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The rough justice of mental health

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Parity of esteem is an elusive ideal. Governments have talked about parity of esteem for mental and physical health, but what is it and how do we get there?

A couple of years ago I spent an illuminating day in a mental health resource centre which was helping recently sectioned patients to transition back to standard primary care. I chatted to service users but mostly just listened, and came away with the sense that society was tolerating a mass miscarriage of justice. In their stories a pattern emerged of decades of psychotic episodes followed by sectioning followed by release to the care of overworked GPs with little mental health experience, again and again and again.

I thought of those folks recently reading of a Royal College of Psychiatrists (RCP) report, revealing how long patients are waiting for NHS care. The RCP’s survey of 500 diagnosed mental patients found that some had waited up to 13 years to access appropriate treatment with predictable effects on relationships and careers.

Some of the cultural stigma around mental illness has broken down in recent years, and politicians like to talk about bringing about ‘parity of esteem’ (even if they’re less keen about defining what that means), but the UK’s mental health services still leave much to be desired, both through insufficient funding and lack of infrastructure. The difference that the promised new injection of £2bn in this week’s budget, and the expansion of specialist mental health ambulances, will make remains to be seen.

Give the Government some credit for appointing the first minister for suicide prevention, but felo de se isn’t the only threat to longevity. An adult with mental health issues in the UK has the same life expectancy as an adult in Bangladesh. They are dying of the same things as the rest of the population, just a lot sooner.

Perhaps the answer doesn’t lie in parity of esteem, but in learning to treat mental illness as a chronic condition in itself, like diabetes. After all the link between poor mental and poor physical health is now well-established. Let’s have justice for all.

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