S&C Contributing Editor, Maddie Wallace, reports on the impact of austerity on mental health services in Portsmouth and across the country.
In 2012, amidst much media fanfare, David Cameron set out his vision for ‘Parity of Esteem‘ between mental and physical health. The Health and Social Care Act decreed that ailments of the mind and illnesses of the body would be equally valued, and in 2016 the Conservative party congratulated themselves for making Britain a country that works ‘not for a privileged few, but for every one of us’. Five years down the line from David Cameron’s vision, and it’s hard to imagine a political party more out of touch with the current mental health crisis in this country, a crisis they have arguably played a significant part in creating.
…we will make Britain a country that works not for a privileged few, but for every one of us.
Theresa May, 13th July 2016
In her annual lecture to the Charity Commission on 9th January, Theresa May praised the work of mental health charity Mind, yet failed to mention not only the closures of local centres Mind have had to endure under her party’s austerity policies – including in Portsmouth – but also that it was Mind who warned in 2013 that those policies were creating a mental health crisis.
In the final quarter of 2010, there were 23,607 mental health beds in the UK. By 2016, there were 18,820, a reduction of nearly 5,000. It’s a similar story for the number of psychiatric nurses in the NHS : 41,320 in 2010 – 36,870 in 2016.
It is worth asking if these statistics can be explained by something other than the cuts: is demand for mental health services decreasing, or has our treatment of mental illness improved?
Sadly, no it isn’t. And no, it hasn’t.
The Conservatives are not responsible for every mental health condition in the UK, but it is hard to argue that austerity has not had an impact, through: benefit cuts, sanctions, closures of community based organisations like Sure Start, the bedroom tax, zero hours contracts and reductions to pensioners’ services, for example. The sweeping reform of welfare benefits alone led the United Nations to report in June 2016 that the government’s policy was a breach of international human rights for those with disabilities. While incidences of mental illness and demand for services have increased by 20% under the Conservative administration, severe cuts to those services, and to the budgets of mental health charities, means fewer people are able to access the help they need.
What does this mean for Portsmouth, in terms of mental health incidence and services?
According to the Joint Strategic Needs Assessment Briefing Note, issued by the city council and the Clinical Commissioning Group:
‘There is a strongly positive correlation between deprivation and people aged 18+ years receiving services for mental health problems from Adult Social Care’.
Portsmouth is ranked 63rd out of 326 local authorities for deprivation, with 26,000 Portsmouth residents living ‘within the 10 most deprived English small areas’. Wards such as ‘Charles Dickens, Paulsgrove, Cosham and St Thomas wards [experience] the highest deprivation in the city, and poorer wellbeing’. ‘24% of children in the city live in poverty compared to 20% in England’ and ‘over half of older people in the most deprived areas live in poverty’.
According to the council’s mental health strategy for 2016-2021, ‘Mental health problems are common. In the population of Portsmouth that equates to around 52,879 people experiencing a mental health problem each year’.
Why, then, are further cuts being made to vital mental health services within the city?
In December, Portsmouth Counselling Service shut its doors to clients after 23 years of providing a unique service to local people, offering support for drug and alcohol misuse, domestic violence, depression and anxiety, trauma, and providing specific counselling for ethnic minorities. Saving a miracle, it will cease to exist by March.
Portsmouth City Council withdrew funding from the service 2 years ago, and at the end of last year, the Clinical Commissioning Group followed suit, prompting residents and the local Lib Dem and Labour parties to campaign for a change in the rules around the council’s Public Sector Challenge Fund, which would allow further investment in Portsmouth Counselling Service. With almost £500,000 still in the pot, the council voted in December to allow changes to the rules which would enable Portsmouth Counselling Service to apply for further funding, however so far this has proved problematic, with Cllr Luke Stubbs admitting in an email exchange with me in January that things are still ‘in a state of flux’.
According to the charity’s director, David Miles, Portsmouth Counselling Service ‘Only needs core funding of £60,000 a year’. This would enable the charity to operate its service, and then apply for extra grants and funding from other providers. When the council can afford to spend £80,000 over 5 years just cleaning the windows of the civic offices, or £95,000 per year replacing the blinds inside the building, questions have to be asked as to where the city council’s priorities truly lie.
Within weeks of the Clinical Commissioning Group announcing it was withdrawing funding from Portsmouth Counselling Service, local youth mental health provider Off The Record also revealed it was being forced to close due to a reduction in local government funding. The service has been in operation since 1977, and provides support and counselling for 3500 young people aged 11-25 in Portsmouth each year. Given that the council’s own Joint Health and Wellbeing Strategy claims that ‘Growing up in poverty has a significantly negative impact on health and wellbeing outcomes for children and has the potential to expose children to more risk factors’, continuing to provide funding for a vital youth mental health service might be seen as a core priority for the local authority.
Unfortunately, Portsmouth’s experience is reflective of the national picture. While the government continues to spin soundbites on the importance of mental health, their policies continue to devastate the lives of those suffering from mental health issues. Meanwhile, the vicious cycle of austerity, cuts and financial insecurity is making more and more people ill, and reliant on the very services the Tories are scything through with blades sharpened on the wheel of corporate tax avoidance.
The national crisis in mental health has prompted Psychologists Against Austerity (PAA) – a campaign group whose members include Clinical and Counselling Psychologists, Academic and Research Psychologists, Educational Psychologists and Forensic Psychologists, as well as trainees, other health care professionals and community members – to produce a damning report on the damage caused by Conservative policies based, they claim, ‘On robust and longstanding psychological evidence’.
