DollYou may recall a couple of months ago that our beloved leader had a moment in the Commons when he unveiled a new ‘people policy’; he likes to do so every once in a while just to make it look as though he cares. This one concerned mental health and its effect on a larger section of the population than is generally acknowledged; the subject became fashionable for about a week, garnering sympathetic headlines far removed from the infamous ‘Bonkers Bruno Goes to Loony Bin’ one that graced the front cover of the Sun when an ex-boxer underwent a breakdown a few years back. As far as I know, coloured wristbands designating various different forms of mental illness weren’t produced for the schoolchildren of Britain to wear; and I never saw any prominent politicians in T-shirts bearing the legend ‘This is what a nutter looks like’. Cameron’s conversion hasn’t prevented the Government and their medical Gestapo, Atos, from clinging to the conviction that mental illness is an illusion perpetuated by workshy fops. But not every sufferer is even old enough to be an unpaid intern at a tax-dodging corporation.

David Cameron announced his initiative four months into the effective imprisonment of a 15-year-old boy called Matthew Garnett, who was detained under Section 3 of the Mental Health Act last September. He was held at a special mental health version of an A&E ward, a Psychiatric Care Unit intended for short-term emergency care. However, Matthew, still legally classified as a child, remains under lock and key at the PICU six months later, despite his parents being promised his stay would be for no more than six weeks. Matthew suffers from a string of mental disorders hard enough for a grown adult to cope with; add autism, learning difficulties and ADHD to the usual adolescent mix and the extent of Matthew’s problems would seemingly require professional care and attention befitting his condition. The fact that he’s also a child – something that would have been trumpeted from the rooftops had anyone over-18 been accused of sexually abusing him – should also ensure the kind of support society expects for a vulnerable minor, no?

Unsurprisingly, Matthew’s condition has gone from bad to worse during his six-month detainment at a location that even the members of staff working there confess is not equipped to deal with Matthew. Layers of bureaucracy are not only prolonging the point at which Matthew can be removed to a specialist autism unit, but they’re also accelerating his deterioration as he continues to be denied the kind of specific treatment he needs. His mother has attempted to give the authorities responsible for Matthew’s imprisonment a kick up the backside by alerting the wider world to his predicament via an online petition demanding something be done; but it hasn’t been done yet. This would be a sorry enough story were it unique, but it sadly isn’t.

Specialist units for children with mental disabilities have waiting lists just like those for council housing; in some cases, the fate of a mentally-ill child rests with committees that sit as regularly as once a month (!) to examine applications. For those parents whose children live at home and attend day schools that, in theory, are there to give the pupils the care that would be impossible at an ordinary school, the strain of looking after a mentally ill child is not eased by having to navigate their way in and out of a care system so complex it makes the EU resemble a jigsaw aimed at 3-4-year-olds. Social workers and other middle-men are assigned to act as go-betweens, but the system itself is a muddle of well-meaning liberal ineptitude and traditional British bureaucratic buck-passing.

There are thousands of overworked and underpaid workers within the system whose selfless dedication to the job shames the ivory tower cluelessness of management; and it is ironic that a society that increasingly places children on a pedestal seems to rate the mental health of its offspring as such a low priority. Perhaps the pervasive image of ‘the perfect child’, perpetuated by everyone from celebrities forever parading their mini-me’s across the media to the yummy mummies at the school gates extolling the prodigious talents of their little darlings, doesn’t help where children who don’t fit the mould are concerned. The modern mother is supposed to be able to do her duty whatever the circumstances, and mothers who fail the Supermum audition are viewed as letting down the Breastapo sisterhood.

At one time, institutions with rather unsavoury reputations (sometimes deserved, sometimes not) served as repositories for parents who couldn’t cope with a mentally-handicapped member of the family; not necessarily out of sight and out of mind, but safely secluded from the social stigma mental illness carried like an incurable virus. Rather than improve the system towards the end of the twentieth century, the decision was taken to dismantle it and introduce a more ‘humane’ method of dealing with the difficulty. No one is suggesting the worst aspects of the old Victorian asylums weren’t worthy of abolition; but what superseded them has shifted the burden from the state back to the family by wrapping the state’s revised role in so much red-tape that it is often next-to-useless.

