I say ‘the End’ in the title, as this will obviously be my last post in this series before the big day tomorrow when we head to the polls; however, in the interests of equity, I will at some point look at what the main parties in the Republic of Ireland have to say on the provision of mental health services. The health service in the Republic is quite different from here in the North, but I’ll address that in the post in question. I’m not saying I will necessarily write this anytime soon, but I’ll get to it eventually.
Anyway, it’s the eve of the election and I’m simultaneously excited and anxious. I’m excited because I’m a total politics nerd, and I always get a thrill out of exercising my democratic right to vote. I’m anxious because I am worried that Gordon Brown will end up back in 10 Downing Street; I pathologically detest the man. I hate Cameron too, mind you, but nowhere near as much as Brown. Like so many people, I now am a fervent supporter of a Liberal Democrat win. I don’t think we’ll get it – not this election – but fingers crossed for the future.
Anyway, it’s kind of moot because I can’t vote for any of those three parties (unless you count the strange alliance between the Tories and the Ulster Unionists). We’ve already looked at both the Unionist and Nationalist parties…but are there any other options, and if so, what do they offer to the Mental Vote?
Well, the answer is that there are other options: here we are with the ‘Others’, the parties often forgotten in coverage of Northern Irish politics. Two of them – the Alliance and the Green Party – are not along the normal Northern Irish sectarian lines. The third – The Traditional Unionist Voice – clearly is. Of course, there are a number of other smaller parties in existence in our wee country; however, mostly they are not running in this general election. Some are – mostly independents – and you can see their details here. However, I am not exploring their positions on mental health provisions, for the simple reason that they are unlikely to have any, being mainly one person parties. Even if they do have something to say on the subject, their chances of election are minimal*, and even if they were elected, as single candidates in Westminster they would need to vote with bigger parties to have any influence whatsoever.
(* With the possible exception of Sylvia Hermon, as she is also the outgoing MP for South Down and has been considered fairly popular in her constituency).
So we’re left with the Alliance, the Greens and the TUV. what if anything do they have to say on mental health services provision?
The Alliance Party and Mental Health Service Provision
Ideologically, the Alliance Party are my preferred party, as they were the first Northern Ireland-specific party to embrace cross-community unity, rather than organising themselves along the usual tribal lines. It turns out, too, that there’s a lot to be grateful about in terms of their mental health policies.
Navigate your way over to here, a page on the Alliance’s website. An entire policy on mental health issues, rivalled only in my investigations by the DUP’s (which was shockingly comprehensive, and about which I wrote the other day).
Unfortunately the page presents some alarming statistics; apparently, there are 20% more mentally ill individuals in Northern Ireland than in the rest of the United Kingdom (which tallies with other material I’ve read attributing this greater incidence to Troubles-related PTSD and depression), yet simultaneously we are the least resourced region to tackle this group of health conditions. Well, what a surprise.
The Alliance Party propose to tackle this sorry state of affairs in the following ways:
- [by] tackling segregation – addressing the exclusion of those with mental health and mental health issues;
- [by] re-balancing the economy – addressing the costs to businesses and the loss of GDP that arises from mental health and learning disability, and allowing people to develop to their full potential; and
- [by] providing of sustainable public services – delivery of a modern system of properly funded services.
All sounds grand to me. Of course, the difficulty with this is that it means fiscal resources will have to be allocated to mental health service provision instead of other areas of importance. I’m only speaking for myself here, but I would genuinely be happy to be more highly taxed/National Insurance-d if psychological and psychiatric resources were improved and developed. Furthermore, if some capital has to be removed from other (non-urgent) areas of the health service to accommodate the Alliance’s proposals, then I could quite easily live with that too. I admit that I am seriously biased here, but don’t forget the old statistic that at least one in four people will be directly affected by mental or emotional illness at some point in their lives. Some lobbyists are arguing now that the figure is one in three. The Alliance also point out that:
Over 19% of the total burden of disease in Western European Countries is attributable to mental illness compared to 17% for cardiovascular disease and 16% for cancer (WHO 2004)
It is sobering to know that mental illness affects more people than the openly-discussed ailments of heart disease and cancer in Western Europe – yet how often have you seen it mentioned in the media, at least without Sun-style sensationalism of ‘Schizo Freak Murders Fluffy Kitten!!!1!1!!!!eleven!!!’?
