costings for these policies.
Before I started looking into the party policies, I already knew about the Liberal Democrats’ interest in Mental Health, so I expected them to be the party with the strongest policies.
Now, after researching, it seems that Labour is the party with the most cohesive policy for improving mental health and creating an integrated approach to health. I particularly like that they see preventative measures as the way forward and that they recognise the importance of mindfulness enough to include it in their manifesto. The Greens and the Liberal Democrats also show a strong commitment to improving mental health.
Disclamer: While I have tried to write a balanced report, it is possible I may have missed information. I will be happy to amend any section of this article on receiving more information, and have already updated it as manifestos came out.
*I looked at the English Green Party’s policies. I have heard Partrick Harvie say that the Scottish Green’s share similar policies although they are a separate party.