Removing the stigma from the mental health discourse

Simon Thomas says the way we treat mental health issues in Wales needs to change.

For too long mental health services have been neglected. Society has scorned or belittled sufferers. Campaigns such as Time to Change and the new #justbeafriend initiative are an attempt to tackle those beliefs head on.

The problem is fundamental: our society simply doesn’t value things that build good mental health- leisure time with friends; access to sports; reasonably priced arts provision; balance between work, rest and family. Most saliently of all, we need proper, well-funded provision for early intervention and support in our NHS.

It’s important to dispel myths: mental ill health is not confined to the weak or inadequate. Nor to one class of person, the unemployed or those addicted to drugs or alcohol.

Unfortunately we saw an example even this week from our First Minister. Opposing mental health checks for all veterans leaving the armed forces, he stated I am not sure that they would particularly want to be seen in that way”.

It is not a statement he, or anyone else, would ever make about a physical health check and shows the distance we have to travel.

In fact, the World Health Organisation states it accounts for 20% of all disease, making it the single most common health issue – ahead of cancer or cardiological conditions.

Recently the National Assembly was presented with a 90,000 work petition on the perceived need for a cancer drugs fund which gave rise to a rather ill-tempered debate. Despite the Assembly leading the way in debating mental health, we are a long way from the day when mental health gets such attention.

But that’s what’s necessary. Mental health services are underfunded, underpowered and unavailable to many.

If campaigns such as Time to Change are successful we can expect increasing numbers to seek assistance for mental health problems as the stigma diminishes.

If they do so today, they will find a service on its knees.

I have participated in an inquiry this year by the Children, Young People and Education committee into Child and Adolescent Mental Health Service – CAMHS. It has been a revelation.

The demand for CAMHS has more than doubled in this Assembly. Our inquiry began because we were concerned that this increase had caused not only delays, but to CAMHS referrals being refused.

After meeting young people and their parents however, it emerged that the increase was also due to a failure of primary health care.

The Health Minister has confirmed that 20% of those presenting to CAMHS should be dealt with at a primary health level, but a lack of resources is preventing this. Exacerbating young people’s mental health problems is a greater national disgrace than any NHS story the Daily Mail can drag up.

This basic lack of services means that too often GPs resort to medication. I firmly believe medication can be a fantastic intervention.  However, the prescribing of strong drugs for children with ADHD needs to be examined closely.

It struck our committee that many young people were simply reacting normally to abnormal situations – the loss of a parent; an upheaval in the family. Premature medication in such situations could hinder rather than help.

We risk assuming that the medical model is the only model to deal with mental health. I now find parents demanding their children receive an ADHD diagnosis as it is seen as the only way of accessing crucial attention and medication.

The same is true of adult services. As an MP 10 years ago I campaigned for greater funding to community services as mental health hospitals closed. Today, despite some improvements, mental health patients face double the wait as acute patients under delayed transfers of care.

Over a quarter of people feel that being around those with mental health problems can make them feel uncomfortable.

A similar proportion feel that those with mental health issues should not hold public office, making the decision by several AMs to state they had experienced mental health difficulties all the more commendable.

I am particularly pleased that two Carmarthenshire men are part of the national #justbeafriend campaign centred around the rugby internationals to demonstrate the importance of maintaining friendships and supporting those with mental health problems. I do believe men in particular have difficulty opening up on mental illness. Society – rugby especially – expects men to be strong and society views mental illness as a weakness. There is a lot of work to do.

But the importance of tackling stigma is only half the picture. We must also create a better understanding of the need to invest in mental health services.

This is particularly essential for Welsh language provision, which is appallingly inadequate. Talking therapies are virtually non-existent, despite the obvious need to access therapy in your first choice language.

Welsh language communities can also have different support structures to English ones, particularly around churches and chapels. This deserves special attention and I know work is being done to address this.

Over the years we have witnessed how evidence-based challenges to assumptions and prejudices can change society’s attitudes fundamentally – from smoking to domestic abuse to same sex relationships.

Welsh Government must continue to support the work of campaigns such as Time to Change and take the lead to ensure the stigma of mental health is removed from our national discourse.

Simon Thomas is Assembly Member for Mid and West Wales.

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