Mindful manifestos?

In which Lauren Heritage examines each party manifesto to see what each is pledging in terms of mental health..

Next month on December 12th we all head to the polls again for what feels like the 26^th time in a year, for another General Election *insert screaming with joy gif*

The main parties are represented in Medway along with some independent candidates for your selection. Mental Health remains a hot topic both socially and politically and all parties will need to be making strong pledges in this area to win votes.

So what are the parties promising in their manifestos and what do I think of them? The focus of this article is to see how Labour, Conservatives, Lib Dems, Green and UKIP (at the time of writing The Brexit Party had not presented any mental health policy) are focusing on mental health and then review the policies.

So, as someone who works within mental health in Medway, what are my biggest areas of concern? 

• Not enough staff. Vacancies are often left unfilled which leads to the existing staff often having dangerously high caseloads, so even if staff are doing their very best they are often swimming against the tide.

• A lack of understanding of mental health within schools, GPs and the wider community means they often struggle to manage emotional difficulties that do not warrant a mental health service. This results in thousands of inappropriate mental health referrals every year which increase waiting lists for those who do need mental health service. Think of going to A&E with a papercut, but for mental health services.

• Lack of inpatient beds, especially in children’s services, leading to young people often being detained for long periods, waiting in A&E for days or being placed in beds hundreds of miles away.

• Cuts to early intervention services because for some reason, some bright spark thought they were not necessary.

• Huge disparity in acceptance criteria between child and adult MH services meaning young people are often left with no support or minimum support when they turn 18.

• In Medway specifically, there is no formal service for children who have been diagnosed with ASD or Learning Disabilities for support with these, often leaving charities or social care to try and help.

• Constant changing of procedures within Trusts, means confusion for staff and families and huge disruption during trust transitions. Once staff get used to dong things one way, it all changes again.

• Overreliance on MH services to ‘fix everything’. 

For arguments sake, lets pretend all the parties have fully costed their policies and they are all workable (whether they are ACTUALLY costed and affordable is a whole other story). Policies are taken either from 2019 election manifesto if available at time of writing or most recent policy documentation available.

Labour – Manifesto 2019

The Headlines:

£1.6 billion a year to ensure new standards for mental health are enshrined in the NHS constitution ensuring access to treatments is on a par with that for physical health conditions.

We will invest £2 billion to modernise hospital facilities and end the use of inappropriate, out-of-area placements.

The legislation for detaining people with learning disabilities and mental illnesses is outdated. We will implement in full the recommendations set out in the independent review of the Mental Health Act, so that people are given choice, autonomy and the treatment they need.

We will invest more in eating disorders services and ensure NICE guidelines on eating disorders are implemented.

We will improve access to psychological therapies to ensure they deliver the quality care patients deserve. We will ensure provision of 24/7 crisis services.

Our £845 million plan for Healthy Young Minds will more than double the annual spending on children and adolescent mental health services.

We will establish a network of open- access mental health hubs to enable more children to access mental health and recruit almost 3,500 qualified counsellors to guarantee every child access to school counsellors.

The Good:

The problem with inappropriate inpatient provision is being addressed as well as inappropriate placements for those with Autism and Learning Disabilities.

Mental Health Hubs sound like a great idea and helps improve access and early intervention.

The Bad:

I don’t like how there is no mention of clinically appropriate treatment, rather just ‘counselling’ which can be helpful to a degree but often not the most clinically effective treatment for many difficulties. Reeks a bit of ‘just give ‘em a bit of counselling and that’ll fix it’. 

No mention of how they intend to increase NHS mental health staff.

No mention of transition to adult care and no mention of adult community mental health.

Conservatives – CPC 2019

The Headlines:

We’re funding twelve trailblazer schemes – which will test new ways of joining up services across NHS organisations and councils – and 1,000 extra staff in NHS community mental health services, to ensure patients have easier access to the support they need.

An extra £975 million going into adult mental health services every year.

Last year we announced a record £33.9 billion settlement for the NHS including £2.3 billion for mental health services upgrades.

We’re investing in young peoples’ mental health, offering mental health training to schools and colleges across England.

