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Mental health champions at Holyrood are driving Scotland mad

by Jonathan Stanley

ONE OF THE MYSTERIES of politicians is how they pick winners in healthcare, almost at random. It seems to be that mental health is something we need to do more for, which means giving it a nice label, compartmentalising it and bludgeoning it violently with large round sums of money and a jeering pouting of the lips before the cameras.

Almost no member of the Scottish Parliament has a clinical background. Considering the NHS is politically and financially huge this is strange but then the consequences in terms of policy are not. Mental health is not the same as mental healthcare. We can have a long debate over why we have a NHS and how we fund it, but something sticks out about mental healthcare.

Almost all decisions in healthcare are based on some socialist-market creation of price-to-value in the outcome of healthcare internventions. This is fine for a bad hip in need of the chop, or a complex heart procedure or various cocktails to bleach various cancers but mental health is extremely difficult to price and define in this utilitarian way.

Mental illness as opposed to mental health as opposed to mental healthcare is a dynamic between ourselves and everyone else. So unless we allocate resources based on these dynamics – instead of the symptoms of those presenting to us as dysfunctional – we have no chance of anything more than firefighting the excesses of mental ill health and so we concentrate on surviving rather than thriving. One can survive with pills, you need motivated people around to thrive though.

Job instability, substance misuse, bullying at work, horrible bosses and spouses, poor diet – all and more contribute profoundly to mental illness. We are told mental illness costs business billions a year and is the biggest health issue affecting working age people.

So why on Earth do we obsess over healthcare instead of the workplace and family life? These are clearly what are causing the issue. Abusive partners, universities and civil service departments stressing their students into sickness, bosses who are clearly psychopathic in nature. We have all helped those mentally ill without realising it. We have also made other people mentally ill by our behaviour or lack of care. Every one of them and at times ourselves is like a pump, a toxic pump that floods the lives of others with negativity. 

Jon Snow knew a thing or two about toxic pumps. During a cholera outbreak in London he traced the cases to a few toxic pumps, closed them off and the epidemic plummeted. You don't prevent cholera by dishing out antibiotics or constipating drugs. You remove the toxic pump, the water clears and people recover. 

Mental illness in that sense is an epidemic but only so far as the cause is systemic within our society. There is a clearly a biological basis behind mental illness but it's odd isn't it how some illnesses are treated by neurologists and others by psychiatry when the real difference between the two is not chemical but who is suffering from the consequences.

Neurology only affects "them" or "us" so it's fine. Mental health only ever affects "us" because regardless of who has symptoms we all experience the consequences. Hence the false compassion of mental health campaigners,

"We need to do more to them, or for them, at a safe distance to the rest of us so we feel better about the whole situation which is happening through no fault of our own and we are going to control this"

This sums up the approach which is clearly based on bigotry. We do need to be more though, and not simply with a few specialists we "pay" with debt our kids or even grand-kids will repay later on. The private setor has done some brilliant work in taking a more societal perspective to mental health. 

Mates in Mind by the British Safety Council teaches people in the building trade to look for early signs of mental stress and act accordingly to head off illness before adverse consequences arrive. Employers pay a very large amount of National Insurance yet social democracy only seems to treat them as an enemy or a neccessary evil. Their contributions should receive a more direct reward with vouchers for treatment and in work plans to keep our workers healthy.

We need to take horrible bosses seriously. This is far more the case in the public sector where a lack of competition allows monsters to hide in their crevices and where junior and temporary staff are not asked for any feedback about their seniors. One need not fire horrible managers but moving them away from junior staff and any form of pastoral responsibility seems smart to me. Job instability is a scourge for many and often it is engineered into employment for no reason beyond controlling workers. The trade unions are silent. Mass immigration and annual appraisal culture don't register with them but they should.

There is almost no funding for relationship counselling, especially where children are involved. This, despite evidence of unstable homes being a breeding ground for future mental illness. Could employer's NI cover insurance to ensure workers as heads of households with children get priority in timely treatment? If we can insure ourselves for a skiing trip why not for employees' marital breakdowns, to prevent them happening?

Educating people in school and university would not be a bad idea either. As for spending more I can't think of better than having more GPs with time to care for those presenting with mental health problems. This cannot be one in 5 minutes but a few extra slots on weekends and evenings could help a lot with assessments.

Treating people in far away special clinics is isolating and extremely expensive. It also suggests we need more specialists. We need in fact far less demand being generated in the first place by actively working through these social and employment issues that are making our society ill.

We need to clear the waters by, yes, by draining the swamp. Until then we can at least reward companies and institutions and families to root out the most toxic pumps and remove their handles (as per photo). Beating issues violently with wads of cash hasn't worked and never will. The rhetoric is just driving us mad now. Isn't madness a form of mental illness?

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Article from Thursday 26, January, 2017