Greetings all!
The Coalition Government has just published its initial plans on mental health - "No Health Without Mental Health":
"No Health Without Mental Health"
I don't want to go into the content of the document at present or even raise the question of how mental health can be improved within a context of service cuts.
Instead, I want to draw your attention to and seek your thoughts on a key expressed assumption within the document highlighted by NHS Networks, namely that " THE GOVERNMENT [HAS THE] AIM OF ACHIEVING PARITY OF ESTEEM BETWEEN PHYSICAL AND MENTAL HEALTH". I’ve never come across such a strongly expressed statement of parity between physical and mental health in ANY government policy document before.
Now, of course, this may all be talk and that the reality may be quite different. However, my cynicism isn't quite so marked - not because of my belief in the intrinsic altruism of governments - but rather because of the financial issues currently being grappled with.
Firstly, there is the issue of the welfare budget. Forgive me if I'm teaching you to suck eggs here but for those unaware of the history of incapacity benefits let me give some brief background. Twenty years ago, Invalidity and Sickness Benefit (as it was then called) along with associated housing benefit was significantly short term in nature (six months or less) and primarily claimed by those with industrial injuries and pain problems. By 2010 this situation had radically changed whereby an increasing number of claimants were claiming for more than six months and over 50% of these were claiming for mental health problems. At estimated costs of £16 billion a year all political parties began to look seriously at the question of addressing this cost. IAPT (Increasing Access To Psychological Therapies), introduced by the last government and extended by this government by hundreds of millions of pounds, is the most visible example of how seriously central government now takes mental health.
(CBT Training);
(Managing Depression)
Secondly, the parity between mental health and physical health has also become apparent as a result of their interconnectedness - again from the perspective of the costs, this time associated with health costs associated with "long term conditions". The latter includes such illnesses as diabetes, cardiovascular problems, respiratory diseases and stroke. They are conditions that are often associated with repeated hospital admissions (which are costly) usually prompted by failure to maintain changes in health behaviour or because of the de-motivating effects of mental health problems such as depression. The thinking is that IF services can address depression or poor motivation in such groups, hospital re-admission rates will fall and costs reduced.
(Motivational Interviewing Training);
(Psychological Coping Post-Stroke)
Now this is all very understandable and laudable stuff - all industrialised countries at present are trying to contain healthcare costs, but a recognition that mental and physical health are intrinsically interconnected strikes me as a radical new framework in which to start debating this. However, it also raises difficult questions about the priorities that we we establish within this however.
• With limited money, do you agree that Depression and Degenerative Arthritis are of "parity of esteem".
• What about Panic Attacks and Palliative Care or Gall Bladder problems and Generalised Anxiety Disorder? Or do you think that we should recognise that such "parity of esteem" varies according to the type of problem.
• Should Botox continue to be funded on the NHS in certain circumstances when those with a diagnosis of borderline personality disorder still have problems finding ANY service wanting to work with them?
• Should Pancreatitis be seen as having a "parity of esteem" with PTSD or should the latter be seen as a more pressing issue.
These are difficult questions with no easy answers. However the government's express acceptance of "parity of esteem" between physical and mental health opens up this debate.
WHAT DO YOU THINK? ALL VIEWS AND IDEAS ARE GREATLY WELCOMED.
