There was something about the events in Westminster this week that made me think of the news that sales of self-help books in Britain are at a record high. As we encounter an ever more stressful and unsteady climate, we are turning to those who offer answers (an issue not least for those who can’t afford the price of a book). Some of this anxiety must come down to more global patterns – climate change, say, or the fragility of democratic norms – but much can come down to the more prosaic matters of life: ability to pay the bills, job prospects, or simply the sense that we have a grasp on the future.
Just look at Brexit. More than four in 10 people say that Brexit has impacted on their mental health in the past two years; hardly surprising considering 44% of respondents to the YouGov survey believed EU withdrawal will worsen their lives. Some EU nationals living in the UK have even reported feeling suicidal as uncertainty about their future steps up.
Go beyond Brexit and this pattern develops. Last week, a survey by NHS providers laid out how a number of domestic policies are adding to the rising demand for mental health care. Perhaps most starkly, nine out of 10 NHS mental health trusts bosses in England said they believe benefit changes in recent years have increased the number of people with anxiety, depression and other damaging conditions. Lack of money and housing, and cuts to local services were also said to be contributing directly to increased demand for mental health support.
It is quite the irony behind Theresa May’s self-styled mental health revolution that her own government is having a hand in an ongoing psychological crisis.
There is a longstanding reluctance in some quarters to acknowledge the relationship between politics and mental health. Some caution is valid: the reasons behind mental health conditions are varied and complex and it’s right that specialists like the Samaritans stress suicidal feelings in particular should not be put down to a single cause. But there is also a sniffy denialism at work – the idea that we shouldn’t get “political” about such subjects, as if poverty or power weren’t related to the decisions of politicians; or the belief that insecurity, fear and hardship are inevitable for certain sections of society.
It is only logical that the choices of those in power would impact citizens’ mental wellbeing. The conditions in which we live – our homes, family, jobs, income – are shaped by the decisions made by politicians. This is particularly true if you’re poor, disabled, an immigrant, or a woman and therefore more likely to be at the mercy of state support – and to take the biggest hit from Brexit-type economic shocks.
As I’ve written previously, mental health is inexorably linked to socio-economic circumstance. Factors such as debt, overcrowded housing or insecure work can significantly impact our mental health. Even growing up in a cold home is linked to an increased risk of depression and anxiety. In 2012 the chief medical officer reported that children in the poorest households were three times more likely to have a mental illness than children in wealthier homes.
A climate of growing economic hardship, from slow wage growth to the rise in private renting, coupled with a decade of far-reaching government cuts like the bedroom tax, disability tests, and tax credits, have all too predictably exacerbated this.
The Children’s Society found in 2016 that reductions in family incomes – including benefit cuts – were likely to have “wide-ranging negative effects” on children’s mental health. Last week’s research from NHS trusts found the roll out of universal credit to be the single biggest driver of demand for mental health services. As Amber Rudd has confirmed, the government are considering hiring additional Department for Work and Pensions staff and providing a hardship fund if economic downturn hits after Brexit. An EU withdrawal will almost uncertainly continue to add oil to this fire.
That this is happening against a backdrop of buckling mental health budgets is a lesson in how economic and social disadvantage works: while austerity measures and uncertain conditions push more people into mental health crisis, disappearing community mental health teams, staff shortages and growing waiting lists mean there are fewer and fewer places they can turn to for help. In many cases, long waits for treatment only exacerbate the symptoms: it’s a vicious cycle of cause, effect and prevarication.
While increased funding to cash-starved mental health services should be a priority, it will amount to little more than a particularly expensive sticking plaster unless ministers address their role in the conditions driving up the need: be it a pernicious benefit system, hostile immigrations rules, or insecure housing conditions.
If not, the result will be a populace whose levels of anxiety, depression and worry will only continue to grow – which right now is the one constant in these unstable political times.
• In the UK, Samaritans can be contacted on 116 123 or email jo@samaritans.org. You can contact the mental health charity Mind by calling 0300 123 3393 or visiting mind.org.uk. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here.
