The news that our Prime Minister has woken up to the damage caused to men, women and especially adolescents and children by mental ill-health is of course very welcome. In terms of the speech she is due to make at the Charity Commission today, the fact that she is predicating her comments on the £105Bn annual costs to society of this issue is not necessarily the best foundation for change, but any catalyst in the area of mental health provision has the potential to improve matters. An indication of how impoverished this really is, is the offer of £15m to strengthen community care. The annual budget for the NHS Trust which delivers mental health provision to Sussex alone is some £250m, so the offer of this extra funding would be 6% of their budget, but of course it is to cover community care across the whole country. Any money is vital and welcome, but it needs to be sufficient to make a difference and this clearly is not sufficient.
The promise of training for every School on the theme of mental health first aid with no indication that there is to be any real provision to back this up is deeply concerning. There is reference to some trials on the strengthening of links between Schools and CAMHS. The are of course always improvements that can be made, but the reason why links are weak in many cases is due to the lack of funds. The fact is we need resources in Schools to pay for the mental health provision that many have already identified is needed, but which will be identified even more quickly if the staff are to participate in a mental ill health awareness course. I was Chair of a charity that provided counselling in Schools across Sussex over a number of years. This was to help address the mental health issues that Schools had already identified in some cases more than a decade ago. The Charity worked with the local mental health NHS Trust. Whilst there were inevitably tensions as there always are between organisations working in the same orbit, the big tension was the lack of resources to carry out the work. Many of the Schools struggled to find the budget to fund the counselling, some of which was eventually funded by the parents, and the NHS Trust was constantly struggling to deliver the services needed with its budgets. Then every couple of years or so due to the internal market within the NHS the Trust was being asked to tender for the work that it carried out and no sooner had the charity persuaded a School of the value of their work and the budget was released, the private sector, usually in the form of self employed Counsellors would undercut the charity to deliver cheaper counselling. All of this churn and change was taking place while the teachers were being placed under immense pressure to carry out their work. One of the very disturbing aspects of offering teachers training in mental health first aid is that it will reveal just how many of them are in need of support and provision, yet if their is no back-up they will be left with needs that have been identified, with no way of resolving them.
My final reflection on this speech is the idea of a mental health review for workplaces. The challenge is that increasing numbers of people work in small enterprises or as self employed workers. Whilst I have every respect for Dennis Stevenson, the Peer being asked to head this up, his business experience is exclusively from FTSE 100 type companies which have full time HR departments and the resources to bring in professionals to deal with issues with relative ease. Whilst we are no longer a nation of shopkeepers, we are a nation of small businesses. It is SME’s that create most of the jobs in the UK and yet they are a very different business model to that which Baron Stevenson of Coddenham is familiar with. Let us hope if their review is to have a meaningful impact that they spend time looking at small businesses or else their review will simply miss the wood for some of the trees.