Feature

Policies in need of treatment

Instead of playing on popular stereotypes of mental illness, New Labour should promote a right to adequate treatment, says Cliff Prior

t is, perhaps, appropriate that the new century finds a new Janus Labour government facing both ways on mental health – back to the bad old days of seeing people with mental illness as ticking time-bombs who need to be contained and controlled through compulsory treatment, and forward to a better-funded mental health system with real improvements in standards.

No-one could accuse the government of ignoring the dire state of mental health services. There has been no shortage of strategies, policy announcements, circulars and speeches from ministers.

Successive governments have failed to invest in or plan mental health services. The great advances in understanding the roots of severe mental illness and how to treat it have not been followed up with resources – human and hard cash – that would allow people to benefit fully.

To complain that mental health services have, historically, been underfunded and poorly planned is to be accused of shroud-waving. But the facts speak for themselves. Better Act Now!, a campaign for the right to care and treatment to be enshrined in the planned mental health act, has thrown up some shocking statistics: one in four people turned away from hospital in a crisis; one in three denied a health or social service.

One in 10 people with a severe mental illness will take their own life. But what does that really mean? Take the case of David Tyrell from Oldham, near Manchester. Variously diagnosed with schizophrenia and personality disorder after troubled teenage years, he drifted back and forth between hospital, social services and prison before hanging himself from the back of a police cell door. He had pleaded to be taken into hospital but had been turned away. He has left behind a family devastated by the loss and angry that David had been failed despite being in contact with just about every service going.

The government’s Modernising Mental Health Services strategy document began with the words: ‘Community care has failed.’ Unfortunately the government did not mean the death toll of people failed by health and social care agencies, rather it was referring to media-generated scare stories over homicides involving people with severe mental illness.

The truth – that the most dangerous people on our streets are young men high on drink or drugs or that over 60 per cent of violent crime has its roots in alcohol or drug abuse – is harder to publicise.

The real failure has been the lack of support for the vast, mostly silent, majority of people with severe mental illness who need decent care and treatment.

Modernising Mental Health Services set the tone for all government initiatives since, including the latest plans for a new mental health act. Government rhetoric plays up to unfounded stereotypes that the 250,000 people with severe mental illness in the UK are potentially dangerous.

I believe that rhetoric should be less important than what happens on the ground – quality standards set and met, resources increased and users and carers involved. Those are the very real possibilities being held out by the government. The task is to grasp what is on offer.

The future is full of opportunities. NSF is still pressing, along with the Manic Depression Fellowship, the Mental After Care Association, the Mental Health Foundation, Mind, the Richmond Fellowship and the Royal College of Nursing, for the government to include a legal right to adequate care and treatment in the new mental health act.

We already have the support of dozens of MPs, trade unions representing over 1 million members and over 20,000 service users, carers, professionals and members of the public.

Extending compulsory treatment to the community is no-one’s priority; instead these are raising standards and offering choice and diversity in services and their modes of delivery. It boils down to changing lives and changing attitudes.

It is now possible to create mental health services where people are fully involved in their own care and treatment, where they receive a clear, early diagnosis, effective new drug treatments with less severe side-effects (even if they cost more than the dirty old drugs), support in accommodation, meaningful occupation, support in maintaining social and family contacts – in short, mental health services where a life is recovered and not lost, as so often in the past.

Copies of the Better Act Now! petition, which must be returned by Friday 31 March 2000, can be obtained from the NSF website at http://www.nsf.org.uk or from Martin Chapman on 020 7330 9108.