It is estimated that one in four people in this country suffer from poor mental health at some point in their life.
Despite this fact, the treatment of mental illness continues to be a poor relation compared to the treatment of physical illness. Additional resources have gone into supporting mental health services over recent years, but we are playing ‘catch up’ in an area that has been underfunded and under-prioritised for far too long. Even now, spending on mental health has fallen as a proportion of the Scottish Government’s overall health budget. That is simply unacceptable and a trend that must be reversed.
To achieve this, I believe, we must put treating mental ill-health on the same legal footing as the treatment of physical ill-health. To date, Scottish Ministers have been reluctant to go down this route but such a change would not only have important symbolic significance, it would also influence the way in which priorities are set and budgets allocated.
I recognise there are few areas of our National Health Service that are not currently under enormous strain. However, the gaps in services available for those suffering with a mental illness appear particularly acute, albeit there are variations in provision across the country.
Here in Orkney, the community mental health team do sterling work but they appear stretched to the limit. The availability of psychiatric input has long been an issue while counselling and support services provided through the voluntary and charitable sectors constantly struggle to attract the funding necessary to deliver.
This is a real concern, particularly if one accepts that current demand for services almost certainly understates the actual need within the community. As leading mental health charity, SAMH highlighted recently in their Know Where To Go campaign a culture of self-reliance and stoicism in places like Orkney can work against efforts to get people with health issues, including poor mental health, to engage early, if at all, with medical professionals.
Even where the wider community is a source of support, this can almost make things more difficult and increase the fear of stigma, not just for the individual but also their wider family. That is certainly an issue that I hear raised frequently by constituents.
The result, perhaps unsurprisingly, is that people then hold off seeking help for mental health problems, often with serious consequences. According to SAMH, “the later individuals engage with health services, the more complex their treatment and recovery will be”. Even where help is sought, if it is not available at a time or in a way that meets an individual’s needs this can reduce the chances of them engaging with support services in future.
These are just some of the complex issues being considered as part of the development of a local mental health strategy for Orkney. That strategy will also need to take a look again at the specific issue of suicide prevention.
If there is a reticence to talk openly and honestly about mental health, then suicide is surely the greatest taboo of all, particularly amongst men. The most recent statistics suggest that three times as many men as women now take their own lives and it represents the single biggest cause of death for men under the age of 50 in the UK.
There is no definitive explanation for this disparity between the sexes, though most academic studies point to the societal pressure placed on men to ‘cope’ and to deal with problems by simply ‘manning up’ or ‘getting a grip’.
Knowing how to respond is not straightforward, however. Three quarters of those who commit suicide have no diagnosed mental illness, making it difficult for statutory services to play a role. Often it's the outgoing guy, the life and soul of the party, the one worrying about whether everyone else is OK, that is really struggling himself.
Part of the solution, however, has to be a willingness to talk more openly and honestly about suicide as well as mental health; reducing the stigma and making clear that it’s OK not to be OK.
Ultimately, as a society, we must recognise there is no good health without good mental health.