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thinking
In mental health

Introduction
Save money on hospital bed costs by catching mental illness early

Our vision is to extend the radical innovation currently underway in Birmingham.

To do so, this short paper calls for the immediate designation of a minister for mental
health,

Mental health care affects many government departments, in varying degrees.
Importantly, mental health, unlike physical health, has a disproportionate impact on
departments other than DoH.

Currently, mental health services are entirely reactive. Part of this paper turns that
notion on its head and suggests that schools have a greater role to play; with the
right training and support, schools could identify mental illness early and intervene.

This paper outlines impacts, department by department, but the headline figure is
that mental health issues cost the economy 105.2 billion in 2014; this figure is
expected to rise.

Judging by the success of the extension of early intervention in Birmingham, reducing
the huge future cost of mental health by investing now looks more and more
pragmatic.























Department of Justice
Information


In a prison population of about 65,000 in England and Wales, an estimated 66%
of the remand population have mental health difficulties and 39% of the sentenced
population.


10% of men and 30% of women have had a psychiatric admission before
entering prison.



25% of women and 15% of men in prison reported symptoms indicative of
psychosis. The rate among the general public is about 4%.


26% of women and 16% of men said they had received treatment for a
mental health problem in the year before custody.


Personality disorders are prevalent among prisoners: 62% of male and 57% of
female sentenced prisoners have a personality disorder.


49% of female and 23% of male prisoners in a Ministry of Justice study were
assessed as suffering from anxiety and depression. This compares to 16% in the total
population.


46% of female prisoners reported having attempted suicide at some point in
their lives. This is more than twice the 21% rate among male prisoners. The
comparative rate for the UK population is 6%.


95% of imprisoned young offenders have a mental health disorder. Many of
them are struggling with more than one disorder

(Source: The prison reform trust. Mental Health Care in Prisons, 2015)


The solution


We are calling for specialist mental health provision in all prisons across England and
Wales and, crucially, in all young offenders institutions.

We need to make sure that our police force has the correct entry level training to
deal with a mental health crisis.


Department of Education

Information



1 in 10 children and young people aged 5 - 16 suffer from a diagnosable
mental health disorder - that is around three children in every class.


Over 8,000 children aged 10 and below suffer from severe depression.


Top schools in the UK have raised a flag of alarm over the terrifying rates of
mental health problems they are seeing among their pupils.


The number of university students reporting mental health difficulties has
risen from about 8,000 to 18,000 in the four years to 2014-15.

The solution


We aim to see teachers working closely with local mental health trusts and charities
to provide continuous support to pupils with mental health problems and their
parents or guardians.

We are calling for one teacher or teaching assistant per year group to be trained in
mental health to help with early identification and intervention. This would enable
pupils to receive the support they need, so that they remain in school and achieve
their potential.

(Source: Young Minds. Useful Statistics, 2015)

Department of Health

Information



1 in 4 people suffer a mental health problem in their lifetime.


A&E admissions due to mental illness rose to over a million in winter 2014
and are expected to rise in 2015/2016.


People with mental health difficulties arrive in A&E because no earlier
intervention has succeeded, or because there has been no earlier intervention at all.
The key is to address mental health issues before this crisis point.
(Source: Bridging The Gap: Royal College of Psychiatry, 2011)

(Source: The Guardian: Mental health patient admissions to A&E set to reach record
levels, 2015)

The Solution


Invest in early intervention to reduce the number of mentally unwell people arriving
at A&E.

To address the issue of lack of training A&E staff have in mental health; we need to
invest in entry level mental health training for all staff in the NHS.

We need to address the rising costs of hospital beds; (Average cost 350 a day) while
to give someone early intervention in the community it costs (Average 13 a day). So
instead of waiting till crisis point; use some of the money we use for hospital beds
and put it back into early intervention in the community.

We need to see more funding for evidence based treatments for mental health issues.


Department for Work and Pensions

Information


Cost of welfare attributable to mental health issues is 29.1 billion


This takes no account of the 'opportunity cost' of failing to introduce these
claimants to the world of work.

The solution

Create a specialist route for unemployed people with mental health issues.

Local mental health care trusts and charities should be encouraged to support
jobseekers in their quest for achievable, appropriate and accessible routes (back) into
first part-time work, whether voluntary or paid, and then into full-time careers where
possible.


Ministry of Defence

Information



19.7% of veterans describe suffering mental health difficulties


4% describe suffering (PTSD) post-traumatic stress disorder.

The solution

We could argue that the stigma of mental health affects service personal and
veterans more acutely than other groups. Indeed, Combat Stress, appears to address
precisely this issue by describing the military mind rather than speaking in the
traditional language of most mental health organisations.

