Paul Atkinson
Mental Health Action formed in 2021 in a merger of London-based mental health activists in Keep Our NHS Public and the Socialist Health Association. Many members of the group are in both organisations, though anyone interested in campaigning around mental health is welcome to join us. We now have over 40 members from different parts of the country – Liverpool, Newcastle, Sheffield, Barnsley, Norwich, Manchester, Bristol. We’ve become a national group. Our members are service users, their family members and carers; current and retired healthcare workers; community workers; NHS campaigners. Many of us have been involved in mental health politics and campaigning for many years. We regularly invite speakers to talk to the group about their experience in the mental health field for part of our meetings. If you would like to join us, please contact us at info@mentalhealthaction.uk
The political context of mental health campaigning
As we all know, mental health is the Cinderella sector of the NHS, disproportionally underfunded, understaffed and undervalued. Currently mental ill-health costs England around £300 bn a year, and while mental illness accounts for over 20% of the disease burden it receives less than 9% of NHS expenditure. People suffering severe mental health issues die on average 20 years earlier than those without such a diagnosis, some because of suicide, but mostly because of poorly treated physical illness. Despite campaigns to fight stigmatisation, achieve “parity of esteem” with physical health, tackle the “crisis of common mental health disorders” and establish basic standards of humanity and respect in our NHS services the state of the nation’s mental health seems destined for continuous deterioration and neglect. It is impossible to avoid the shameful conclusion that, along with people who are homeless, people on welfare benefits, immigrants, people with physical disabilities, people dependent on social care, the poor and racialised minorities, people suffering chronic and ongoing mental health issues are treated as an underclass in the UK as in so many other societies.
It’s also true that mental health is underrepresented in NHS campaigning – check out the websites of KONP and SHA for example. In part this is due to the nature of psychological ill-health. Sufferers and service users face potential isolation and the experiences of shaming and relational challenge that mental ill-health often brings. Physical ill-health more readily unites us in a common experience of health issues and the need to consult medical practitioners. Everyone sooner or later needs medical advice and treatment. Psychological problems still tend to divide and isolate us, and expose us to real or imagined social stigma. And yet, at the same time, given the history of denigration and/or patronisation of madness, campaigns to improve and transform mental health services need the initiative and leadership of service users and their families and carers, however necessary the support of professionals and the general public may be.
Mental health campaigns often need to target failings in the nature and quality of NHS services, as well as the ideologies informing them. The more familiar focus on funding, staff-levels, restoring the NHS, opposing service cuts and hospital closures, resisting privatisation and outsourcing are relevant of course. In fact, the sector is consistently ahead of the game as far as destructive attacks on the NHS are concerned. But this is not enough. The imposition of medical and scientific models on the cause and treatment of mental ill-health – biochemistry and drugs, behavioural science and behaviour modification, digitalisation and app-based therapy – represent current expressions of a historical denial of care, care in the form of empathy, communication and human relationship. Psychiatry is still over-focused on medication, community mental health services are too often limited to responding to crisis, NHS talking therapies are predominantly short-term courses of behaviour modification. Long-term person-to-person support is virtually non-existent in today’s public health services. For mental health services reliable empathic and enduring human relationship is the central ingredient of therapy and support.
What campaigns is the MHA group involved in?
MHA is a forum of collaboration and mutual aid supporting a variety of groups and individuals around the country involved in the politics of mental health. Below are examples of the campaigning work of the group’s members.
Several local groups of service users, their families and carers are members.
The Barnsley Mental Health Forum:
A service user led group formed in 2017: “We worked alongside services, staff and commissioners and were invited, in lockdown, to join online MH Strategic meetings. Now we contribute regularly in MH service planning and commissioning, influencing local MH services, and undertaking a Service User Review of the new local MH Strategy this winter. Also we are working with Healthwatch and service staff to develop an Accountability Group to hold MH Decision-makers and Engagement Teams to account for the effectiveness of decisions and the service-user involvement in them.”
