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In her speech entitled The Shared Society at The Charity Commission’s annual meeting, Theresa May made her third major policy address, further setting the tone of her prime-ministership. During the thirty minute address she outlined her vision for said “shared society” and what she envisages the role of government to be within it. The largest portion of her speech outlined what she imagines the future of mental health support in Britain to look like.

While May’s speech was fairly comprehensive, finally elevating the status of mental health in this major policy address, it will remain to be seen whether ‘parity of esteem’ initially legislated in The Health and Social Care Act 2012[1] can truly be reached. The statistics that she sites are frank and hopefully highlight the severity of the problem surrounding the treatment of mental health in Britain. The address outlines 6 main objectives, to tackle in her words ‘the burning injustice of mental health’.[2] While this announcement will be seen as a positive first step by those in the field of psychiatry it is just that, a step.

The Spark Notes

May highlights that 1 in 10 children have a diagnosable condition, therefore part of the overhaul revolves around transforming the way mental health is dealt with in schools and with younger generations. By educating teachers and parents alike she proposes to help spot the early markers of a diagnosable mental health condition and provide the support a child in question might need before it is too late. By talking about mental health in schools, it is hoped that this will decrease the stigma around these conditions, and make the young feel more confident to speak out when they are suffering, the same way they would if they had the flu or any other physical illness.

She then moves on to changing the way mental health is dealt with in the work place. Mental health issues cost the British economy £105 billion annually. This includes all the medical costs, such as inpatient facilities and emergency services but also associated costs such as time missed at work and illness benefits for those who are incapable of work altogether. This figure is roughly the same as the whole budget for the NHS. Additionally, the figure associated with psychiatric care in what is called the “disease burden”[3] is the biggest out of all the other sectors, almost double that of the whole of cancer care.

May mentions some additional money earmarked to aid these new initiatives; £15million towards extra funding of clinics, crisis cafes and alternative prevention services and a £6.7million investment in digital mental health services. The aforementioned astronomical cost of mental health treatment means that these increases are relatively negligible, only amounting to about £23,000 per parliamentary constituency. Paul Farmer, the chief executive of Mind, the mental health charity discusses this on the Today program the morning of May’s address. He highlights that while over time the budget for mental health has increased, the increasing number of those suffering and inefficiencies within Mental Health Trusts means that the additional funding doesn’t always successfully trickle down in equal measure to the patients themselves.

Current Practice

Disappointingly this is something May doesn’t mention in her speech, and could be key to decreasing the waiting times for treatment of milder mental health conditions, which can be up to three months in London. It is here that perhaps she falls down in her efforts to bring about true reform to the system, because although she mentions early intervention for the young, she doesn’t really touch on tackling this waiting time for adults; a period which can often be detrimental to a patient’s mental health while they wait in limbo for specialist treatment. This is owing to the fact that we are living in an increasingly medicalised society. Where the current route to diagnosis involves several consultations with a General Practitioner, usually followed by the prescription of a more or less relevant drug with the hope of counteracting the condition over an interim period. The patient will then be placed on said waiting list usually first for an alternative therapy such as Cognitive Behavior Therapy or in more serious cases to see a psychiatrist. The crux is that from clinical research SSRI’s, the most common form of anti-depressants only work on 30-50% of the patients who are prescribed them and can sometimes actually intensify the condition if misdiagnosed. This is not to accuse GP’s of bad practice but more to highlight the frustrating lack of advancement in testing for mental health disorders.
Meaning that a GP has to act on what the patient tells them alone, which depending on their mental state can vary wildly from day to day.

Her other plans revolve around cross-government and emergency service suicide prevention strategies. There has been progress in this particular area through amendments to the Policing and Crime Bill of 2015/16, resulting in a 80% decrease in the number of those detained under the mental health act being held in police cells rather than put into health based institutions. While this is a huge step in the right direction, the overhaul of psychiatric healthcare is not something which will happen overnight. Nevertheless, if the Prime Minister sticks to at least some of her pledges we will hopefully see psychiatry beginning to catch up to the progress we have seen in the treatment of other physical diseases, where breakthroughs and new treatment methods are developing constantly.