I’m not an evidence-based blogger. I write quite calmly – but under the surface I am always far too angry to know how to communicate effectively with those who count.
So. Evidence-based blogging is not my forte.
But this open letter to the Coalition government, first published online in the Guardian yesterday evening, provides even someone as emotional as myself with sufficient proof to convince someone as logical as yourselves that something very wrong is taking place at the very highest levels of power in this country.
This is how the United Nations defines our inalienable rights to mental wellbeing:
Q: What is mental health?
A: Mental health is not just the absence of mental disorder. It is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.
In most countries, particularly low- and middle-income countries, mental health services are severely short of resources – both human and financial. Of the health care resources available, most are currently spent on the specialized treatment and care of the people with mental illness, and to a lesser extent on an integrated mental health system. Instead of providing care in large psychiatric hospitals, countries should integrate mental health into primary health care, provide mental health care in general hospitals and develop community-based mental health services.
Even less funding is available for mental health promotion, an umbrella term that covers a variety of strategies, all aimed at having a positive effect on mental health well-being in general. The encouragement of individual resources and skills, and improvements in the socio-economic environment are among the strategies used.
Mental health promotion requires multi-sectoral action, involving a number of government sectors and non-governmental or community-based organizations. The focus should be on promoting mental health throughout the lifespan to ensure a healthy start in life for children and to prevent mental disorders in adulthood and old age.
Whilst this is today’s reality in Britain, as per Liberal Conspiracy’s overview of the matter – and published today:
Regular readers will know my endless horror at the system of “assessment” in place to now determine whether or not someone is “Fit for Work”.
Run by ATOS, a private company charged with making impersonal decisions, the system uses a computerised, tick box questionnaire of just 15 questions that take no account of variable conditions, no account of consultant or GP based evidence and no account of pain or most symptoms.
In a recent survey, Mind found that an enormous 95% of respondents don’t think that they will be believed at assessment. Evidence abounds of mentally ill people being found “fit for work” simply because they manage to turn up at the assessment centre dressed and washed.
I have to say that my own experience of mental health assessment – a sad and traumatic moment in my life, conducted as it was under the alleged objectivity of GPs and consultants – left much to be desired. But I was one of the very lucky ones. I survived the diagnosis – and managed to put my life back together. And this was under the previous system, where a supportive approach was supposed to be at the heart of the whole process.
Today’s Britain, however, seems aimed at making this almost impossible for the vast majority of sufferers. All part and parcel, in fact, of an attempt by those in charge to ensure that the poor and vulnerable in society will remain under the lock and key of a Darwinian capitalism at its very worst – and, it would seem, for evermore.
Coupled with the move to a free-market NHS, where presumably paperwork for patients at point-of-delivery will multiply a thousandfold, the strategy would appear to become clear: reduce the need to pay for care for those who are suffering severely by ensuring that form-filling and what we might term personal bureaucracy becomes a useful barrier to accessing such services (in my own particular case, for example, I only have to think of the mental pain I go through, even now, when I have to complete the forms to claim back my dental fees).
Where in the world, I then ask myself, does a company propose winning over more potential customers by making it more difficult for the aforesaid individuals to use their products and services? Unless, of course, the idea is to cherry-pick the profitable customers and, in true free-market style, absolutely forget about the rest. You know. Your granny, my auntie and the village idiot down the road.
I really fail to understand how even those who propose these changes are able to live with the daily burden of not squaring the obvious circles. Most of them run large businesses – or are in contact with large businesses – whose main reason for existing is (supposedly) to satisfy the needs of external customers.
(Or, perhaps, not – as the case may be.)
So would their shareholders sanction treating customers with such utter and despicable disrespect? Would they approve of procedures and processes which were designed to make it easier for such companies to operate and more difficult for their customers to engage?
Maybe that’s what’s wrong with latterday capitalism. The real customer of the vast majority of modern companies becomes the internal self-serving owners whose yearly dividends are far more important than any end-user’s experience. And that is the model we are now imposing on our public services.
This is not Darwinian capitalism after all, not the survival of the fittest. This is the survival of the incestuous. The inbreeding of the hypocritical.
And if you thought the public sector needed turning over, just wait until you experience the full force of the private at its most navel-gazing.