The Good:

Better access for adults to access mental health services – adult services often get ignored in favour of children’s services.

The Trailblazer scheme sounds good, a big hurdle to effective treatment is difficulties agencies have working together, especially between social and mental healthcare and different care providers.

Mental health training for schools and colleges is a positive. Improves early intervention and means mental health services are not flooded with inappropriate referrals.

The Bad: 

No mention of inpatient provision.

Not very specific about where the money will be spent, such a vague notion of the individual areas money will be spent makes me suspicious that it is a policy that has not had much thought.

1000 mental health staff? Is that just for the trailblazer scheme? It is unclear. Certainly a 1000 more mental health staff in general aint gonna cut it.

Lib Dem – Manifesto 2019

The Headlines:

Introduce further maximum waiting time standards so service users are seen in a reasonable timeframe for assessment and treatment and ensure that everyone who needs it can access evidence-based mental health therapies within 28 days.

Increase access to range of talking therapies and equal access for groups such as LGBTQ+, BAME and those with ASD and LD

Make mental health prescriptions free

Improve perinatal mental health services and make sure every new mother gets dedicated postnatal appointment and improved diagnosing post natal mental health difficulties.

Make crisis care 24 hours with provisions round the clock to make sure no one is turned away and make sure emergency bed is always available. All inpatients to be treated as close to home as possible and reduce the need for people being admitted who don’t need to be, by improving community and social provisions

Ensure all frontline public service staff receive mental health training and train more mental health first aiders and Introduce student mental health charter to make sure all universities and colleges provide good level of MH provision.

Improve transition from child to adult care so young people are not left abandoned at 18.

Make sure fair proportion of public health research funding goes towards mental health research and this is equal for different communities

Improve mental health treatment in the prison system and introduce better rehab programmes within prison.

Reward employers who invest in employee mental health

Introduce levy on all gambling companies to fund research and treatment of gambling addiction and ban credit card spending on gambling, restrict gambling ads and introduce gambling ombudsman.

The Good:

The most detailed manifesto of the lot which shows a lot of thought has gone into it.

Addresses the problems with current inpatient placements.

Free prescriptions for mental health medications can only be a good thing.

Mentions evidence based treatments, which suggests they aren’t just going to chuck counselling at everyone.

Prison treatment and rehab services are really important and often overlooked. High percentage of prisoners have diagnosable MH problems on entry to prison. Improving their MH and any addictions means they are less likely to reoffend.

Inclusive to minorities and those with additional needs.

The Bad

Probably not entirely realistic in terms of maximum waiting times for treatment.

No mention of early help services other than training for frontline staff, but this is likely not going to be specialised enough.

Green – Manifesto 2019

Focus funding to enable major improvements to mental health care to truly put it on an equal footing with physical health care, and ensure that everyone who needs it can access evidence-based mental health therapies within 28 days. 

We will ensure that tailored and specific provision is readily available for (LGBTIQA+) and Black Minority Ethnic (BME) communities, children and adolescents, and older people.

The Good

Wants to make care inclusive and tailored to all communities.

The Bad

Well it’s not very detailed, is it? Feels like a bit of an afterthought, or in this case, barely a thought.

Again, the 28 day maximum wait for treatment is unrealistic.

UKIP – Manifesto 2019

We will introduce practical policies to improve the delivery of mental health services and increase mental health funding by £500m per annum.

The Good

They are going to increase funding.

The Bad

Much like the Green policy, it’s not very detailed.

I mean really, it’s 2019, surely mental health policy deserves more than a sentence.

So if mental health policy is important to you and going to be a main deciding factor in who you vote for, you should be looking to put your X in the box of the party you feel has the most well thought out policies that are going to work not only in the short term, but for the long term benefit of us all; because with at least 1 in 4 of us likely to experience mental illness at some point in our lives, we may very well come to rely on the strength of these policies.

Lauren Heritage is a mental health professional born and raised in Medway. She wants Medway to be the best it can be and is growing more exasperated by the day with politics. She likes to travel, enjoys good food, is a scuba diver, and a wannabe pilot.