Campaign to save Mental Health Services in Norfolk & Suffolk:
The campaign was born at a public meeting in Norwich by service users, carers, bereaved families & staff involved with the Norfolk and Suffolk Foundation Trust (NSFT), concerned about the impact of the ‘radical redesign’ necessitated by 20% funding cuts imposed by the Coalition Government. The RR caused cuts to vital services and resulted in staff being downgraded in pay with more workloads after fighting for their job and experienced staff leaving all together. A founder member of the Campaign, Terry O’Shea, was pivotal in providing mortality data and raising concerns about the number of deaths at NSFT alongside suspicions the trust had lost count of how many people had died. NSFT did lose track of deaths, confirmed by the Grant Thornton report published in 2023. Every year since, things seem to get worse, death count steadily rises and the numbers of unmet need is spiralling out of control. The Trust has had 10 CEO’s in 10 years and the campaign has stacks of evidence of governmental and regulatory neglect on the matter as people continue to be harmed by the Trust’s failings. This trust was named the worst mental health trust in the country, sat in special measures and its own staff gave stark warnings and yet no one listened. This trust’s self-acclaimed culture of fear and local and national budget cuts are delaying chances of improvement despite another set of new management and countless transformation plans. The campaign continues to push for parity of esteem in funding, safe services, scrutiny on mortality and accountability for the bereaved families and people still having to use the local services as they have no other choice.
Website: https://norfolksuffolkmentalhealthcrisis.org.uk
CHARM – Communities for Holistic, Accessible, Rights-based Mental Health:
CHARM, the Community for Holistic, Accessible, Rights Based Mental Health was launched in September 2020. We established CHARM as a society, following the concerns that we raised about the lack of meaningful consultation and co-production that took place regarding the re-development of Park House as a single site psychiatric hospital.
Charm Projects CIC was established in October 2022 in order to conduct research and community development projects to further our central values of compassion, community, human rights and holistic approaches to mental health. We are a campaign calling for radical changes in the way psychiatric services are provided in Manchester. We’ve teamed up with people with lived experience, trade unions, family groups and citizens ……….Read more
Adult Inpatient Bed Closures: Members of Hammersmith and Fulham Save Our NHS and Ealing Save Our NHS (both affiliates of KONP) have been doing work on permanent adult inpatient bed closures at the two trusts in NW London – in Ealing and at the Gordon Hospital in Westminster. They have also been pressing strongly, for some time, for the development and publication of a NW London-wide strategy for mental health provision, covering ALL mental health provision – and open for public engagement – so that the adequacy of provision and the effects of partial cuts and closures can be seen in a strategic context.
Long-term Prescription of Antipsychotic Drugs: The impact on people of long-term prescription of ‘antipsychotic’ drugs, often including long periods of polypharmacy, for 20+ years. Anecdotally, families report loss of ‘the person they knew’, personality change, sedation/energy loss, loss of memory (especially short-term memory), early onset dementia, Parkinsonian type symptoms. It is generally acknowledged that life span is reduced by about 25 years. “We hope to gather information from families and professionals, and to confirm (or not) with those collating such long term data officially, how commonly they occur. What is done to help people with such disturbing symptoms?”
Prisons and Mental Health: Prisons are a current way of dealing with long term mental health problems. In some gaols, it has been reported that 70 – 90% of prisoners have diagnosable mental health problems. Other than specialist hospitals like Ashworth, Broadmoor and Rampton, prisons are not hospitals; they have inadequate staff numbers, with no professionals capable of supporting these people let alone helping rehabilitate them.