On paper, a support network is in place for the tremendous strains that are placed on parents struggling to cope with the myriad of antisocial side-effects that can come from mental illness; yet, in many cases, the current system is failing them, and with endless cuts to services on a loop, there’s little hope the situation will improve; and that’s just not good enough.

© The Editor



  1. In an ideal world, there would be all types of care/treatment available on-tap for all types of mental conditions, but the world of big, systemised organisations doesn’t work that way, it has to be simplified, mechanised, almost binary.
    When the decision was made, for lots of good reasons, to focus on ‘care in the community’ and away from largely Victorian institutions, that became the single mantra to be followed by all involved in the process – it’s how McDonald’s gets all its order-takers worldwide to say “Do you want fries with that?” or how Starbucks gets to deliver exactly the same hot beverage in every shop – give them a simple message, no deviation, no discretion, and there’s a better chance it will be followed.
    Trouble is, mental health care ain’t a burger or a brew, it’s an infinitely-shaded grey-scale, ranging from what we accept as normal to what we call utterly deranged – any comprehensive care system needs to accommodate every step on that scale: having a single, all-encompassing mantra won’t ever manage it.

    But then, if you’re a huge organisation, the other way means giving infinite power and discretion to the low-level operatives on a case-by-case basis, which then means you (the NHS) can’t manage what they’re providing, nor can you accurately cost it or make financial provision for it, because you just don’t know, one month to the next, what their thousands of individual local decisions will be and what that will cost to provide across the land. If you can’t measure it, you can’t manage it.

    That’s the problem seen from ‘above’ – the problem with the current approach, as seen on the ground, is that it appears to get it wrong most of the time – it appears to be underfunded, surrounded in defensive red-tape, unable to respond to critical need and rarely giving the right service to the right people at the right time.
    I don’t know how to solve it and neither does the NHS – the Government claims it is starting to give greater focus to mental health issues, but the scale of the problem it faces is huge. Merely throwing thoughtless money at it (the Gordon Brown approach) isn’t the route to a solution, the service needs a ground-level-up rethink, starting from understanding the users’ full range of needs, only then working out what that will cost to provide and finally how to deliver it nationwide. That’s a long job, longer than any 5-year term, so don’t hold your breath.

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  2. In addition to Mudplugger’s analysis, I would say the current regime operated by the DWP with regards to benefits for those with mental illness needs a radical overhaul and needs bringing into the closer co-operation with the Department of Health/NHS.

    I am supporting someone now going through the work assessment. He has memory problems which have been diagnosed by a neurologist as being consistent with anxiety and depression (which is ALMOST a relief as we feared it was early onset dementia). He is also borderline alcoholic (more of a binge drinker when he can’t handle stuff).

    He was assessed by the DWP as unfit for work, then called in for his annual re-assessment to be found fit for work on the same information. The assessment was carried out by a physiotherapist. So he is going through the appeal process, has been dicked around by the DWP with the wrong information about how to navigate the process (deliberately?), and, as a result, this has made his mental health worse and he is drinking more.

    When I hear this government is prioritising mental health I can see what they mean – they intend to make it worse, for those with mental health issues and their carers – as a matter of the utmost importance.

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  3. To add to windsock’s introduction of the DWP and to complicate it further, there’s also the local authority, which is involved in the provision of various services under its ‘public health’ remit. So we’ve already got three organs of government, all working in their own silos, with their own missions objectives and budgets, and which the ordinary service-user (customer, victim) is unable to penetrate or co-ordinate – the services may be there, the money may be there, but you just can’t access it.

    Because government is so complicated, there may be a potential solution in providing people with a single ‘pilot’ to guide themn through this maze. My reason for suggesting that dates from trying to get support for my aged widowed mother more than a decade ago – I was fortunate to encounter Angela from the local Social Services who, once I’d explained the issues, quickly took ‘ownership’ of the situation and she personally navigated my mother’s different needs through the various arms of the support providers – within a short time a full package of services was in place, all down to the co-ordinating role played by Angela and the fact that she knew what was available, from where, and how to get it working.
    Maybe that model could offer a solution to the challenge of how those in need relate to the complexities of modern, and often remote, government agencies. It probably couldn’t be any worse and it may even save money because the right services would be invoked at the right time. Just a thought.

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