On Monday, 20th January 2014 our deputy Prime Minister Nick Clegg addressed a conference where he advocated that change is necessary to improve mental health care. Initially, I was delighted to finally witness a vital area of health being brought to public attention. It has been well documented that at least one in four people will experience a mental health problem at some point in their lives. This staggering statistic illustrates a domain that deserves priority but more importantly requires attention urgently.
But before I could even gather my thoughts on his grand speech, I was bombarded with articles, comments and tweets, all of which appraised his views on the current problem of mental health and aims to overcome these. I, however, remain sceptical of his grand remarks and perhaps agree to some extent with Paul Jenkins, who wrote in the Independent ‘while the government is saying all the right things, the reality on the ground simply does not match up to the rhetoric’. Of course, as Jenkins argues this is greatly worrying for several reasons and I will discuss a couple based on my interests, knowledge and experiences.
My overarching concern with Clegg’s speech is the over simplicity given to the nature of mental health. He identifies that ‘we’ are still not comfortable talking about mental health and this issue of hiding as well as being ashamed of mental illnesses is old-fashioned. Whilst arguing against stereotypes he falls into his own trap. Is this merely old-fashioned? And for whom are these views old-fashioned? It may be the case for some groups that the hiding of mental health issues is a very real problem and cannot just be dismissed as ‘old-fashioned’ and outmoded. For example, my research data, which is exploring understandings and management of mental health problems amongst the Gujarati community in Leicester, suggests this notion of hiding, being ashamed and uncomfortable is far from old-fashioned but a lived reality, deep-rooted in culture. It is not as simple as talking about mental health to remove stigma, but rather understanding where these opinions arise from and how they can be overcome from communities’ perspective; what a sociologist might refer to as a ‘bottom up approach’. It is far too easy for politicians to make grand claims that they think serve the majority but by doing so not only do they neglect the growing population of ethnic communities, but are on the road for further complications and obstacles. I may then – and have been many times – been asked what the solution is. Although I am at a stage where I do not have a definitive answer, I can firmly argue that services provided in the UK need to be more person-centred to accommodate for the multifaceted nature of mental illnesses.
The document ‘Closing the gap: priorities for essential change in mental health outlines 25 areas for health and care services in support of the governments’ priority policy of ‘making mental health services more effective and accessible’. One change the document presents, and Nick Clegg reminded us of, is the prospect of allowing people with mental health difficulties more choice and control concerning their care. As Jenkins rightly argues we have seen a 2% cut in mental health spending whilst mental illnesses are on the increase. How can improvements and more choice be provided if both services and funding are not available? Once again, an assumption is made that if more choice and control is given this will be a positive change regarding mental health services. Legislation geared towards greater autonomy does not always mean this is being preached on the ground. What about communities who face cultural and social barriers regarding their healthcare? I am not arguing that these steps should not be strongly considered, but that a central element is lacking, of understanding the complexity surrounding mental health and how we are able to manage it. Nick Clegg talks the truth about current issues of stigma and people being uncomfortable talking and responding to mental health and it is far too easy to call this ignorance. I agree it is key that we all work together (health, education, employment, justice and welfare); in a way where assumptions are not easily drawn and institutions closely work alongside our communities.
Therefore, Mr Clegg, I agree there has been an attitude to mental health which is just plain wrong and thank you for bringing these critical issues to the public domain. But as Jenkins argues ‘words simply aren’t enough’, and may I add too naively simple and broad. If we want to improve mental health care we need to see a detailed venture not only financially but how the government specifically sets out to bring mental health out of the shadows; that with greater understanding.
PhD Research Student, Department of Sociology and Social Policy