The politics of mental health: Taskforces and commissions, manifestos and madwash

Your vote has value. People with an interest in mental health – whether people with lived experience or carers or professionals – are viewed as one of the many niche markets that political parties will be trying to tempt in the run up to the 2015 general election with the aim of encouraging us to vote for them. So what tempting tidbits have been offered so far?

• October 2012 – The opposition Labour party launched its mental health taskforce. This was an exciting development, as I wrote at the time. Over two years later, however, and it seems less of a priority. The taskforce was due to report in spring 2014, so shadow mental health minister Luciana Berger told me in April. However, in June I was emailed by the Labour party to say it would be summer, with the report published online giving the public the opportunity to comment and help formulate policy. No report. Other deadlines have passed and still no report.  Apparently it is due to report later today. I don’t know whether that means the public consultation aspect has been dropped.
• January 2014 – Nick Clegg MP, Liberal Democrat deputy prime minster, launched the coalition government’s mental health action plan (Closing the gap: priorities for essential change in mental health). This sets out the top 25 areas for immediate action to ensure equality for mental health and increase access to the best possible support and treatment. (Here’s Mind on the action plan.)
• August 2014 – Norman Lamb MP, Liberal Democrat minister for care announced he was establishing a task force into children’s mental health services. We know some of the answers to the questions already. Do we really need to gather more data? Without announcing a plan of action at the same time as announcing a taskforce, announcing a taskforce simply kicks the need to take action into the long grass.
• September 2014 – Prospective Labour party candidate for London mayor David Lammy MP announced he was launching a London mental health commission. (I haven’t seen any details yet.)
• October 2014 – Nick Clegg made mental health a central part of his speech to the Liberal Democrat annual conference. The first ever mental health waiting time standards were announced.
• November 2014 – Nick Clegg announces a cross-government taskforce on mental health services. It is to examine how to improve mental health crisis care and services for young people, and the large numbers of people with severe mental health problems who end up in police cells and prisons. The taskforce will be chaired by Nick Clegg and include senior ministers from across the coalition, such as Theresa May (Home Office), Jeremy Hunt (Health) and Vince Cable (Business).

(For earlier government policy documents, see here.)

Are these developments substantial? Or are they merely what I have termed “madwash”?

I coined the term “madwash” (inspired by the environmental campaigning term “greenwash”) to describe the window dressing done by an organisation (company, government or other group) to try to give the appearance that mental health matters. Madwash is where an organisation makes a show of sympathising with or of prioritising mental health issues, but this is used to hide a festering nest of ignorance and prejudice, or inactivity around mental health issues. This thin veneer of “madwash” is used draw attention away from lack of meaningful activity, or to distract from practices or policies which, overall, are detrimental to mental health – or which operate in a manner which is opposite to the mental health initiatives announced. Madwash may involve actively making misleading or unsubstantiated claims.

Here are some more musings on mental health taskforces.

On the other hand, we have had several manifestos launched in advance of the election. These include:

• Alliance of Mental Health Research Funders (October 2014)
• King’s Fund (September 2014)
• Mental Health Policy Group (August 2014)
• Mind (June 2014)
• Royal College of Psychiatrists (September 2014)

Summaries of these manifestos are set out below. What impact will these manifestos have? And what results will the various taskforces and commissions bring? Watch this space to see if they are any more than mere ‘mad wash’.

And finally, everyone loves a taskforce!

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Mind’s manifesto

Take action for better mental health – Our manifesto for the General Election 2015 (June 2014)

What the next government must do in its first 100 days

1. Commit to reducing mental health stigma and discrimination and to supporting the Time to Change campaign to sustain its work.

2. Mandate that the NHS in England offer a full range of evidence based psychological therapies to everyone who needs them within 28 days of requesting a referral.

What the next government must do in its first year

3. Commit to ensuring everybody has safe and speedy access to quality crisis care 24 hours a day, 7 days a week, whatever the circumstances in which they first need help, regardless of where they turn to first.

4. Transform the support offered to people who are out of work because of their mental health and create a system that really helps people to overcome the barriers they face.

What the next government must achieve by the end of its five year term

5. Increase the overall NHS mental health budget by a minimum of 10 per cent in real terms.

6. Develop, consult on, fund and implement a national strategy for wellbeing and resilience.

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The Mental Health Policy Group

Joint manifesto by the Centre for Mental Health, Mental Health Foundation, Mental Health Network, Mind, Rethink Mental Illness and the Royal College of Psychiatrists

A manifesto for better mental health – The Mental Health Policy Group – General Election 2015 (August 2014)

13 commitments are asked for, grouped under the following 6 headings:

1. Fair funding for mental health – Commit to real terms increases in funding for mental health services for both adults and children in each year of the next Parliament.
2. Give children a good start in life – Ensure all women have access to mental health support during and after pregnancy. Raise awareness of mental health by putting it on the national curriculum and training teachers and school nurses. Invest in parenting programmes across England.
3. Improve physical health care for people with mental health problems – Ensure Government targets for smoking reduction apply equally to people with mental health problems. Create a national target to stop people with mental illness dying early, due to preventable physical health problems.
4. Improve the lives of people with mental health problems – Continue to fund the Time to Change anti stigma campaign. Offer integrated health and employment support to people with mental health conditions who are out of work.
5. Better access to mental health services – Introduce maximum waiting times for mental health care and support, including psychological therapies. Commit to continued improvements in mental health crisis care, including liaison psychiatry services in all hospitals. Continue to fund liaison and diversion mental health services, working with police and the courts.

