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.

Clegg on Marriage Part 2: We'll Take Your Toddlers

Following on from yesterdays post about Nick Cleggs views on marriage, there's also a deep contradiction at the heart of Cleggs speech on how to spend government money. Take this:

...I have made clear that intergenerational social mobility is the principal objective of the Coalition’s social policy. And why I have been so determined to increase our investment in the vital early years, including, recently, by extending the new two-year old offer to an additional 130,000 toddlers in working families

and a reminder of what Clegg said about state finance and marriage:
We can all agree that strong relationships between parents are important, but not agree that the state should use the tax system to encourage a particular family form.

Now I may be being thick here, but I can't actually see the difference between using state money to encourage marriage and using state money to encourage a particular model of childcare. Both are using state money to incentivise/encourage/nudge (pick your own) a particular family form.

In the first case, the family form is of two working parents, and the state picking up more of the childcare. This has various benefits for the government: a more flexible labour market, a chance to get it's OFSTED-regulated hands on the children of 'problem families' at an earlier stage, and some good headlines about spending money on kids. It also has benefits for families where both parents want to work (or need to work to pay for mortgage, student fees, fuel bills, you name it) it's less costly to do so with small children. It also extends the pressure on new mums to go back to paid work, and basically says that the government would prefer them doing this than the work of parenting.

So this isn't actually about whether the government should subsidise or incentivise a particular family form. It's politics: being sniffy about marriage puts clear yellow water between Clegg and the Tories, spending money on kids is like motherhood and apple pie. Unless your a mother of course, because you're being told that what you do doesn't matter as much as if you were on the checkout at Tesco. Clegg is simply continuing the social engineering begun under New Labour: let the state raise your children, now you go find your place in the economic machine.

If Clegg really wanted to be radical, he would make the offer of free childcare conditional. Not means-tested, but linked to some form of parenting support and training, such as Positive Parenting (used extensively by our local Sure Start centre). That would incentivise a social good (good parenting), whilst promoting the governments aim of early intervention in troubled families.

Nick Clegg's Straw Bride and Groom

The much trailed speech by Nick Clegg this morning has this passage about marriage:

The institutions of our society are constantly evolving. Just look at the way the roles of men and women, and attitudes to marriage and divorce, have changed over the last century.

We should not take a particular version of the family institution, such as the 1950s model of suit-wearing, bread-winning dad and aproned, homemaking mother – and try and preserve it in aspic.

That’s why open society liberals and big society conservatives will take a different view on a tax break for marriage. We can all agree that strong relationships between parents are important, but not agree that the state should use the tax system to encourage a particular family form.

As other people have already pointed out, this is a straw man and woman. I don't know of anyone who promotes marriage who is lobbying for the vision which Clegg describes here. It's not the marriage Nick Clegg has, and as far as I'm aware the tax break for married couples, small as it is, isn't means tested on the basis of ties and aprons.

More importantly, Clegg is sawing off the branch he sits on. The substance of his speech is an explanation of why a liberal vision of an 'open society' is better than either the conservative or the socialist vision. At the heart of the 'open society' is social mobility, the principal that a childs circumstances of birth shouldn't determine how life turns out for them. There are few things more destructive to a childs life chances than a fractured home life, and, for all its faults, marriage promotes stability.

The Centre for Social Justice points out that family breakdown among unmarried parents is much higher than among those who are married. This in turn has marked effects on poverty, education, mental health, ability to form successful relationships etc.
Liberals have been at the forefront of the campaign to recognise civil partnerships: a chance for people in committed gay relationships to formalise and mark their commitment to one another. It seems slightly odd that at the same time, Clegg is basically saying that this kind of ceremony doesn't really matter, and isn't something that society should value or promote.

If there is a family form which does the best job at promoting the kind of environment where both adults and children can thrive, then why shouldn't the government promote this? After all, it is promoting other social structures - the same speech mentions the extension of nursery education to more 2 year olds. That's using government money to promote a social structure: more 2 year olds raised in state/private education facilities and raised less in the family home.