PAA outline key areas or ‘ailments’, where government policies directly cause, or influence, greater hardship for those who are already struggling under the weight of austerity: Humiliation and shame, fear and mistrust, instability and insecurity, isolation and loneliness, being trapped and powerless.
The group claim:
People living in particularly deprived circumstances are likely to be exposed to situations that have elements of all of these ailments. Many austerity policies, such as harsh benefit sanctions, are likely to produce experiences that have more than one of these features. These experiences can also intertwine and coalesce to compound experiences of distress over time.
Psychologists Against Austerity, The Psychological Impact of Austerity
In other words, more and more people are experiencing mental illness because the pressures of living under austerity are creating situations where their lives have become unstable, or even untenable. For example, many people, although in work, are employed on zero hours contracts, and do not know from one week to the next how many hours they will work and what they will earn, let alone have any entitlement to sick and holiday pay. They exist in a constant state of uncertainty which is at best mentally exhausting, and at worst, extremely detrimental to mental health.
Psychologists Against Austerity claim that: ‘Robust research has established that job insecurity has damaging effects on both individual employees, and organisations. The more insecure the job, the higher levels of mental distress and physical health complaints found in employees’.
The number of people on zero hours contracts increased from just under 200,000 in 2009 to over 900,000 in 2016. It’s hard to argue anything other than that ordinary people are once again bearing the brunt of government policies which don’t have their best interests at heart. According to research from the Joseph Rowntree Foundation cited by PAA, under Conservative austerity policies, in 2014 poor people in work outnumbered poor people out of work for the first time ever.
And for those people claiming benefits, the implications for mental health are equally concerning. In 2013, the DWP was reprimanded by the House of Commons Work and Pensions Committee for releasing misleading information and statistics, particularly in the way figures were presented to the press. It can equally be argued that the mainstream media has been complicit with the government and the DWP in presenting a negative view of benefits claimants that serves to undermine the public’s confidence in the social security system.
Government statistics should be used objectively to shed light on policy implementation, not to prop up established views and preconceptions. DWP should set out the specific steps it is taking to ensure that statistics are released in a way which is accurate, and fair to benefit claimants.Work and Pensions Committee, March 2014
For instance, research from the University of Kent showed that 30% of media stories discussing benefits focus on fraud, despite the fact that the fraud rate is only 0.5-3%. The researchers’ analysis of media coverage of benefits in national newspapers from 1995 to 2011 found that ‘while newspapers contain both positive and negative representations of claimants, the content of press stories is indeed skewed towards negative representations.’
The Conservative Government has relied on the – knowing or unknowing – complicity of the mainstream media in painting a bleak picture for the necessity of its austerity policies to a myopic British public. According to the Media Reform Coalition, six corporations now own 80% of local newspapers, 2 radio conglomerates have control of over 40% of independent radio licenses, and just 3 companies now dominate 71% of the national newspaper market. In cutting funding to mental health services since 2010, and in failing to address the financial uncertainty affecting the lives of millions – for example through a fairer taxation system – the Conservative austerity agenda has exacerbated the mental health crises of many in the UK.
Listening to Theresa May pledge to address the ‘stigma’ of mental health feels as if the government has suddenly woken up after a bad dream and just needs a good, strong coffee to get them through the day. But like all dreams, the government’s mental health crisis has an underlying reason at its root, something eating away at its subconscious that needs to be dealt with.
In the case of mental health in the UK, and as a day to day reality for many of those suffering, the nightmare is austerity.
UPDATED 13th February: Following the submission of this article, the writer received the following statement from Cllr Luke Stubbs:
The council has finally concluded a deal to preserve adult counselling services. A public statement will be made about this, probably on Tuesday [14th February 2017].
UPDATED 14th February: Announcement of award to YOU Trust of £50,000 from PCC’s voluntary sector transition fund which will allow it to continue the work previously undertaken by Portsmouth Counselling Service, including retaining the counselling service’s former volunteers.
This report is part of S&C’s renewed focus on investigative, critical journalism and our exploration of how it can be funded without compromising editorial independence through advertising or ‘advertorial’ (articles that have been paid for by businesses for promotional purposes). All of our writers work for S&C for free, supported by a team of 2 volunteers currently giving 4 days a week to S&C unpaid. If you would like to see more in-depth coverage of local issues and news, please consider supporting our work as a donor or a volunteer, following the links below.
Find out more
- Statistics on the financial impact of austerity on people with mental health problems and disabilities, Royal College of Psychiatrists
- Research on Benefits Stigma in Britain (2012) assessing the impact of stigma and other social influences on applying for benefits
- Report on ‘Counting the Costs of Austerity’ by Psychologists Against Austerity
- Submit your experiences of how the cuts have affected you and/or the people you work with to Psychologists Against Austerity’s Everyday Austerity project
- Take part in the government’s consultation on ‘Work, health and disability’ seeking views on what it will take to transform employment prospects for disabled people – submit your views by 17th February 2017
- Ask your councillor about plans to make the £500,000 funding in Portsmouth City Council’s Public Sector Challenge Fund more accessible to local voluntary sector organisations struggling with the impact of austerity
- Ask your MP what she is doing to address the impact of austerity on Portsmouth residents suffering from ill mental health
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