by Hannah Rose
Last week I met with two mental health campaigners following an RSA-hosted event at St Michael’s Church called: ‘Combating Norfolk’s Growing Mental Health Problem.’ The Royal Society for the Encouragement of Arts (RSA), Manufactures and Commerce is a fellowship-led organisation, whose aim is to encourage “the sharing of powerful ideas to deliver a 21st century enlightenment.” I’d gone in the hope of being enlightened.
Sadly, I was not.
Instead, I was perturbed by the oddly formal sense of occasion — cheese and wine were offered on arrival — and I was given instructions to mingle. I had the distinct feeling that I was definitely at the wrong meeting. Only around fifty chairs were set out — where was everybody? Then a quick show of hands told me much of the audience was made up of RSA ‘fellows.’ That’s not to say that they did not have their own vested interests in mental health — the organiser spoke candidly of his own experiences —but the number of ‘fellows’ suggested that this was an exclusive event. Surely, if we are to build a dialogue around the failure of the government to deliver a public service, then service users must be at the heart of this conversation?
This was the elephant in the room — or, as was the case, not in the room — and we were eating canapés.
By excluding [mental health service users], it infantilises them
The Campaigners, representatives of which had been stationed outside the church, and who had been refused a space on the panel of speakers, shared my concerns that no service users, carers or professionals had been invited to speak that night. “By excluding [mental health service users], it infantilises them,” they told me.
Instead of service users, there were a surprising number of CEOs – four in total. One from a large mental health charity which has a branch in Norwich, and one from the Norfolk Community Foundation — a network of charity donors. Then there was the CEO of a private mental health consultancy, and finally the chairman of the Norfolk and Suffolk NHS Foundation Trust (NSFT) – the main mental health provider for the East. His presence was perhaps the most contentious; between 2014-15 the chronically underfunded Trust report 129 deaths among those patients receiving mental health care – an increase of 61 from the previous year. The outcome of these findings prompted an independent investigation into the Trust, which was put under special measures by the Care Quality Commission. The chairman endorsed better funding for primary and preventative care, yet the mental health campaign points out that the Trust would indeed have a budget £70m higher if mental health were “treated in the same way as physical health”. This is the same Trust that reportedly spent £8.8 million on redundancy pay in 2013/4.
the mental health campaign points out that the Trust would indeed have a budget £70m higher if mental health were “treated in the same way as physical health”
The charity CEO began her speech with the premise that they are “non-political,” which I found completely at odds with the issue that night. The failure to deliver a proper mental health service is, in part, a result of an austerity agenda. Better integrated health and social care services were, she continued, “a priority”. So if it is such a priority, why the refusal to bring politics into the room?
In 2013, 22 mental heath patients died under the care of the Trust in just 5 months. This prompted the beginning of the ‘Campaign to save mental health services in Norfolk and Suffolk,’ and it was these campaigners who agreed to speak to me. “We’re not a party political campaign,” they told me, “But it is a political issue…nothing stigmatises people with mental health issues more than denying them proper treatment. The things that help people with mental health issues recover are stability and positive relationships; it keeps people safe.”
Stability and the need to identify and untangle the politics which prevent patients from receiving early treatment clearly weren’t thought of as achievable amongst those at the RSA evening, who seemed to agree that the public sector is dead – a message upheld by the Norfolk Community Foundation. “The public sector is not the answer,” said their CEO, whilst making reference to the spurious claim that New Labour “spent all the money.”
It’s unrealistic to pretend that the voluntary sector can offer an alternative to public services when the truth is they don’t have the resources or stability to deliver them.
The public sector should be the answer, though. Is it not a matter of rights? It was the failure to identify the governmental duty of care for people living with metal health issues that angered both myself and the campaigners. While there are many excellent charities delivering high quality support to people, I agreed with the campaigners when they said that “[the voluntary sector] should be the cream on top of a comprehensive and safe mental health service.” It’s unrealistic to pretend that the voluntary sector can offer an alternative to public services when the truth is they don’t have the resources or stability to deliver them. The campaigners I talked to echoed this. “The role of the voluntary sector is unique,” they told me, “but it’s not to provide public services.”
Yet the RSA event suggested otherwise.
The RSA advertised the event under the following premise: ‘Throwing money we don’t have at a problem that just won’t go away is not the answer‘, but the mental health campaigners don’t buy this and shot back with the following on their website: “We absolutely disagree. Mental health services have been subject to vicious and highly discriminatory cuts in comparison to physical health. This isn’t a problem that ‘just won’t go away’. It is a problem that has been created by cuts and discrimination.”
“Who are the deserving and undeserving in our country? Who decides?”
This notion, that public money is somehow being squandered on mental health provision, pivots around a dangerous idea: “It accepts the narrative that [the government] are not going to fund mental health services,” the campaigners said. “Who are the deserving and undeserving in our country? Who decides?” This atmosphere was quickly picked up on by the first audience member to speak up when questions were opened, and he made the most salient point of the evening: “This is not a Victorian society. We cannot expect charities and private donors to address the issue of mental health care.”
The campaign to save mental health services in Norfolk and Suffolk is made up equally of service users, carers/families and mental health professionals. They put their energy into advocacy, helping represent people with mental health issues; supporting people with complaints procedures, and signposting people on to services. “Our concerns are over quality and safety,” they explained, and I feel they have every reason to be concerned. The RSA claims an enlightenment approach to addressing societal issues, but after attending their event, I fear that some, particularly those with power and influence, are still in the dark ages.