The invisible illness we are struggling to tackle

IT’S been called the “invisible illness” and a “hidden threat”.

While according to the Mental Health Foundation, one in four people experience it in some form or another during the course of a year.

But despite this growing awareness our understanding of mental health problems still has a long way to go.

It’s an issue that has been brought back into sharp focus this week following the publication of a new report by the charity Mind, which says that local authorities in England are spending “unacceptably low” amounts on mental health prevention services compared to physical health.

Research by the mental health charity reveals that local authorities, who took over responsibility for public health from Primary Care Trusts in April, are spending on average just 1.36 per cent of public health budgets on mental health this year.

Of the 152 local authorities in England, 86 replied to Mind’s freedom of information requests about public mental health budgets. According to the charity, local authorities plan to spend £76m on increasing physical activity, £160m on anti-smoking initiatives and £671m on sexual health services in 2014/15. This compares with just £40m on public mental health.

The figures for Yorkshire make little better reading. Local authorities in Yorkshire and Humber have a combined public health budget of £228m for this financial year, but are allocating just £3.5m to public mental health, a mere 1.5 per cent of their overall public health budget.

Mind says spending on preventing mental health problems is just as important as physical health - particularly for vulnerable groups - and its chief executive, Paul Farmer, believes far more investment is needed. “Mind’s findings show that while local authorities are happy to spend on preventing physical health problems, their equivalent spending on mental health is unacceptably low.

“We need to invest in everyone’s mental health, particularly for people who are more likely to become unwell such as younger people, pregnant women, people who are isolated, or those living with a long term physical health problem,” he says.

“With demand for mental health services increasing, anti-depressants on the up and more people accessing talking therapies, we are beginning to see the scale of the unmet need for mental health services in England. As a society, we must start looking at what we can do to help prevent people from developing mental health problems in the first place.”

Prevention measures include awareness campaigns at schools, support groups for new mothers and training council housing staff and members of the local community to look for warning signs.

Farmer says local authorities need clearer guidance and support on how best to tackle mental health problems. “We want the next government to introduce a national strategy to ensure local authorities know what to do, and use their budgets to prevent mental health problems developing and reduce the number of people becoming unwell.”

However, Izzi Seccombe, of the Local Government Association, feels the report’s focus is too narrow. “There are many things that councils do that impact positively on mental health but might not come with a mental health ‘badge’.

“We would support the development of a national strategy that gives greater attention and focus to promoting mental health, but would caution against any approach which dictates to local authorities and public health teams how to use their health promotion budgets.”

Public Health England (PHE) has highlighted the importance of having mental health on an equal footing with physical health. Dr Stephen Morton, PHE director for Yorkshire and Humber, says it is also important to recognise the wider work that local authorities in Yorkshire and the Humber are doing to promote and support good mental health. “Their work to create jobs, provide decent housing, promote physical activity, and tackle social isolation are all vital in supporting good mental health.”

There are also countless charities and mental health projects across Yorkshire that are making a difference to people’s lives, like York-based St Nicks.

The charity turned a former landfill site in the city into a 24-acre nature reserve and in 2011 set up an ecotherapy project, called Bearing Fruit. The aim was to give people who either had mental health issues, or were recovering from some kind of mental health illness, the chance to help work in a community orchard and boost their psychological wellbeing in the process.

Tom Waring, St Nicks’ chief officer, says it has made a tangible difference to those involved. “The idea is they get involved in various tasks, it can be conservation work, tree thinning or litter picking. They can also get involved in growing fruit which they can then turn into chutneys or jams.”

Mental health is often viewed very differently from physical health, but there is a growing belief that we need to start adopting a more integrated approach.

Waring says doing outdoor activities not only boosts people’s physical health, it’s beneficial to their mental wellbeing, too. “There’s an intrinsic link between physical health and being outside, it makes you feel better. You see how much better people are and how much more confident they are and that’s what it’s about, it’s about building up resilience against mental ill health.”

Most of the 150 volunteers and mental health service users who took part in the Bearing Fruit project were aged between 30 and 60, but as Waring points out, mental health illness cuts a swath across age and background. “It can affect anyone, young and old, male and female. It’s not choosey, it doesn’t just affect poor people we’re talking about all walks of life.”

However, he believes one of the main reasons why mental health doesn’t attract the same kind of funding as other health projects is because it’s often harder to tell if something has been successful.

“If you break your leg you go to hospital and you get a pot put on and you can see that the leg has been mended. But with something like mental illness it’s not like that, because it’s not a visual thing. You can walk past someone in the street and have no idea if they’re suffering from depression, or if they’re bipolar or have schizophrenia. So it’s very difficult to gauge the results.”

The three year scheme has now finished but St Nicks has applied for further funding to expand the project and show how ecotherapy is one way of improving mental health without costing a fortune.

But Waring admits that many health related projects are struggling to attract funding at the moment. “Charities are being increasingly relied upon to deliver more front line services with less money and this has lead to a shortfall in mental health service provision,” he says. “Charities are closing the gap where possible and we hope our project will go some way to addressing the current need.”

It’s certainly not an issue that is just going to disappear. A study by the Centre for Mental Health in 2010 estimated that mental illness costs the UK economy as much as £100bn through treatment, lost working days and benefits.

“It costs the NHS an awful lot more to treat than it does to prevent it in the first place,” says Waring. “How many times have we heard the old saying ‘prevention is better than the cure?’ Well it’s the same with mental health just as it is with physical health.”