Final point: there's a deep ideological problem in Clegg's speech. Whilst Labour saw the state as the answer to pretty much everything, in Clegg's 'open society', everything is about the individual. No merit is attached to social structures, even if they are ones valued and embraced by large numbers of individuals. The place of families, neighbourhoods, unions, charities, political parties, co-ops, churches is mentioned but ascribed to 'conservatism'. Maybe he wouldn't go so far as to say 'there is no such thing as society', but Clegg doesn't seem that far away. I certainly couldn't imagine him talking about the kind of mutual dependence and community life depicted in Acts and 1 Corinthians. Cleggs world consists of individuals and institutions (in constant need of reform by individuals), but very little in between. The liberal self sounds mightly lonely.

Getting Stuck In

New research from the Evangelical Alliance reveals a startling level of community engagement from Christians, compared to the general population. "Does Belief Touch Society" is part of an ongoing research project into the beliefs and practices of evangelical Christians in the UK.

The research is based on a survey of 1151 people around Easter last year, and covers social involvement as well as spiritual practices. Some of the headline figures:
25% are trustees of a charity (10 times the national figure)
9% are school governors (0.7% is the national average)
81% do some kind of voluntary work at least once a month
91% had voted or were intending to vote in local elections (the turnout was 42%)
4% are members of political parties (1.3% is the national average).

there were a cluster of questions around Easter: 41% had taken part in some kind of outreach, 57% had done something with another church (hooray!), and 65% had attended something on Good Friday - mainly older folks (which could be work pressures). We've ended up with 2 Good Friday events, a family-friendly workshop afternoon, and a churchy meditation thing, which between them seem to cover all the bases.

There's a section on social attitudes: 80% are opposed to same sex marriage, and there is a mixed picture on military action in Afghanistan and Libya. And there's also a section on beliefs, which deals mainly with the atonement: it's a shame it's quite narrow, but I guess they couldn't cover everything.

Thoughts:
1. It's great to see that, for lots of Christians, their faith inspires them to serve their communities, and to be involved in politics and social issues. I would hate us to become like US conservatives, where there's a cultural identification between evangelical Christianity and particular political viewpoints. At the same time, is there any kind of consensus or common mind on a Christian approach to politics (with committed Christians in all 3 major parties) or social issues?

2. Nick Cleggs speech yesterday focused a lot on liberal values, and the core message was that you act true to your values, rather than true to your paymasters or public opinion ('not easy, but right'). It was a reminder to the LibDems what they stood for, what motivated them, and what battles they should be prepared to fight. It was the first time I'd even got remotely stirred by the phrase 'Social Mobility', which is a massive injustice lurking underneath an insipid label.

Clegg gets it: values drive behaviour. If you don't value others, the planet, the future, your community, yourself, then that's a toxic combination. Christian faith provides a framework for all of this, and the research backs this up by showing the fruit of that, but I sense these values are being eroded in many other places. Big Society behaviour needs more than just a slogan, it needs a foundation of values and morality. 

3. I would like to see the link between the questions the EA thought important to ask (about how the Cross works) and the involvement of people in their communities. How are churches joining the dots? And how is this reflected in the workplace? The voluntary sector is a natural place to serve and bless, but are we helping people to live differently in secular workplaces too?

Pros and Cons (and Libdems)

I'm still not quite sure what to make of the amazing events of the last few days, but a few thoughts:

1. I'm delighted that the Conservatives and Libdems are aiming high: a coalition rather than a laissez fair 'understanding', coupled with a fixed term parliament that will lock them into it for 5 years. There appears to have been some genuine give and take over policy. For a floating voter like me, who supported roughly 30-40% of each parties policies, this only way of getting a government which delivers a majority of stuff I agree with. Of course, it could go the other way and end up with all the policies I'd oppose, but early signs are ok: no Euro, no ID cards, progressive taxation, though I did think the immigration amnesty idea had something going for it.

2. This could be good news for Labour: as the only major opposition party left, if anything does go wrong then they get 100% of the benefits, as well as plenty of time to rebuild after the end of the Blair/Brown years. It is much more high stakes for the Libdems: this kind of coalition would be the norm under PR, so if they can't make it work, any argument for PR would be holed below the waterline.

