A society should be judged by how it treats its children. A country that fails to invest in its children is imperilling its future. And that’s why we should all be alarmed by the crisis of mental health among Britain’s girls and boys – and the chronic lack of support to overcome it.
Nearly a quarter of a million young people are receiving specialist health care for mental distress, ranging from depression to eating disorders. Disturbingly, it is a crisis that is getting worse: Childline reports a doubling in five years of the number of children contemplating suicide. But the services simply aren’t there to support them. A Guardian poll finds that seven out of 10 specialist nurses believe mental health services for children and adolescents are inadequate, and 43% believe the services are actually getting worse. Overwhelmingly, a lack of nurses and delays in appointments are identified as the main culprits. The price of this failure is our children’s wellbeing – and, more horrifyingly, even their lives.
It is easier to diagnose a crisis than to cure it, of course. Part of the problem is the expectations society places on our children: changing them is necessary, but will not be easy. Research by Girlguiding finds that just 61% of girls and young women aged between seven and 21 are happy with their bodies, a sharp decline from 73% in 2011. That over a third of girls aged between seven and 10 say that they are made to feel their looks were the most important thing, or that 38% felt they were not pretty enough, is chilling. For those aged between 11 and 21, an astonishing 80% felt looks were the most important thing about them. Here are the consequences of a sexist society that imposes impossible standards that even little girls are expected to abide by.
Gender expectations damage boys, too. A rigid and unreconstructed form of masculinity is enforced, sometimes brutally, in the playground. Boys deemed to be insufficiently manly face being abused as “girls” or “gays”. Speaking about mental distress is certainly not seen as “manly” – it is “weak” – and that there are more boys in contact with mental health services is striking.
Yes, we need investment in services. But there must be a remorseless focus on what drives children to mental distress in the first place. Overcrowded and poor housing. Poor diet. Lack of exercise. Family conflict. The stresses of poverty, from internalised shame to being conscious of not having the same opportunities as other children. Consumer capitalism, which judges and defines children by what trainers they wear. An educational culture obsessed with exams. If we want a society that promotes happiness and wellbeing among children, these are all problems that have to be addressed. How tragic, then, that life is being made harder for children by both government policy and ever harsher attitudes and expectations. The children will suffer for it, and so will our country’s future.
The government’s abolition of the disability living allowance (DLA) and its replacement with personal independence payments (PIP) means that people with disabilities – many of whom had been told their support would be for life – are being forced through a process of reassessment. But what’s the impact of this?
It’s a topic that Frances Ryan covered in her Hardworking Britain series last week. She wrote: “The retesting of PIP claims means, in practice, blind people, paraplegics and those with Down’s syndrome will be put through reassessment: forced to provide information about their disability that the government already has and cannot possibly have changed.”
We asked for your experiences of this. Here, five people share their stories.
‘It’s hard to understand why we have all had to go through this’ – Angelene Wright, 66, from Lincolnshire
I’m a carer for my 64-year-old husband who is in the final stages of multiple sclerosis.
My husband received a lifetime DLA award about 15 years ago. He is now unable to walk and we are dependent on our home carers for most of his personal care. I have lasting power of attorney as he can no longer sign his name. He can just about feed himself with special cutlery, as long as the food is soft and cut up small. He is totally dependent on others for all his needs.
We went through the reassessment process earlier this summer. With the help of our social worker and rehabilitation consultant, my husband was granted the new benefit without having to go through a face-to-face interview – only a phone call for extra details from the assessor was required.
The whole thing was very stressful. The initial letter, announcing that his DLA was to stop and telling us to phone the number within 14 days or face losing the benefit, was scary. I have to say that all of the people I had to speak to were extremely courteous and helpful. The 40-page form was a pain to contend with – I’m a retired teacher but it was formidable. Also my original registration of lasting power of attorney was required and was not returned – thankfully, I had it scanned. All they actually needed was our registration number.
When you have been given a lifetime award it’s hard to understand why we have all had to go through this. If a person is incapacitated to the level that a lifetime award was thought appropriate, they are not going to get better. They clearly designed it to try to catch people out and it seems to have caught a lot of the wrong people.
‘Irreversible brain damage is irreversible. I don’t understand why I am being reassessed’ – Anonymous, 31, from Glasgow
I have cerebral palsy, a visual impairment, dyspraxia and epilepsy. I’ve been on disability living allowance (high mobility and medium care), receiving around £450 a month, since I was 16. That’s all my adult life. I thought DLA would always be there and am profoundly shocked that it’s now changed and I am due to be reassessed soon.
I am so scared of what this may bring that it keeps me awake at night. When my DLA money comes in each month, I am very relieved. I have had periods when it was my only source of income and I don’t know how I will manage if it goes away.
Reassessment of lifelong conditions makes no sense to me. It is a waste of money and energy and it is cruel.
I am profoundly shocked about being reassessed. I do not understand why this has to happen – cerebral palsy and epilepsy do not go away. They do not change in any way. My balance is as bad now as it was when I was 16 (in fact my joints are probably in a slightly worse condition). I still don’t have a lower field of vision. I’m still having fits. Irreversible brain damage is irreversible. Reassessment of lifelong conditions makes no sense to me. It is a waste of money and energy, and it is cruel. I know I will never get better. I’ve accepted that and am getting on with my life. I feel ashamed and helpless in a way I never did before.
‘The whole process was costly and demeaning’ – Anonymous, 38, from Staffordshire
I am writing on behalf of my daughter who has a personality disorder and complex mental health needs classed as severe and enduring. She had been given a lifetime award, but last year we had to submit a claim for PIP, which meant reassessment. It was incredibly painful for her to go through this process again, and we submitted medical evidence for every question on the form.
