By John Pring Disability News Service May 11th 2017
Two user-led groups have accused the Conservative party of “hypocrisy” after it promised to end the “burning injustices” facing mental health service-users.
Both groups pointed out that Conservative social security policies, including the coercion and bullying of benefit claimants, had created and worsened mental distress.
And they said the party had been responsible for years of drastic cuts to mental health services.
They spoke out after the Conservatives promised to replace the “anachronistic” Mental Health Act (MHA) and address the increasing numbers of people in mental distress who are detained under the act.
Prime Minister Theresa May also promised further powers to protect people from discrimination in the workplace through “sweeping changes” to the Equality Act – offering more protection to those with fluctuating mental health conditions – and to fund an extra 10,000 mental health staff working in the NHS by 2020.
But Labour pointed out that the number of mental health nurses and doctors working in the NHS in England had fallen by more than 6,600 since 2010.
Figures released to Labour by health minister Philip Dunne last October showed the number of qualified mental health nurses working in the NHS in England fell from 46,155 in 2009, to 45,384 in 2010, and then fell for each of the next five years and finally hit 38,774 in July 2016, a fall of more than 6,600 nurses in six years since the Tories came to power.
A Conservative party spokesman refused to confirm these figures.
The party said that more than 63,000 people were detained under the MHA in 2014-15, an increase of 43 per cent compared with 2005-06, with black people disproportionately affected.
It said the new mental health treatment bill would include “revised thresholds for detention”, and new codes of practice to “reduce the disproportionate use of mental health detention for minority groups, especially black men”.
The party also promised “safeguards so that when people with mental health problems have the capacity to give or refuse consent, they can never be treated against their will”.
But the Conservative attempt to take the initiative on mental health early in the general election campaign was greeted with distrust and accusations of hypocrisy by many disabled activists.
The user-led group Recovery in the Bin (RITB) described May’s plans as “window dressing at best”.
In a statement, RITB said that it was “government policies on welfare that are taking us to the brink in the first place”.
RITB calls in its statement for an end to the work capability assessment, personal independence payment, benefit sanctions – all of which have been associated with causing benefit claimants severe mental distress, and even deaths – and the new mandatory health and work conversation, as well as the “coercion and bullying” of claimants with mental health conditions.
Recovery in the Bin fears that what will replace the current Mental Health Act will be a “more punitive law” that will “possibly make it harder to detain but harsher for those detained – especially for black and minority ethnic people and for people routinely monsterised through the rhetoric of welfare reforms and neo-recovery narratives”.
It calls on the next government to scrap community treatment orders (CTOs), and stop the use of section 136 of the Mental Health Act – used by police officers if they believe someone has a mental illness and needs immediate care or control – and address the “horrific prescribing of anti-psychotic medications”.
It also calls for an end to “the consistent underfunding of mental health services and cuts to front line mental health staff”, and for compulsory mental health training for all doctors.
Denise McKenna, co-founder of the Mental Health Resistance Network (MHRN), accused the Conservatives of hypocrisy.
She said the Tories in government had “created mental distress through their austerity measures and they have withdrawn mental health services on an industrial scale from people who really, truly needed it.
“Now they say they are going to put right a problem that is of their own making. I don’t have any faith that they are going to come up with something better
“We are highly suspicious of their motives. We don’t believe people should be forcibly treated, but we are very worried about what it’s going to be replaced by.”
McKenna said the party’s focus in power had been to “get us off benefits”, with an increasing emphasis on forcing people with mental distress on the out-of-work disability benefit employment and support allowance (ESA) to accept treatment.
And she said MHRN was also concerned by the increasing emphasis on the idea that nearly everyone will have a mental health problem at some point in their lives, which “minimises the experience of people with very severe mental health issues” and makes it easier to remove their benefits and say they are fit for work.
McKenna said the way the mental health system was working was “an absolute disgrace”.
She said: “People with severe mental health problems are being discharged back to GPs, who are not trained to deal with them.”
She added: “Every time they announce something with mental health my blood runs cold because they don’t have our best interests at heart.”
Liz Sayce, chief executive of Disability Rights UK (DR UK), said it was good that mental health and the “soaring” number of compulsory detentions – a “key” issue raised by DR UK in its shadow report to the UN committee on the rights of persons with disabilities – were being discussed in the general election campaign.
But she called for new laws that were compliant with the UN Convention on the Rights of Persons with Disabilities (UNCRPD), in discussion with people with lived experience of mental distress.
She said: “We have seen in the past (eg the 2007 legislation that brought in the hated and ineffective CTOs) that law reform in mental health is not always positive. We need law based on our commitments to the UNCRPD.”
Sayce said there were calls previously for mental health laws based on capacity – as the Tories have suggested – because “at present you can be forcibly treated against your will when you are quite capable of deciding yourself”.
But she said the problem with this argument was that legal capacity law in England and Wales was also non-compliant with the UNCRPD, which says “that everyone has legal capacity and what is needed is supported decision-making, not substitute decision-making”.
She said: “We would like to see mental health law and mental capacity law replaced by legislation that genuinely supports and protects everyone’s rights; coupled with strong practical measures to make this a reality.”
She pointed to how some countries had committed to phasing out the use of restraint, which she said has been shown to work.
And she said the death of Olaseni Lewis in 2010 – who was killed by prolonged restraint by 11 police officers on a mental health ward – showed the potentially “tragic” impact of restraint.
An inquest concluded this week that excessive force had contributed to his death.
Matilda MacAttram, director of Black Mental Health UK, also welcomed the pledge to reform the Mental Health Act.
But she warned that “a change in legislation would be meaningless without a fundamental change in the power dynamics that drive the coercive way that the Mental Health Act is used as a tool of oppression against black people of African descent from the UK’s African Caribbean communities”.
She said that “the deployment of Taser firearms and the overuse of anti-psychotic medication are all part of the routine human rights abuses that disproportionately are meted out to black people of African descent”, both in the community and in medium secure and secure psychiatric settings.
As part of the announcement on mental health, the Conservatives promised that every primary and secondary school in England and Wales would have staff trained in mental health first aid and a single point of contact with local mental health services.
A Tory government would also change health and safety at work regulations “to take account of risks to mental health as much as those to physical health”, and fund the Samaritans helpline through the next parliament.
And it would end the fees of up to £150 that patients must pay their GP for a mental health and debt form to prove their mental ill-health to their creditors.
Meanwhile, the Liberal Democrats said they would spend an extra £1 billion a year on mental health – part of the £6 billion a year the party says it would raise by increasing income tax by 1p (see separate story).
Among 12 priorities for this spending, the party said it would improve waiting time standards, aim to end the “scandalous and inappropriate” use of force against mental health patients in hospitals, end out-of-area placements, prioritise national action to reduce the number of suicides, and “accelerate the roll-out” of the Individual Placement and Support back-to-work scheme.