Wednesday, October 08, 2014

Nick Cleggs mental health target: a remarkable moment in politics

Update: there is currently a 'synchroblog' by dozens of Christian bloggers on mental health. A full list of links can be found here (scroll to the bottom) and here

This may or may not be a watershed. For the first time ever, the main announcement in the conference speech of a major UK political leader will be about mental health. Just before his 5 years in government ends, Nick Clegg wants to see a maximum waiting time of 18 weeks for counselling/'talking therapies', and a 14 day target for younger patients.

Here's the relevant section of the speech, in total the section on mental health made up over 10% of Cleggs address this afternoon, and I can't recall hearing anything like it ever before from a party leader
Labour introduced waiting times in physical health – we will do the same for the many people struggling with conditions that you often can’t see, that we often don’t talk about, but which are just as serious. So if you are waiting for talking therapies to help with your depression, you will be seen within six weeks – 18 weeks at an absolute maximum – just as if you are waiting for an operation on your hip.
If you are a young person experiencing psychosis for the first time, you will be seen within 2 weeks, something we are going to roll out across the country – just as if you suspect you have cancer.
If you are having a breakdown, if you are thinking of harming yourself, for any emergency which takes you to A&E, you’ll get the help you need – just as if you had gone to hospital with chest pains or following an accident.
These are big, big changes. And in Government again the Liberal Democrats will commit to completing this overhaul of our mental health services – ending the discrimination against mental health for good. And while I know not everyone in the party is going to agree, I can tell you now: I want this smack bang on the front page of our next manifesto.
This is a major step forward, and hopefully is the beginning of proper treatment for mental illness. The Chief Medical Officer recently pointed out that mental health is more than 50% underfunded by the government, and (with Clegg in government) funding is still being cut.

But lets get this in perspective. 18 weeks is 3024 hours. If you have a broken arm and report to A&E, you'll start getting treatment within 3 hours. People with depression will get anti-depressants before 18 weeks, but if you are down, anxious, possibly suicidal, an 18 week wait feels like an eternity. It's 1/3 of a year. It's unclear what the 6 week target is, but if that was the average wait then that would be a major step forward.

And, Clegg needs to make sure that the talking therapies themselves are therapeutic. Simply getting someone to a CBT counsellor after 18 weeks isn't enough. The counsellors themselves need to be well trained and competent. It's not a question of getting people into the system at the appointed time, or off the books after they've had their quota of 6 weeks of CBT. Mental health is usually a recurrent condition, and the practice of discharging patients, who then have to start all over again a year later when they've relapsed because there was no ongoing, low-level support, is counter-productive.

It's the nature of depression, anxiety and mental illness that people with it tend to shout about it less. We're less likely to let on to other people, and we're less likely to have the energy and confidence to complain about inadequate treatment, or lobby for something better. It tends to shrink your world, rather than expand it. Mental health needs consistent, well-informed advocacy from politicians and the wider community if it's going to cease being the Cindarella service.

The £120m pledged by Nick Clegg is a drop in the ocean, but given the current uninspiring choice between the main parties, if one of them is promising a thought-through plan and funding to raise mental health from non-league to championship status, then I'll be voting for them in 2015.

(PS, there was a good piece on Newsnight last night, including a report by Katharine Welby on mental health, in relation to Cleggs speech. It also touched on how mental illness is seen by the church. Worth a look, starts at 20min 50sec in.)

Update: some media coverage
Nick Robinson at the BBC ignores mental health completely
Ross Hawkins at the BBC has 7 words on it
the commentators simply don't seem interested.


  1. Good for Mr Clegg. It is a start, at least. Getting mental health on the agenda is a success in itself. The commentators are too often self opinionated and in some cases arrogant. Nick R has become too big for his boots. Time he went.

  2. Interesting that this comes up at the same time that some |Christian bloggers are having a synchronised blog on mental health Blessed are the crazy: Mental illness and the Christian faith | Khanya