In the run-up to the General Election, I shall consider how far Liberal Democrat, Conservative and Labour General Election proposals live up to the need to deal with nation-wide issues from local perspectives.
With less than six months until the General Election, the three main parties have selected their key campaign topics. It seems unnecessary to point out that, when fighting a General Election, it’s a good idea to campaign on issues that attract voters from across the UK. Though, the fact that an issue affects people from all over the nation does not render localism irrelevant. Far from it.
The upcoming election will be fought largely around the UK’s health services. And what issue could be more national than the NHS? But, organising our National Health Service does not mean rolling out blanket policies from the centre.
Liberal Democrat Leader, Nick Clegg, has taken this opportunity to campaign on one of his long-held political interests: mental illness. Improving mental health services can only be a good thing. Mental illness accounts for 23% of the UK’s disease burden. But, receiving just 13% of NHS funding, mental healthcare is woefully under-resourced. What is more, mental illness is still surrounded by a damaging taboo, which is shocking, considering that, at any given time, an estimated one in six people are dealing with a mental health issue.
The Lib Dems’ focus on mental health is extremely welcome. At this year’s conference, Nick Clegg announced the coalition’s plans to introduce NHS waiting time standards for mental health patients. As of April 2015, all patients dealing with depression will receive talking treatment within 18 weeks. Those experiencing psychosis will begin treatment within two weeks of transferal. What is more, the leader wants to see mental health, ‘bang on the front of the Lib Dems’ manifesto.’
Clegg’s determination to get mental health onto the Westminster stage constitutes a vital step towards dismantling old-fashioned taboos. Though, the UK needs a more nuanced, more localised, approach to mental wellbeing than the institution-based investment that the Lib Dems are recommending. What happens beyond hospital walls is fundamental because mental illness encompasses a broad spectrum of conditions. Addiction, depression and psychosis all require wildly different treatment. The term ‘mental illness’ is actually something of a misnomer. Conditions such as anorexia and alcohol dependency have obvious social and physical dimensions, and the strain of anxiety and depression upon the body is often overlooked. Physical, psychological and social variables all influence our mental well-being. Mental health, therefore, is a fundamental public health issue.
Differences in the geographical distribution of certain conditions further highlight the influence of people’s immediate social conditions. During 2013, one quarter of working-age adults in Blaenau Gwent, South Wales, were on benefits. Unemployment has long been associated with depression. And, sure enough, a staggering 10,000 prescriptions for antidepressants was issued for Blaenau Gwent’s population of just 60,000. Unlike areas with more average employment rates, Blaenau Gwent requires both medical services and employment initiatives to improve its mental health situation.
Local government must play a central role in dealing with mental illness. Our immediate environment heavily affects our mental wellbeing, and it is local authorities that have the most influence upon the surroundings in which we live.
In fact, local government is already taking the lead. In 2013 the Local Authority Mental Health Challenge was launched. Since then, 28 councils have appointed an elected member to act as a mental health champion. Councils also assess how all of their policy, covering housing, leisure and planning, is likely to affect mental wellbeing.
Indeed, providing services through local bodies is not enough. If we approach mental illness by rolling out isolated and strictly medical treatments, we risk forcing communities to rely upon an unpredictable amalgamation of services, determined by CCGs, mental health trusts and GPs with little stake in the local community.
GPs commonly report that patients who complain of depression and anxiety often also relate experiences of loneliness and isolation. One-to-one counselling provided through a national scheme will not strike at the root of the issue. Also, high levels of reliance upon services strips people of control over their own lives, which can, in turn, generate anxiety. If isolation is a key cause of depression, we much engage local people. The key to improving the situation lies in community empowerment.
Yes, Nick Clegg is right that mental health is important. But, before the Lib Dems get ahead of themselves, the party needs to consider exactly what it means by ‘mental illness’. If they do, and if they realise the deeply local ramifications of the nation’s mental health needs, the Lib Dems may well be onto something…
For further reading, members can access the policy briefing, The social and economic impact of the Rotherham Social Prescribing Plot