Moving on from what could easily become a rant, the Alliance Party at least do move on to tackle the fundamental issue of funding. One of the primary failing of political pledges, in my view, is that there is endless rhetorical sentiments expressed, without any substantive explanations of how the pledges can be achieved. At least here we have an awareness that achieving what is desirable will not an automatic development; it’s something that requires compromise and hard bloody work.
The party then move on to discuss what they term ‘Key Issues and Principles’, which (conveniently, a cynic might say) are right in line with the perennial Bamford Review.
The lines that interested me most was these ones: ‘Services should be needs-led‘ and ‘[we need] increased access [to] psychological therapies‘. Sounds obvious, doesn’t it? Yet as my own case underlines, that’s not the way it is in the current NHS in this region (and in the country in general in many cases), oh no. Access to psychological therapy and services in general are resources-led:
Therapist: I’m dealing with a really mental bird at the minute, she has about 403 different diagnoses and she needs long-term psychotherapy.
Manager: Throw a few weeks more at her, then kick her out, we can’t afford her.
Therapist: But what if she’s not better?
Manager: Oh my poor dear man, you’re new here, aren’t you? That’s not how it works!
The above was, of course, an entirely hypothetical scenario. *whistles innocently*
The Alliance also draw attention to the need to tackle stigma head on, and in a particularly commendable move address the issue of greater focus on the needs of carers for the mentally ill. They are the only party that have also pointed out that the recommendations of Bamford are not always fully transparent and, indeed, fully achievable.
Finally, they point out that the current situation regarding the Mental Health Act in Northern Ireland. Apparently, two major revisions were due to this legislation as it applies here in both 2011 and again in 2014. Sound fucking stupid to have two modifications? Well, the Alliance concur. In a demonstration of the fact that they can make a difference in this policy area, after their lobbying of Michael McGimpsey, the Health Minister, it has been agreed that – in principle at least – one modification will incorporate all the proposed statutory changes.
The Northern Ireland Green Party and Mental Health Service Provision
I’ve been wittering on in this series of posts about how we in Northern Ireland are not afforded the right to vote for the ‘mainland’ parties, but I suppose this kind of contradicts that a little. The Green Party are, of course, a national force – national in both the sense of the UK and Ireland.
Their widespread nature means that someone, somewhere, will inevitably have had to bring up the issue of mental health. In Northern Ireland, it seems primarily to be student Karly Green. Ms Green is heavily involved in developing a cross-party youth initiative on mental health, and that’s not to mention her considerable involvement in lobbying current politicians for better care for mental illness in our wee country.
(An aside – Ms Green’s hard work makes me wish I’d taken a more active role in politics at university. I was involved heavily in student politics – the running and management of the Students’ Union – but never in actual, meaningful party politics. I feel like I wasted my youth when I could have been out there making a fucking difference).
To get more details on the Greens’ position on this matter, however, we need to look at their policy South of the border. This has, quite obviously, questionable relevance to a Westminster election, but their UK health policy is surprisingly and disappointingly silent on the issue of mental illness.
As with the Alliance, the Greens argue that mental health is an area that is ‘greatly neglected,’ and interestingly, they’re the only party of the lot that I’ve looked at that has made more than a passing reference to preventative medicine and its relation to mental illness, which is to be applauded.
Of course, with this document focusing so heavily on the Republic, the contents are not always 100% applicable to those of us in the North; for example, they discuss how many patents with mental health difficulties are seen only under their GP. This is actually true up here too – the CMHTs generally only manage more serious cases – but in the Republic, the whole system is different, meaning that some people do not even have the primary care of a GP (something that is rarely true in Northern Ireland). Clearly this is an appalling state of affairs, and I would hope that the main parties down South are looking at this deficit too.
One point that applies to this jurisdiction is that they want to emphasis the need for psychological treatments, rather than an over-reliance on drugs. Remember this moment, readers, because it is possibly the only time you will see the Green Party agree with the DUP 😉 (see somewhere or other in the Unionist post).
