Someone asked me recently how mental health services had changed over the last 20 years, my tenure as CEO of Solent Mind. Though loathe to admit it, I go back even longer in mental health. 33 years ago I was working in supported housing. We were closing down the old asylums and long stay hospitals, where at one time 120,000 people languished, many living out the last decades of their lives in powerless anonymity. Supported housing meant group homes or care homes – pretty old fashioned by today’s standards but no longer hidden from public gaze. Community care had at least begun.
By 1997 when I started at Solent (then Southampton) Mind, mental health was still the Cinderella service, stigma was rife, with the media preferring to stoke fear rather than celebrating hard-fought freedoms, and much hospital care was still grim. So in 2017 how does the mental health landscape look? We know that 3 in 4 of people with mental health issues don’t or can’t get help, that only 1 in 7 people in crisis get appropriate care, that the benefits system is stacked against people, and that services are desperately overstretched as government, commissioners and providers struggle to meet ever-increasing demand.
And what fuels that demand? 40% cuts in social care investment, provide part of the answer.
But it’s not all bad. When we take a moment to reflect on what really fosters and sustains good mental health – decent housing, a job, social and family life, physical wellbeing, a sense of purpose, the ability to give: it’s not just politicians and health managers that can make this happen, all of us can have a role. The media know now that their public are less likely to tolerate stigmatising headlines: well done Time to Change and Mind. Commissioners are aware of the need to value mental health as they do physical health. In some areas – locally Portsmouth stands out – truly integrated mental health care, with organisations like Solent Mind staff working within wider NHS teams, no longer require the user of services to navigate complex pathways and knit together multiple services to whom they’ve been ‘signposted’. Instead single, coherent, informed, wraparound services are beginning to emerge.
And above all we are realising that clinical expertise by itself is not enough: we need to inspire people going through the worst of times that there really is hope. Nothing inspires like the support of someone who has been through it themselves, come out the other side and is there alongside you to help. Mental health communities are beginning to galvanise themselves; peer support and the value of lived experience are here to stay.
That’s why, 20 years on, I’m still an optimist. It’s been a privilege working in mental health and in particular within the Mind family. Thank you to my colleagues inside and outside Solent Mind for being my inspiration.