Cameron's Clumsy Question Dodging

David Cameron was interviewed last night by Fiona Bruce on the Paul Farmer report on the state of mental health care in England. She asked him about the fact that 3/4 of mentally unwell people are not receiving any treatment. His answer? "We must deal with stigma." What? He wasn't asked about stigma. He asked about the fact that budgets have been reducing in mental health care for decades. He answered with a statement about stigma, because he wants more mentally ill people off benefits and into work and he knows that one of the reasons mentally ill people don't work (among many) is that employers don't like taking on mentally ill people. Their employees don't want to work with them either, because the image of mentally ill people is tainted with acts of violence, that come directly from film and television, plus the tendency of news organisations to make a huge story of incidents of violence by mentally ill people. There are plenty of nasty murders that happen, that go unreported, but if a mentally ill person kills someone then it hits headlines.

The mental health system has been in decline for years, as a deliberate act of the leadership. That's why Cameron didn't want to answer a direct question on the subject. The number of beds available has been in steady and constant decline for over forty years. The only people that get in-patient care are those with a track record of harm to themselves or others. Everyone else - well they can just be treated at home can't they?

The idea of community based care is a good one. No-one wants to get sectioned when they're young and just stay in an asylum until they die. However, from personal experience, a good therapeutic in-patient care facility, is a vital part of community care. This is where the system has failed so many people. We the mentally ill need to have a place we can go, when life at home becomes unbearable. But the managers of the NHS and the politicians, don't want to spend money on in-patient care, so they are forcing thousands of people to cope at home on their own. Home can become a terrible nightmare at times. A lot of patients find that they are less able to socialise the older and the more entrenched their problems become. So having a few days in a relaxed environment with nurses, doctors and other patients around can be absolutely vital to manage the ups and downs of living independently. As far as I am concerned, this balance has never really been achieved in the NHS. When I got ill in 1995 you could get sectioned for looking at a nurse the wrong way. Fast forward twenty plus years and you'd have to have a serious attempt at suicide to get onto a ward for more intensive care and monitoring.

The fact is general medicine within the NHS gets priority over mental health. It's always been like that and any increases in budget promised at various times by Cameron, either in coalition or as a single party government, was effectively stolen by the commissioners of healthcare and moved to keep waiting lists down in general health. Cameron can promise all he likes. Unless increases in mental health budgets are specifically ring fenced and protected from commissioners, mental health care will continue to decline and more people will die.