Friday, 11 December 2009

World on Fire: Sinking and Swimming

[written for Progress magazine]

After 12 years of Labour governance, Britain remains a largely pleasant and prosperous place to live – but not for everyone. The Young Foundation’s latest report, ‘Sinking or Swimming’, is a damning investigation into increasing levels of social deprivation and insecurity. The report exposes how, for many people, simply maintaining their material and emotional wellbeing is a lonely, near-Herculean feat.


Self-reported cases of anxiety and depression have almost doubled in 12 years, with 10-15% of the population feeling depressed or anxious most of the time. With one in four people experiencing a mental health difficulty at some point in their lifetime, policymakers are only now beginning to seriously examine the connections between social deprivation, poverty and mental health difficulty, rather than assuming that mental health difficulty is merely a sign of ‘weakness’, occurring in isolation from social factors.

Behind this trend in policymaking – borne out by the government’s proposed mental health strategy, ‘New Horizons’ - is a profound sense of shock that rising material living standards have failed to make the people of Britain fitter, happier and more productive. In fact, as the report demonstrates, 60 years after the advent of the welfare state ‘psychological needs have become as pressing as material ones: the risk of loneliness and isolation; the risk of mental illness; the risk of being left behind.’

The Young Foundation report demonstrates that the psychological resilience of ordinary citizens, along with our ability to cope with setbacks and changes in our lives, is directly affected by our level of social, personal and financial stability, concluding that that ‘To deal with transitions, people need to have a stable home, an adequate income and supportive relationships’. Unfortunately, although Britain is a wealthy country, it is also a hugely unequal one, with a gap between rich and poor that has widened over the past decade.

Consequently, swathes of the population find it difficult to maintain this basic triumvirate of stability. Mark Brown, the editor of Britain’s mental health lifestyle magazine, One In Four, explains that ‘people need a regular income, a safe place to live and a supportive network of people to stay stable. It's like a stool: three legs, you're sitting pretty; two legs and you can keep yourself stable as long as nothing knocks you off balance; one leg and you're pretty much just holding on; no legs and you're on your arse and everyone else is looking down at you.’

Emma Mamo, policy and campaigns officer for Mind, agrees that ‘Poverty can cause and be caused by mental distress, and there are associations between lower levels of income, higher rates of unemployment and being on benefits, debt, poor housing and mental health problems. For example people with mental health problems are three times more likely to be in debt.’

Even before the extant financial crisis, various social groups were particularly at risk of experiencing mental health difficulties, or, as the report prefers to call them, ‘unmet psychological needs’: elderly people, school-leavers, the unemployed, and those making difficult life transitions such as coming out of prison or residential care, losing a loved one or starting a family. Today, with extra pressure on the Treasury to make cuts to frontline mental health services, the Young Foundation is not alone in expressing concern over the long-term future of Britain’s social and psychological wellbeing.

The Foundation’s recommendation that policymakers take a holistic approach to wellbeing and welfare provision is welcome indeed. In this period of social crisis and spending cuts, it is incumbent upon all of us to understand that investment in financial and social equality is also investment in mental health.

This government and whatever administration follows in 2010 must be made aware that investment in social justice, including a welfare state that allows claimants to live above the breadline, is essential to safeguarding the mental health of the nation. The needs of Britain’s most materially and emotionally vulnerable will not be met until investment in mental health services is enjoined with a commitment to improve the material and social stability of the poorest members of our society.

6 comments:

  1. "Self-reported cases of anxiety and depression have almost doubled in 12 years"

    Yes, but rates of depression have fallen since 1993 according to GP records and self-reported depression & anxiety hasn't changed since 2000 (and only slightly increased from 1993 to 2000) according to the largest national survey.

    The Young Foundation point out that "the number of prescription items for anti-depressant drugs has increased from 9 million in 1991 to 33.8 million in 2007" but this is not because "The treatment and diagnosis of mental ill health appears to have increased hugely since the early 1990s." SSRIs were introduced in the early 1990s which are much safer than earlier antidepressants & hence are prescribed more liberally. Also the number of people getting antidepressants has not risen since 1993; the number of prescriptions per person has risen (people are taking them for longer) however.

    Their own report notes that "analysis of the English health survey that uses a variation
    of GHQ [General Health Questionnaire) suggested that the proportion of the working age population with poor psychological wellbeing decreased from 17% in 1997 to 13% in 2006" (page 80)

    The one thing that has increased over time is the % of people who say that they "suffer from anxiety or depression" (page 238) - not in the sense that people report suffering from more anxiety or depression symptoms (rates of symptoms have fallen, see the last para) but in the sense that more people claim to have these diseases.

    So we're actually feeling no worse than 15 years ago but we're more likely to label it as a disease - a fascinating phenomenon & I think I'm going to have to write it up as a blog post...

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  2. I keep hearing how much more liberated and unbuttoned we are since those dark repressed days before the cultural revolution. Yet at the same time we're apparently becoming more and more miserable.

    Despite all the tremendous advances since Attlee's time, like abortion on demand, freely available contraception, comprehensive education, sex discrimination legislation, decriminalisation of homosexuality, retreat from Empire, minimum wage, mass immigration, a massive expansion in female employment, social workers and sex educators - in other words, despite the complete implementation of the reforming liberal agenda of the 1960s - we're less happy.

    How so ?

    I suppose it's all down to income differentials and lack of mental health support workers, isn't it ?

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  3. Even by your standards, this is a wonderful article. Thank you so much. :-) All of this needs saying, and then saying again.

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  4. Thank you, Elly. I will say it again. And again.

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  5. The Labour government does not care about mental health, otherwise they wouldn't be telling so many people with serious mental health problems that they are parasites because they don't have a job. They wouldn't be cutting services. They wouldn't be allowing discrimination against people who are too ill to work, I refer of course to "No DSS" conditions set by property owners seeking tenants.

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  6. Laban wrote, "Despite all the tremendous advances since Attlee's time, like abortion on demand, freely available contraception, comprehensive education, sex discrimination legislation, decriminalisation of homosexuality, retreat from Empire, minimum wage, mass immigration, a massive expansion in female employment, social workers and sex educators - in other words, despite the complete implementation of the reforming liberal agenda of the 1960s - we're less happy."

    Well, to tackle just one point, I know more than one person who is extremely happy that homosexuality was legalised.

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