Tony Blair says we need a national conversation about MH as its costing too much

[B0xes]

Tony Blair said recently on Jimmy's Jobs of the Future Podcast (clip available on youtube) that we need to have a national conversation about mental health. Why are we spending so much on it. Why are people self diagnosing. He believes people are being encouraged to view everyday challenges we all face as mental health issues.

Is he being unreasonable? In one sense, I'm inclined to agree to an extent, in the other, I believe he led the charge for so many of the social changes that have made us less resilient and many of these issues are due to individualism which led to atomisation and loneliness and being encouraged to see the market as the entity that fulfills our needs rather than strong families and robust social networks.

YABU - Blair can do one.

YANBU - He might have a point

Carers are provided through agencies, not directly via the NHS. If a caring need is identified via the Local Authority, a financial assessment is carried out and often the person requiring care has to fund all or a proportion of that care because it is means tested. So the person described upthread may well be funding it through their PIP.

Some people can be compelled via MH laws to accept treatment whether in the community or as an inpatient.

Some people refuse to engage because of lack of trust in those dealing with them, due to poor experiences or because their condition has a component of paranoia. If they are deemed to have capacity, which appears to be moveable feast according to recent experiences dealing with elderly care services and mental health services, they can not be compelled to accept help or treatment.

So many of the situations that fall under this threads remit are beyond the scope and understanding of people who think they know how the system works, or should work, because until you've been in or dealt with the system on your own behalf or someone else's you can't fathom how complex and illogical it seems to be.

Some people, with all the treatment in the world, will never be able to live "a normal life". What do you propose happens in those situations? What else is there, that has not been done before? Tough love, will never work in those cases. It is not an option.

I’m really confused. How would that help people who have no interaction with Ofsted (which I imagine is most people?)

I am only sharing with you what I have come across. Yes people do this unfortunately eg stating they are suicidal or hearing voices to kill people. It’s saddening as people are clearly desperate and not getting the help from other areas. I have other examples of people stating quite serious things to try and get what they think they will get eg a supporting letter for housing only to retract what they’ve said or say they are ok now after urgent process is actioned. It’s an abuse of the system.

But it isn't necessarily helpful or compassionate to enable people to live in such a way.

I'd genuinely love to know what you think the solution is. Take away care and just let people rot? Or let them starve until they're in hospital being tube fed and are too weak to move?

No human who is mentally well is going to choose a life where they can't even feed themselves. Yes, there's therapy but waiting lists are years long and often they only provide a few sessions before they discharge you.

I don't doubt that some people take the absolute piss but by taking away the safety net, you're basically dooming those who are genuinely unwell to death.

I have OCD and have met many people with OCD, and in some cases it is so severe that multiple rounds of therapy is needed. That isn't always available on the NHS.

OCD can be disabling, and very often it is a trauma response and not always simple to treat. OCD can be very complex. In the past, my OCD was so bad I couldn't function. I was lucky that in my area there is a support group for OCD run by a therapist for free, and that was what saved me. That isn't available in every area.

The answer is to spend more money on mental health to give people the treatment and support they need. That is what will lead to more people being able to get back into work. We need to get in there early with therapy and support, that's where change happens.

There will always be people whose mental health is so poor that they aren't going to recover and they are not going to be able to work. As I said previously, we don't talk enough about people with treatment resistant schizophrenia, or people who will never recover fully enough to be able to work.

Very few people are living on benefits because they can't be arsed to work, or because they are too lazy. No one really wants to live like that. If someone has a carer for OCD then I am guessing they are severely unwell and their condition very complex. We can't judge what they do or don't need unless you are actively involved in their care.

@Shakeyourbaublesandsmile isn't it more a sign of a broken system than abuse? If you can only get help by exaggerating your symptoms then that says that the system is broken and not providing the initial support people need.

So many people can't even get a GP appointment let alone access to any further support - if we don't intervene at primary care level and provide basic help for people then it's hardly surprising that they end up in a position where they can't do anything at all,

Early, primary intervention is key - not letting people slip through the cracks until it's too late,

This and it’s happening.

What are you talking about?

I am guessing you are a teacher? Either way, it is not relevant to this conversation. The majority of people we are talking about on this thread aren't involved with Ofstead.

but how exactly are companies ment to employee people with mental health issues ?

So they need to clear the waiting lists for treatment as you simply can’t magic away inability to work.

Ultimately if we want people with mental or physical health problems to work, then society needs to start prioritising that.

Put more money into the NHS so people aren't waiting weeks just to see a doctor. Invest in therapists so they're not faced with trying to find £50 a week from their pay packets to go private. Don't just stick people on medication and leave them to it - there needs to be additional support provided from
day one.

Continuity of care is another major problem - booking to see the same doctor about the same problem is near-impossible, so you end up seeing multiple people all of whom are starting "from scratch" with you every time.

It's taken me seeing over five different GP's across two decades before one of them realised I'm probably autistic - it shouldn't be like that.