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Royal College of Psychiatrists manifesto

Making parity a reality – Six asks for the next government to improve the nation’s mental health (September 2014)

The ‘six asks’ are:

1. Tackle the mental health beds crisis – Everyone who requires a mental health bed should be able to access one in their local NHS Trust area, unless they need specialist care and treatment.  If specialist care is required, then this should be provided within a reasonable distance of where the patient lives.
2. Introduce maximum waiting times – No-one should wait longer than 18 weeks to receive treatment for a mental health problem, if the treatment has been recommended by NICE guidelines and the patient’s doctor.
3. Improve crisis care – Everyone experiencing a mental health crisis, including children and young people, should have safe and speedy access to quality care, 24 hours a day, 7 days a week.  The use of police cells as ‘places of safety’ for children should be eliminated by 2016, and by the end of the next Parliament occur only in exceptional circumstances for adults.
4. Improve liaison psychiatry services – Every acute hospital should have a liaison psychiatry service which is available seven days a week, for at least 12 hours per day.  This service should be available to patients across all ages. Emergency referrals should be seen within one hour, and urgent referrals within five working hours.
5. Introduce a minimum unit price for alcohol – A minimum price for alcohol of 50p per unit should be introduced. This will reduce the physical, psychological and social harm associated with problem drinking, and will only have a negligible impact on those who drink in moderation.
6. Invest in parenting programmes – There should be national investment in evidence-based parenting programmes, in order to improve the life chances of children and the well-being of families.

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The King’s Fund

Transforming mental health – A plan of action for London (September 2014)

The plan, though developed for London, is said to be applicable to the whole country. The key steps identified as being necessary are:

1. Developing a process of collaborative commissioning to facilitate change
2. Driving change through collective systems leadership
3. Ensuring that service users and clinicians are at the core of provision
4. Using contracting systems to support integration
5. Building a public health approach to mental wellbeing
6. Developing pan-London solutions to increase impact
7. Improving the availability of meaningful outcomes data
8. Utilising London’s academic infrastructure to disseminate best practice
9. Creating a new narrative for mental health

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Alliance of Mental Health Research Funders

Prioritising mental health researc – General election manifesto (October 2014)

The Alliance of Mental Health Research Funders is a national coalition of charities working to further research into mental health. They call on all UK political parties to:

1. Champion mental health research funding in General Election manifestos – The government can redress the current imbalance in publicly funded health research, influence other funders and lead the way in tackling the stigma that hinders mental health research funding.
2. Seek to remove current blockages to mental health research – We cannot improve mental health and wellbeing without better quality data and information. To unblock research we need better access to high quality data about mental and physical health, improved coordination of data sharing between government departments (for example between Health, Justice and Education) and more mental health knowledge among the wider public service workforce.
3. Give priority to research that will make the biggest difference to people’s lives – The biggest gaps include research into children’s mental health, prevention and promotion of mental wellbeing and the links between mental and physical health. Setting research priorities should begin with the knowledge andexperience of people with mental health problems.

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Related links:

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Manifestos:

• The King’s Fund – Transforming mental health – A plan of action for London (September 2014)
• The Mental Health Policy Group (Centre for Mental Health, Mental Health Foundation, Mental Health Network, Mind, Rethink Mental Illness and the Royal College of Psychiatrists)
  • A manifesto for better mental health – The Mental Health Policy Group – General Election 2015 (August 2014) #BetterMentalHealth (16 pages)
    
  • The manifesto on one page (13 commitments)
• Mind – Take action for better mental health – Our manifesto for the General Election 2015 – (14 June 2014) – #MindManifesto
• Royal College of Psychiatrists –
  • First steps to making parity a reality (9th October 2014)
  • Commentary on the manifesto by the Mental Elf blog – Making parity a reality: RCPsych launch manifesto to improve the nation’s mental health (12 September 2014)
  • Conversation with Mental Elf about why the blog reviewed only the Royal College of Psychiatrists’ manifesto and none of the others (September 2014)

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Labour MP David Lammy’s London mental health task force

• Storify story (September 2014)

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Labour’s mental health task force:

• My endeavours to find out about the taskforce (Storify stories):
  1. February & March
  2. A conversation with Luciana Berger – April 2014
  3. April 2014
  4. Looking for an up date – September 2014
  5. Looking for an update – September 2014 & World Mental Health Day 2014
  6. November 2014
  7. December 2014
  8. January 2015
• The politics of mental health: Labour’s new mental health task force – my blog post from 2012

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