Preventable Deaths among People Living With Severe Mental Illness: The life expectancy of people living with SMI is upto 20 years shorter than the general population. This is partly due to social and economic deprivation, poor housing conditions, poorly managed physical health problems, difficulty accessing medical care, lack of holistic treatment. But it is also a result of understaffed and underfunded services, and neglect and mismanagement of inpatient care. The Norfolk and Suffolk group and CHARM have both been campaigning on this issue for a number of years. More recently, similar campaigning work is beginning in East London. MHA is helping co-ordinate work on the evidence of Coroners’ Reports to Prevent Future Deaths.
24/7 Crisis Care at the Maudsley Hospital: Developing crisis care at the Maudsley Hospital, exploring how to develop improved mental health services in SE London based on the Trieste approach. The lack of facilities to respond to mental health crisis in London. What are the best ways to support and provide care for people experiencing acute crisis through alternatives to inpatient admission?
Digitalisation, AI and the use of data: The entry of digitalisation and the use of data and AI in mental health care. If the policy of ‘sustainable’ healthcare through the use of tech continues to make inroads, what will our future mental healthcare be? Other sectors have already been ‘disrupted’ by Big Tech – data, algorithms and digital innovation. Through intellectual monopolies and costings, healthcare data is increasingly ’controlled’ by corporations. If the money is spent in this way for healthcare what will be left of human interaction? Will chatbots and behavioural programming be for the poorer classes, while those with wealth pay for human relational therapies? Why would private psychiatric hospitals want to keep their customers away? Will state funded psychiatric hospitals and staffed places of safety disappear as beds are cut, and those without money have to take their chances in the community with mental health digital/ virtual care – after all suicide is not illegal, some in government may almost see it as a lifestyle choice?
The Failure of NHS Talking Therapies: We have an NHS Talking Therapies working group. Group members inNE, SE and NW London, and Bristol (Bristol Protect our NHS – a KONP affiliate) are campaigning to expose the ineffectiveness and inefficiencies of NHS Talking Therapies, and the decimation of longer term, more relational counselling and psychotherapy services from mainstream NHS primary and secondary provision. Two-thirds of NHS referrals to talking therapies drop out each year. A two-tier system of psychotherapy and counselling has been established – short-term CBT via the NHS and relational therapy for the well off.
Refugee Mental Health: Refugee health has always been problematic and especially mental health. But in times of austerity it increases, not least because of the invisibility caused by stigma. “Our work is to publicise the needs of refugees & asylum seekers. Asylum seekers are those we target as they are the most in need and their goal is to become a refugee. A goal only one step higher than being an asylum seeker, but incredibly tortuous to reach.”
Mapping the privatisation of mental health services: Some work in London has already been started to map the privatisation of MH services. An initial impression is that the market for private clinics for wealthy, stressed Londoners is burgeoning, while residential care for people with severe, enduring mental illness and dementias is being forced into the suburbs where property is cheaper and profits can be assured. The private hospitals continue to take the overflow of patients from under-funded state services. Private community care services may become available for those who can afford it. We need to document this more fully and compare with other cities and rural areas.
Freedom of Information work: The group has consistently made use of FOIs to research anad challenge for our campaigns. In particular, we have been pursuing the facts on closures of psychiatric beds in London, thanks to the determination and stamina of one of our West London members.
A Mental Health Manifesto: One of our first projects has been the drawing up of a Mental Health Manifesto, an attempt to lay out an understanding of the political context and the current realities of mental health services in the UK. To quote the manifesto’s preamble: “It is not aimed at a particular audience but exists, we hope, as a potential resource for anyone interested in understanding not just ‘who and how’ but also the ‘why’ any us with a mental health problem may feel ostracised and receive a poor service.”
The Common Good: Members of the group have helped create a YouTube channel on the politics of mental health – “The Common Good” – and to date have posted four episodes. See https://www.youtube.com/channel/UCDhaglpiX9qMFs1WOstgGNw
Join the group
The group meets on the third Tuesday of the month at 7.00-8.30pm.
We welcome new members from all areas of the UK. Anyone interested in campaigning to transform public mental health provision is welcome to join us. Please contact us at info@mentalhealthaction.uk