The shining flagship of the Shared Society policies is mental health. You can see why, since for the Prime Minister it falls into a crucial policy zone as the Brexit negotiations heat up – presumably the notes read “soft but not too soft, preferably children”. Call me cynical, but mental health is just one of a number of positions Theresa May has taken that seem designed to soften the blow of Brexit negotiations, rather than to effect real change.
A focus on mental health care and especially on CAMHS (Child and Adolescent Mental Health Services) is absolutely the right thing to do and as more specifics of the planned programmes are published, there is some reason to overcome our cynicism. Paul Farmer, the CEO at Mind, praised the level of consultation in the government’s plan in the Five Year Forward response also published last week and it’s good to see mental health in the dialogue of mainstream politics.
There are, however, also reasons to maintain our scepticism about these pledges. MQ puts the number of mental health issues that begin before 18 at 75%, a figure not reflected in the underinvestment in CAMHS. The underlying problem is that mental health needs a real injection of cash into research, education, and services; and the Prime Minister’s focus on the stigma and the need for attitude change, seem like a prelude to saying that the will to change rather than a chronic lack of funding and resources is the “real problem” with mental health care. As so often, the political discourse on mental health becomes a hall of mirrors, in which we tell people that they must simply have the will to change the stigma – the policy equivalent to telling someone with depression to cheer up.
Some of the charities we work with have years of experience tackling youth engagement, a major issue in the tangle of mental health policies, and in empowering young people to build solutions to the problems around them. The Citizenship Foundation educates and encourages young people to navigate and to participate in public life - to believe that they are capable of building change. The University of the First Age run programmes helping young people to expand their skills and advocating for a whole education approach to leadership. We have worked with coalitions like Learning Away and seen the benefits to young people of self-care and emotional strength by the programmes of coalition members, and the long term effects of investing in extra-curricula learning. A New Direction support teachers working to build arts and culture into their schools, something closely linked to success and resilience, and the mental health issues surrounding disadvantaged children.
There is a huge amount of knowledge already in these programmes and others like them, but what they need is real long-term backing, not only in funding but in integration into structures and concepts of education. We need to make it easier and more acceptable for schools to spend money on extra-curricular learning as part of a plan to build sustainable achievement in their pupils, to lean into a virtuous circle of well-being and attainment in young people so that it can continue into adulthood.
We need to invest in an open practice not just of accepting and treating conditions, but also building resilience and self-care. We need to see mental health care as the result of an interplay of factors, just as we see other illnesses. These conclusions are not new and they are not untested but what they are is under-funded and under-practiced – and we see the results in the workplace.
Mental health has for years been a conveniently uncontroversial area to declare for, but without ring fencing budgets it is meaningless – and dangerous, as it creates a false sense that the problem is in hand. As traditionally prioritised areas of medicine are squeezed, the probability that money will actually find its way into CAMHS decreases further. The central issue, when we take down the mirrors of stigma and attitude and policy, is painfully simple: as the Prime Minister would no doubt say, funding must mean funding.