Alarmingly, the Greens point out in this policy that apparently Irish mental health spending is less than half what it was 20 years ago. I suppose the rationale was along the usual lines that people were severely traumatised by the violence of the Troubles (any flippancy is to do with the fact that the Troubles existed at all; I don’t for a second see how anyone could not be traumatised by so much of what happened). Whatever the case, the fact that this party want to see at least 12% of the health budget devoted to this area is a worthwhile aim.
I particularly like their pledge to offer more post-graduate positions for the training of clinical psychologists. It rather seems to me that we could do with some of that up here too.
A few of the parties I’ve looked at in the course of this series have alluded very briefly to the human rights of the mentally ill (the UUP were the main ones that I mentioned, if memory serves me correctly). The Greens, however, have their own page as part of their general mental health policy devoted to this. Although their point is indeed commendable, unfortunately they miss the opportunity to fully address what could and should actually be done about the difficulties faced by many individuals on involuntary detentions. At least the UUP had the clear viewpoint that they would support amendment to legislation that shifted the legal onus on hospital release from the patient to their assessing tribunal.
In essence, in the area of mental health provision, the Green Party want to see greater staffing, greater funding and greater community, non-institutional care. I don’t think any of us would agree with these fundamental aims, but the approach sadly feels a little lacking in substance and discussion in how these aims could be achieved.
The Traditional Unionist Voice and Mental Health Service Provision
Hahahahahahahaha. I’m not even going to waste the energy it takes to type anything vaguely related to this non-entity of a vicious, nasty little scumfuck of a so-called political party. Well, except this rant of course. Just read their manifestoss (no spelling error). Nothing on mental health, scant on health in general, scant on education except their hate-filled bile, scant on sanity. I guess I’ll see Jim Allister in the bin.
Conclusion – Alliance, Greens or TUV
I don’t think you’ll be stunned to hear that the TUV are very instantly ruled out, and indeed it wouldn’t be a huge leap of faith for you to think I’m siding with Alliance as the victorious party amongst the so-called ‘Others’. The aims of the Green Party are certainly admirable, but they fail to fully articulate how they hope to achieve them, and cannot exemplify any occasions in which they’ve made a difference in this arena in the past. Furthermore, there is very little information on their exact position in this specific region.
The Alliance Party, on the other hand, have set out a number of very clear mental health objectives, and fully recognise the challenges of achieving these – yet they can articulate with some authority how they would achieve them. They can even cite an example of when their lobbying of a minister has previously made a difference to mental health issues.
I was not surprised to find that they had a mental health policy, but I was most gratified by its comprehensiveness and the fact that their aims are not all pie-in-the-sky-ness, but real, obtainable goals.
So, here we find ourselves at 11pm on the eve of the election, having investigated the policies on mental health of the main UK parties, the NI Unionists, the NI Nationalists and, finally, this, the NI nebulously-named ‘Others’. Who’s getting my vote?
It’s important to note that I am not, nor should I be, a single issue voter. I have a view on the economy, on Iraq, on crime, education, etc etc etc.
Most of all I have a view on the tribalism that Northern Irish politics has traditionally presented. To that end, I have almost always supported the Alliance Party, and my enthusiasm about their mental health manifesto above was surely palpable. I was undecided as to whether to vote tactically tomorrow but this has been the final deciding factor: the Alliance Party will, once more, get my vote tomorrow. They won’t win, but I aim to be a conscience voter, and the things that they strive for (not just in terms of mental health) are things that, for the most part, I want.
In terms of this series of posts, I still think Alliance have trumped the other parties, but the mental health policies of Sinn Fein and the DUP were actually surprisingly impressive, even if I don’t trust either of those parties as far as I spit out my own shite. I was very disappointed by the UUP and the SDLP, parties that I otherwise don’t mind. It was hard work finding anything on the UUP at all, and whilst the SDLP had a little more substance, ultimately they seemed to be trying to echo points already laid out by SF.
It’s time mental health was an issue taken seriously by all political parties; just like I did at the bottom of the first post, I would again urge you to sign Rethink’s petition for the next government.
In conclusion – please, whatever you do, don’t be apathetic tomorrow. In some ways it doesn’t matter who you vote for, as long as you give enough of a shit to go out and put one ‘x’ on one bit of paper. This is a democracy. We have the right to vote here. Not everyone has that right, so please exercise yours.
Happy voting, darling readers.