3. There are a lot of cynical voices about the coalition, and maybe it's just my optimistic temperament, but I'm not one of them. In our parish there are 2 clergy, we're quite different from each other in many ways, but know that the best way to run it is to talk things through, agree a common approach, and run things as a team. This kind of thing happens all over the place. For politicians it will be a massive culture change, but the two leaders are themselves both quite new to all this (both entered Parliament this century), and perhaps a wholesale culture change is possible. If they manage it, great.

4. Will the 'New Politics' involve the rebuilding of the House of Commons? The chamber is organised for adversarial politics, unlike many more recently built chambers which are circular or multi-sided. Maybe they should move across the road to the circular Church House synod chamber - might generate some much needed rental income for the CofE.

5. Will the spirit of co-operation infect the media too? Like the House chamber, the press is based on adversarial politics. Come to think of it, not just the press: the spirit of Paxman lurks over everything from the Apprentice to Dragons Den to the X Factor, we love our bear pits. What happens if politics tries to move out of the bear pit and refuses to offer routine bloodletting for public entertainment? Will it be allowed to? Can journalists act like grown ups too? I would love to see a change of political culture - and culture in general - to something less adversarial. Perhaps that's enough to hope for. As Simon Parke puts it in his cracker of a book Desert Child

"The message... is that we turn our attention to the Great Possibility, the Grand Miracle, the Massive Moment, the Huge Resurrection"

"And what is that?"

"That we might actually do what we're doing with a little more kindness."

Pause

"That we might actually do what we're doing with a little more kindess?" Musselly was checking that he had heard aright. Peter, however, confirmed the astounding declaration.

"Indeed. That we might do what we're doing, only with a little more kindness."

The earth stopped revolving for a moment in shock as the two men considered the implications of the words just spoken; as the two men felt the fall-out from the bombshell just lobbed into the conversation. The visitor spoke first.

"Now that is a very revolutionary thought, my friend."

6. It's a good way to bury bad policies: there are a few duffers and vote-losers in there which can be quietly shelved in the name of compromise, on both sides. If both sides of an argument are represented within a government, then someone somewhere is right, and hopefully no party is arrogant enough to think it has all the answers.

7. It's important not to get carried away. Tony Blair wasn't the Messiah, at times he was just a very naughty boy, and neither are these two. There are some things that politicians can't fix: I was in a meeting recently over a local trouble spot, and the overwhelming feeling was one of impotence over the ability of local government, agencies, etc. to do anything significant to change things. Bill Hybels writes:

"For 8 years during the '90s I went to Washington DC every month to meet in the foremost centres of power with some of the highest elected officials in our country. What I discovered was not how powerful those people are, but how limited their power really is. All they can actually do is rearrange the yard markers on the playing field of life (I'm guessing that's an Americanism). They can't change a human heart. They can't heal a wounded soul. They can't turn hatred into love. They can't bring about repentance, forgiveness, reconciliation, peace. They can't get to the core problem of the kid I saw in the airport (an 8 year old boy punching his 5 year old brother in the face then bashing his head into the floor) and millions of others like him.

I scrolled through every other option I could think of, considering what they have to offer. Businessmen can provide sorely needed jobs. Wise educators can teach useful knowledge of the world. Self-help programs can offer effective methods of behaviour modification. Psychology can aid self-understanding. And all of this is good. But can any of it truly transform the human heart?"

So we carry on praying for our leaders, and I'll be praying that it works - that's partly the optimist in me that likes to see people trying something new, and partly the knowledge that if it doesn't work then that won't really do anyone any good.

Clegg "I'm not a man of faith, sometimes I very much wish I was"

Despite the effective banning of politicians from the main BBC news bulletins, to give the pundits more time to stare meaningfully into the camera, there are some excellent bits of interviewing and journalism going on in the bowels of the Beeb.

One was last nights Eddie Mair interview with Nick Clegg on PM (starts 16:20 in). After leading on Gordon Browns gaffe yesterday, Mair asks (17:10 in) "Why don't you believe?" a question right out of the blue, and Clegg is first taken aback, and his eventual response is unusually revealing. He talks about spirituality as something 'which makes us human', that religion isn't something he's closed off to, and it sounds like several members of his family are committed Christians.