After all, when the only people that can understand what it is like to come under fire,
are those that have shared that experience, so it is for people suffering from mental
health issues.

Now imagine what it must be for the one group to be a subset of the other.

How would you tell one from the other?

And if you were in that subset, how would you figure that out?

(Source: Telegraph Online: Veterans PTSD cases up a quarter in a year charity warns
2015)

(Source: Mental Health Foundation: Veterans Mental Health, 2015)


Business innovation and skills

Information


40% of working days lost to sick leave were caused by mental ill health
Cost to United Kingdom businesses is approximately is 26 billion a year

The solution

We are calling for occupational health practitioners to focus on mental well-being.



We aim to see mental health support officers in post, at the heart of public sector
workplaces, acting as a pilot, to be extended into the private sector.

Their aim will be to see fewer work days lost and support employees suffering from
any sort of mental health issue. Additionally, their role would be to support mental
health sufferers returning to employment after a period out of work.

(Source: Social Market Foundation: Shifting Responsibilities, Sharing The Cost, 2008)


Sports and Culture

Information



90% of the mentally unwell experience stigma and discrimination


A quarter of young people suffering from mental health difficulties said they
didnt join a local a sports club for fear of discrimination


The solution

Reduce stigma with campaigns to celebrate the successes of people who have
suffered from mental illnesses. Work with national and local sports clubs to spread
awareness of mental illness within sport. Work with coaches and players on how to
support young people with mental health issues in the sporting environment.
(Time to change, 2015)


Treasury

Information


Cost of poor mental health to the economy is estimated to be 105.2 billion
in 2014 and predicted to rise.


Despite effective, evidence-based interventions, mental health problems
continue to cause mental anguish and physical suffering.

(Source: Bridging The Gap: Royal College of Psychiatry, 2011)

(Source: Centre For Mental Health: Economic and social costs of mental health
problems, 2010)

The solution

Invest 10 billion a year into early intervention in mental health over a five year
period.

According to the studies from Birmingham and Dr Tom Foley, the expected savings
would be 200 billion in a single Parliament.


Conclusion

Mental illness affects us all, whether unwell or not; it touches every department of
state. It comes at a massive cost to our economy, our national purpose, our workers,
our pensioners and our schoolchildren.

Our recommendations are:

First, people with mental health issues interact with almost every department of
government. The opportunities to improve their lot and cut the long-term cost of
providing services to people with mental health issues, cut across departments;
hence our call for a dedicated minister for mental health.

Second, the minister will need to confront fear head-on. People suffering from
mental health issues are afraid; they are afraid of their condition, their environment,
and often of themselves.

Third, equally, the minister will have to confront head-on the natural wariness and
fear that the mentally healthy reserve for the mentally ill, for these are the causes of
stigma.

Unless one has suffered from a mental health issue, one cannot really understand
the suffering of the mentally ill.

Whilst this may sound as though we are suggesting that the blind should lead the
blind, there are very few examples of an illness, which is hidden, little understood
and truly terrifying, both for the sufferer and for the people around them.

Only people that have suffered a mental health issue can really relate; everything
else is mere compassion. Whilst we do not disregard the value of compassion, what
is needed is action.

The Bowman Foundation contributors think




Pat Martin
Wellbeing Worker
Belfast, Northern Ireland
We need to extend the age to 25 before transferring to mental health adult services


Sharon Sutton
Mental Health Community Voluntary Support Worker
Durham, England
We need to invest in early intervention because financially it will help the country
save money and ultimately save lives

Savannah- Alicia Lloyd
Mental Health advocate
London, England
Simple mental health training for tutors and staff at schools as children and young
people seem to go to tutors first in hope for help and tutors spend most of the time
with the young person apart from parents which would mean they would notice any
change in the person.

Laurence Griffin
University Student
Leeds, England
Those in the NHS need far better training with mental health, from personal
experience.

Jenny Langley
Parent
Brighton, England
In schools there should be a whole school approach of prevention and early
intervention with all staff being trained in the basics of mental health and how to
respond to student disclosure. This would massively increase the likelihood of
students coming forward as soon as they start to struggle rather than waiting until
they are in crisis.

John Steward
Parent
Heddon on the wall
I think that more needs to be implemented in office workplaces as I think that some
companies still don't understand the full scale of mental health issues and any signs
that they are looking out for. Companies are starting to put more pressures on to
staff throughout the UK with higher targets which at times are not realistic which

causes stress, anxiety and turns people to increase the intake of alcohol which leads
to further mental health issues. There certainly needs to be a balance. The more
those boards understand mental health the better the staff they will but mentally
and physically.

Penny Bowman
NHS Mental Health Manager
Northumberland, England
There is too much of a postcode lottery when it comes to mental health care. We
need to make sure that you can get good support whatever area you fall into.

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