The enhanced living component was awarded, but the standard mobility component was taken away on the grounds that she could walk 10 metres unaided. However, eventually we challenged this and won. We were very relieved and pleased, but the whole process was costly and demeaning. What’s more, no one has actually met with my daughter and every decision has been made on paper. It feels like she has no voice. I am the one who has to pick up the pieces when ignorant bureaucrats treat a fragile, seriously ill person so badly.
Protesters gather in Westminster in 2014 to demonstrate against disability benefit cuts. Photograph: Nick Ansell/PA
‘The arbitrary nature of the system infuriates me’ – Charlie Saben Fox, 61, from Edinburgh
My son has autism, global learning difficulties and epilepsy.
How much help you get really is a lottery and many people seem to be losing out.
He has been in receipt of DLA since he was two and was awarded an indefinite award at 16. He was “invited” to migrate to PIP, taking a paper-based assessment. After this he was awarded enhanced daily living and mobility components, but only for five years. I couldn’t understand the length of award as the assessor stated his condition might only change marginally. I called the Department for Work and Pensions to ask for a mandatory reconsideration and they weren’t very helpful. First they told me I couldn’t challenge the five-year award, but eventually I got it extended to 10 years.
I’m pretty strong-minded and wasn’t scared of challenging it, but a lot of people might have been bullied into submission. I’m still angry when I think about it. The arbitrary nature of the system infuriates me most. How much help you get really is a lottery and many people seem to be losing out.
‘By the time I got into the room I was a nervous wreck’ – Catherine Hart, 36, from Sheffield
I have serious mental health problems and my DLA was not a lifetime award, but a long-term one – after being assessed every three years it was extended to every 10 years. That changed under PIP. I had to fill in a very long form within three weeks, but it took them several months to tell me if I had been awarded PIP. This severely affected my mental health.
I was starting to get myself back on track when I was told I had to go in for a face-to-face assessment. My care coordinator was off work ill so I had a stranger from mental health services take me, because I don’t do well getting out of the house on my own.
By the time I got into the room I was a nervous wreck. The person I saw was very sympathetic, understanding and patient. He didn’t rush me for answers when I was struggling to speak, was delicate with his questions about my suicide attempts. He even told me he was sorry to be putting me through this.
It took less than two weeks for the letter telling me that nothing had changed in my award. The letter itself was entitled “Changes to your personal independence payment”, which scared me, until I read further and found out that it would be the same.
All the people I had contact with throughout the PIP process were kind and sympathetic. The problem I had was with the paperwork – there was a lot of it at all stages. To truly reflect how bad a mental illness can be, you have to talk about your darkest times, and this process takes you right back there.
GPs should behave far more like actual enterprise people, and find out the disciplines which stability assets with sustaining great buyer support, argues Dick Vinegar. Photograph: RayArt Graphics/Alamy/Alamy
Doctors’ leaders are always moaning that the profession is overstretched and underpaid, is at the finish of its tether, and is about to up-sticks to Australia en masse, exactly where the government treats its doctors with respect. But, when I check out my GP’s surgical treatment, all is calm. The staff welcome me with a smile. It is clear to me that they perform quite tough, and operate prolonged hours, but they present no signs of stress or imminent breakdown.
Why, I inquire myself, is there this gap in between the rhetoric, and what I knowledge as the actuality? Is it that the medical doctors, nurses and receptionists who treat me are consummate actors, hiding unbearable amounts of tension, and managing to child me that my symptoms are all that matter to them?
Or is it that the noisy “politician” GPs, who attend conferences and pass motions condemning any stage government can make in any direction at all, particularly the ones that motivate them to adjust their 19th century doing work routines, are not extremely excellent at managing their time or their budgets? They are abetted by GP columnists and correspondents in the trade press, who all seem to be to be on the verge of boarding a plane to depart the country, since of disgust with the NHS.
Obviously, these doctors need courses in time management and resource allocation. Or they ought to employ much more personnel, to lessen tension amounts. Or they must organise much more effective rotas, to remain open longer. Or, dare I say it, they might even pay out themselves less to shell out for the extra staff.
GPs pride themselves on currently being not just clinicians, but independent company men and women. They should behave far more like true business folks, and learn the disciplines which stability assets with keeping a great buyer – ie, patient – services. They may well then grow to be more like my productive GP practice.
It seems to me that some GP practices have permitted their standards to slip. They are now in a spiral that they can not get out of. Consider accessibility, for illustration. I usually get an appointment on the day I ring. But I study in the Guardian that “the proportion of individuals acquiring a GP appointment in 48 hrs has fallen from 80% underneath the final Labour government to forty%. Almost a quarter of individuals now can not get an appointment in the identical week.”
Possibly I have been spoiled by the excellent service I get from my GP, but I wonder how can anybody who calls themself a physician not be ashamed by this kind of a delay in providing his individuals with care? Possibly undesirable routines have crept up over time, and a week or two weeks have come to be regarded as an acceptable norm. So a lot so that I study that Ed Miliband’s daring promise to ensure individuals a GP appointment inside 48 hrs “is likely to be deeply unpopular with medical doctors”. So, these medical doctors are so wedded to their accessibility delays, that they reject an inititiative that is good for their patients.
Why can not the badly-performing GPs get suggestions from family medical doctors, like mine, who do offer their patients an sufficient booking service? Physicians do seem to be to be reluctant to understand good practice from one yet another.
And, why don’t individuals of individuals medical doctors with appalling waiting instances rebel, and move to yet another practice with shorter waits? To assist individuals decide on the prompt GPs, the “selection” web sites like Patient Opinion could publish appointment waiting times for personal GPs. That would title and shame the poor performers. And boost patient electrical power.
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