At last week’s Council meeting I delivered a speech in support of the Labour motion on improving health outcomes in Wandsworth. I chose to focus on the issue of mental health in recognition of World Mental Health Day (10 October). A transcript is available below. I am now following up with Council officers on my recommendations.
Why we need to step up to the challenge
Many of you will be familiar with the statistic that one in four of us will suffer from a mental health condition at some point in our lives. In this chamber, it means 15 of us. Within Wandsworth, this equates to nearly 80,000 residents – with nearly 50,000 residents thought to have a mental disorder at this current time. If we have not personally experienced mental illness at some stage in our lives, then we almost certainly know friends or family that have.
The issue has a clear youth dimension: around half of those with mental health conditions will have experienced their first symptoms before the age of 14. In Wandsworth, the latest report on health and wellbeing of children and young people found that the proportion of year 7-10 pupils reporting ‘excellent’ or ‘good’ emotional health is in decline (from 74% to 72%). The estimated prevalence of children aged 5-16 years in the Borough with mental health conditions is more than 3,400, with a much higher prevalence among males than females.
The imperative to act on mental health is ultimately one focused on ensuring everyone can fulfil their potential and live a healthy life. However, it is also clear that failure to address mental ill-health has broader social and economic consequences. In England alone these are estimated to cost up to £105 billion a year – both from the inevitable impact on health and social care services through to lost economic output.
“Not enough help to hand”
In her first speech as Prime Minister in July this year, Theresa May was spot on when she said: “If you suffer from mental health problems, there’s not enough help to hand.” Only a quarter of people with mental health conditions receive treatment, with the majority of those that do only accessing services when they reach crisis point.
Much of the problem relates to historical underfunding: Although mental ill health accounts for 28% of the burden of disease it gets just 13% of the NHS budget. And at the local authority level, the average spend on direct mental health initiatives amounts to just 1% of public health budgets.
Yet in spite of legislative commitments to “parity of esteem” between mental and physical health – and in spite of political gestures calling for an end “to sweeping mental health issues under the carpet” it is clear that the rhetoric remains a far cry from reality.
The Public Accounts Committee certainly took this view when they published the findings from their inquiry into mental health services last month. Their report concludes that the full cost of implementing the changes set out by government are not yet fully understood, leaving the financial burden with Clinical Commissioning Groups. However, they themselves are having to divert funding away from mental health services to prop up acute care and more than half have already cut their mental health budgets this year. Only 55% mental health trusts have reported increased investment since 2012.
Mental health is not just about crisis intervention from health providers; it is about addressing the underlying risk factors, as well as maximising ways to promote emotional wellbeing. It is as much about early years’ outreach, libraries and recreational activities as it is about hospital wards and GP services. It is about providing safe and affordable housing, tackling food poverty, supporting new parents, children in care and ensuring decent work opportunities.
Proactive and preventive measures stop a problem becoming a crisis. They also reduce pressures on an already overstretched and financially struggling health service.
So what can Wandsworth Council be doing? How should it be marking World Mental Health Day this week?
Firstly, Wandsworth Council could sign up to the Mental Health Challenge, an initiative designed specifically for local authorities and set up by the Centre for Mental Health, the Mental Health Foundation and Young Minds among others. The challenge commits local authorities to take clear leadership in addressing mental ill health across all aspects of their business. Involving both officers and members, It would provide the opportunity for the council to learn from what other councils are doing as well as share some of the innovative work it is itself engaged in, such as the ‘active well-being’ pilot developed with Wandsworth Mind and the CCG.
The voluntary and community sector can play a significant role in providing early, targeted and cost effective interventions to those at particular risk of poor mental health. They can provide a critical bridge between clinical and community care. However, they need a supportive infrastructure so that they can collaborate, innovate and work effectively with statutory services. The council could play a much bigger role in supporting the development of this infrastructure.
Finally, as an employer Wandsworth Council could join other local authorities, government departments, leading retailers and FTSE 100 companies by signing up to the Time to Change Employer Pledge. It could also encourage other leading employers across the Borough to do the same. At a time when the council is undergoing significant organisational change – and a time when staff absenteeism rates are of concern – this would seem to make clear business sense.
The Prime Minister is clear that not enough is being done, so I hope she will hold true to her words and ensure mental health services receive the investment they desperately need. We too though can step up to the mental health challenge and I hope we as members of this council commit to do so this evening.