Problem for the govt to work out

I think possibly this poster is reflecting there is a big issue with emotional based school avoidance and mental health issue in young people that seem triggered in school, and those people are part of this 'explosion' in young people who are apparently claiming pip for mental health and tipping the balance of what tax payers can support?

So if school was right, there would be few teachers off sick with mental health, and few children entering the workforce with bad mental health.

Of course in theory I have a choice. While my mental health is fine, my blood pressure is sky high due to the constant stress and pressure and if I went to my GP now with my tale of woe, I imagine he'd sign me off work in an instant. Then I could stay in and weep and wail. But in reality I have 3 high impact projects on at work which if I make a good job of will open doors for more money and long term security, I've got two teenage boys who need feeding and clothing and taking to extra curricular which need paying for, and I've got a house that needs renovation to make it habitable before I move in and then the rental to redecorate before I leave, which again takes money and physical effort. So in effect I have no choice. The rest of the world is no different, its just that many people decide that life is too hard and then the rest of us have to pick up the slack because they'd rather be at home feeling anxious.

If someone needs feeding by a carer then their OCD is complex and severe.

Exposure and response prevention can help, but whilst waiting for that therapy, or waiting for it to start working, what should they do? Starve? ERP can be a long and slow process. No one would prefer to be fed by a carer for the fun of it. Most people want to be able to do the basics for themselves. There will be so much more to this situation than you know.

Trust me, no one is getting a carer for a fear of germs unless it is so severe and complex they need it to survive. It just doesn't happen otherwise.

OCD is not just a fear of germs etc. It's an offshoot of anxiety. Thought patterns become distorted. Because of my experiences over the last three years, I have mild OCD. It manifests in compulsive checking of my flat for potential sources of conflagration if I leave to go out. Checking over and over that both back and front doors are locked. Having to peer into my windows to make sure there is no sign of anything going wrong while I wait for transport. Even as I'm doing all this I am berating myself for the ridiculousness of it. It absolutely stems from losing my DP, the home we shared and my business in a two year period. I know this, I rationalise it. I will even take photos to prove to myself I have locked the bloody door but my lack of trust in myself and the world leaves me nauseous and jittery. Don't worry, I have strategies for that too and I frame it all as a jokey quirk so as not to upset other people.

Prolonged stress rewires the brain - due to neuroplasticity. Hence CPTSD. There are therapies available but they are expensive and hard to access in a therapeutically beneficial time frame via the NHS.

There are physical effects from neurological dysfunction. It can be a perfect storm. One feeds into the other and if early intervention doesn't occur, then by the time issues are addressed it's a bigger situation than it might have needed to be. In the current economic climate it's difficult to convince myself that I can ever have a modicum of the security that would help me get past this constant fear that I will lose the very little I have now.

Early intervention would help massively but it is impossible to access. Catch 22.

Anyone can get a carer if they’re on standard rate PIP and can find someone willing to do it - friend, neighbour, family member. This person can in turn claim carer’s allowance.

all that would happen is the company would avoid them and choose other workers, and if the govt said companies have to have x quotas then it seems unrealistic overall.

That's a completely different scenario to alleged "carers via the NHS" and carers allowance isn't the gift people think it is, given the restrictions around earnings while claiming it. You have to be actively caring for 35 hours a week, and CA is less than 100 a week. It gets factored into UC claims which are adjusted down so it's not an extra.

There has been a recent furore around people being paid even a penny over the earnings threshold and losing the entire weeks CA as a result. Failures in the system have seen people being criminalised due to this going on for years unchecked, in some cases despite repeated attempts to notify changes with the authorities.

but how exactly are companies ment to employee people with mental health issues ?

Ideally with support put in place by the government - it's never going to happen though as the majority still seem to believe that mental illness doesn't deserve support or compassion, sadly.

Hi - glad you were able to access help OCD same as health anxiety can fluctuate a lot. Though with OCD it takes up a lot more time often and takes over everyday.

That person who I think of a lot was severe and complex but the presence of the carer is a massive safety behaviour to overcome. So becomes a chicken and egg situation. Reliance’s but a barrier at the same time.

Yes, but do you think anyone would want a carer to help feed them unless it was really necessary?

No one is being a carer unneeded for the money, either.

If someone has a carer for OCD, then the simplest explanation is that they need it to function.

I have no idea about the ins and outs of carers providing feeding help for this fictional person under discussion, I was just stating that a person on standard rate PIP can, if they wish, find an “informal” carer to help. I made no further comments.

Sometimes people just need minor changes like working patterns, a quiet corner, walk breaks, access to appointments, only attend essential meetings, phased returns that are properly managed, being able to wear headphones, matching capacity appropriately ie would it hurt to let some do quieter shifts, be respectful of different communication styles, reasonable demands, and sadly refrain from cruel bullying. Take time to understand the person as an individual and get the most out of them mutually beneficial.