Improving mental health should be a priority in this election

http://www.theguardian.com/commentisfree/2015/apr/01/mental-health-election-issue-nick-clegg

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To be fair to Nick Clegg … you won’t find me saying these words too often, what with his broken promises and his propping up of one of the nastiest, most rightwing and incompetent Tory governments we have known. But – to be fair to Clegg – he has at least helped drive mental health and mental illness up the political agenda. He has been a consistent supporter of the Time to Change campaign. He made mental health the centrepiece of his conference speech, and the subject of his first major outing of the election campaign, with a Lib Dem manifesto commitment pledge of £3.5bn funding for mental health over the next parliament.

Related: I’ve suffered from depression. The only life I’ve ever considered taking is my own | Matt Haig

So Clegg has talked the talk, and that is a good thing. But over the course of this parliament, though we have made some progress in the anti-stigma campaign – if not enough to prevent some awful reporting of the Germanwings tragedy – on services I believe we have gone backwards. Indeed, there is a danger that politicians see improvement in attitudes as a substitute for the need for services when in fact improved awareness and understanding will lead to more reporting of mental health problems, and therefore the need for more not less resources within the NHS for mental health.

Mental health has long been the Cinderella service. NHS managers and commissioners, confronted with the reality of austerity policies, have to make tough judgments. When it comes to a choice between, say, cancer, A&E, and mental health, we all know where they find it easier to make the cuts.

I sometimes crowdsource before making speeches and when doing one such speech on mental health, I asked people to tweet me telling me what was going on in their area and I was deluged by people saying “we used to have this service and now it’s gone”.

The last Labour government did good things such as introduce IAPT (Improving Access to Psychological Therapies), which signalled an understanding of the role that talking and counselling can play in helping people improve their own mental wellbeing. If Ed Miliband becomes prime minister, I hope he can put mental health right at the heart of the NHS agenda where it needs to be. And I hope the NHS can involve mental health patients more in their own care, and also integrate physical and mental care better for the individual patient.

I don’t think the Conservative part of the Department of Health gets it at all. When I met the health secretary, Jeremy Hunt, he said he didn’t understand how someone like me could get depression, because from the outside it looked like I had a great life. To be fair to him – something else I don’t say too often – he did at least seem embarrassed when I pointed out that I didn’t choose to be depressed, any more than I choose to be asthmatic, or would choose to have cancer.

Enshrined in the NHS constitution is a commitment to parity of understanding and treatment between mental health and physical health, but we are a very long way from that.

This is not just about resources, vital though they are. It is also about our general attitudes, and the importance of educating people to understand, and look after, their own minds. Get this right, take it seriously from childhood onwards, and instead of ever-increasing demands for patient care when people are in crisis, we can save money by preventing the crisis from happening.

Think of all those people who end up in A&E for drink- and drug-related incidents. I make no criticism of the under-pressure staff in pointing out that their priority is to patch them up and get them out again, not least because there are others they need to deal with. But this is surely a point where many of the early signs of addiction or other mental health issues, like self-medicating for depression or anxiety, can be spotted and should be treated.

When I was in London’s brilliant Royal Free hospital for dysentery a couple of years ago, a doctor treating me told me that in every ward of the hospital, whatever it said on the door, there were people with serious illnesses as a result of addictions due to mental health problems. He later showed me around. He was right.

The campaigns that fought and won battles against the tobacco lobby show the way forward on this. The ban on smoking in public places didn’t cost a penny. It didn’t require new buildings. It didn’t require new nurses and doctors and hospitals to implement it. It required new thinking. It is arguable that that change saved and improved as many lives as the new hospitals we built.

We need a similar preventative approach to mental health. Diet, exercise, sport, investment in youth, community and self-help groups – the kind of things Tories dismiss as nanny state nonsense – should be part of a modern health policy. So should Sure Start, one of the best investments Labour made, decimated by the Tories for reasons both of austerity and ideology.

I wrote a paper for David Cameron before the London Olympics setting out how I thought they could exploit the legacy of the Olympics to improve the nation’s mental health and wellbeing through sport. I received a polite note from a civil servant saying it wasn’t really the prime minister’s thing. It is hard to discern what is, other than wanting to be prime minister.

If we could be as open about our mental health as we are about our physical health, we will all be better off. The dark-ages reporting on German pilot Andreas Lubitz, some of which suggested that any history of depression ought to mean a lifetime ban on looking after other people – the clear subtext of tabloid headlines and ignorant social media chatter – shows how far we need to travel.

I know people who say the stigma and the taboo, especially in the workplace, are sometimes worse than the illness. And so they bottle it up, they resist help, and bit by bit the illness leads them to crisis, and when that happens, they cost the state a fortune. Go to any hospital, any court, any prison, and you will see what I am talking about.