He also talks about wanting the disestablishment of the CofE, and Mair quizzes him about how his Liberal principles play out in allowing religious expression - e.g. burkas, wearing crosses in the workplace, Bed and Breakfast admissions policies etc. Clegg talks about allowing the 'personal expression' of faith, but there are clearly places where liberal tolerance runs up against intolerance of what's percieved to be (sorry) 'bigotry'.

Nick Hood of Bournemouth: Clegg's Conference Speech:

In another part of the blogosphere there are debates on 'pirate theology'. In Bournemouth this week Nick Clegg gave us pirate politics. Perhaps drawing inspiration from Jack Sparrow, and the romance and appeal of the outsider, Clegg sought to put clear amber water between the Libdems and the 'red and blue' tankers of his rivals. At the same time, he made an audacious raid on their rhetoric.

Key Lines

"Let me tell you why I want to be Prime Minister"

"The beginning of real change in Britain"

"There is less to him than meets the eye" (on David Cameron)

Key Ideas

This was a policy-heavy speech, in contrast to last year which focused more on principles and overt attacks on Brown and Cameron. It could have been a manifesto launch speech. But the top two key concepts were a smash and grab raid on Labour and Conservative:

- Change: the word was used 39 times, lifted straight from the Tories campaigning tagline, but Clegg's argument was that Cameron offered 'fake change' whilst the Libdems' is real.

- Fairness: the words fair/unfair used 15 times, lifted straight from Gordon Browns conference speech last year, where 'fairness' was the repeated mantra.

Having raided the clothes of both parties, Clegg then sought to paint himself as the champion of the poor, against the bonus-earning rich and their tax loopholes, the Robin Hood of the Recession. Nick will go into battle for ordinary people and your taxes, for young people and your jobs, for children and your class sizes. Armed with a bow and arrow and Vince Cable (no more Trident), Clegg's charge to the polling booth has begun.

Various bits of libdem philosophy came through: smaller state, individual freedom (scrapping of ID cards), environmentalism etc. But in his conclusion, Clegg sought to paint the LibDems as the natural heirs of Blair, the people upon whom all the hopes of 1997 now rested.

Much of the rest was positioning: talking of 'the old red-blue politics', listing several areas where both main parties had failed, and talking of the Libdem ability to stand up for their principles and for the ordinary person.

Policies:

Almost too many to list. Here are some of the specific policy commitments made during the 50m speech -

- Begin talks with Taliban
- 150 fewer MPs
- change the electoral system
- cut defence spending
- no replacement for Trident
- end the Child Trust Fund
- independent review of public sector pensions
- young people will be found a job or training within 90 days of losing a job.
- Cancel the VAT cut
- 10,000 more university places, 50,000 more college places
- Paid internships with £55 a week
- 800,000 placements for students.
- Classes of 15 for 5-7 year olds (inconsistent – Clegg spoke of the earliest years being crucial, so why wait till kids are 5?)
- Raise Income Tax threshold to £10,000
- More tax on the richest.
- Cancel ID cards
- 10,000 more police on the streets

- Elected House of Lords

Comments:

- It was odd that Nick Clegg began the speech with, effectively, a separate statement on Afghanistan. This seemed to have nothing to do with anything else he was saying, and the speech proper only began once he'd finished this section.

- The 'less to him than meets the eye' line on Cameron has something going for it. The Conservatives have still to come under proper scrutiny, they have bobbed to the top of the polls without very much effort, and very little in the way of concrete policies.

- No engagement here with crime levels, family breakdown, and the need for a change of culture and values, most of his solutions seem to be economic or legal. Nothing about the NHS either, which, considering how much money it hoovers up, is remarkable. But that's my hobby horse of the week at the moment....

- There's also nothing which challenges the basis of debt-driven consumer capitalism, apart from a couple of warning shots at bankers. Lots of small to medium ideas here, but I would have expected something more radical. Go back to Sherwood Forest and prepare for government? Or is Robin more effective as an outsider?