Broadening the debate on mental health | Letters

Jeremy Hunt has once more propelled mental health up the political agenda with the promise that an extra £1.3bn would be invested annually in mental health services by 2021 (Report, 10 October). However, while such promises constitute a significant step forward, it will take a lot more than policy and funding to resolve a problem reaching pandemic proportions in the UK. In light of World Mental Health Day, we need to broaden the debate from how to resolve mental health issues – to how to prevent them. And data suggests that at least part of the onus should be on employers.

Our research has found that almost half of UK employees believe that their workplace has a negative impact on their physical or mental health; it’s time for UK employers to assume a degree of responsibility for their employees’ mental wellbeing. Introducing measures such as resilience training, mindfulness and mental health first aiders could make a significant difference to both the support offered to employees and UK business – alleviating the impact of our tech-enabled 24/7 work lifestyles, reducing employee absence and fundamentally improving business productivity.
David Dodd
Consulting director, Thomsons Online Benefits

• Money Advice Service figures tell a worrying story of the link between mental and financial health – it’s not uncommon that when one suffers, so does the other. Our research also shows the two are inextricably linked, with more than half of those who suffer from mental health issues saying they are not confident they could handle a personal financial crisis (compared with the national average of 34%) and 79% saying they do not consider themselves financially secure (versus a national average of 48%).

Last year, mental illness was the most common cause of income protection claims at LV=. Despite the fact one in four of us will suffer with this at some point in our lives, few people realise income protection exists and will pay out if they can’t work because of mental health issues. LV= believes more needs to be done to ensure people – particularly from the most vulnerable groups in society – are properly prepared to withstand shocks to their income. Everyone should be able to feel safe in the knowledge that if they unexpectedly lost their income they and their loved ones would be able to cope, and we are calling for the government’s new single financial guidance body to have a specific focus on helping build UK financial resilience among those who need the support most, such as those suffering from mental health issues.
Justin Harper
Head of protection policy, LV=

• Susanna Rustin (We all need psychoanalysis, 9 October) is surely right that “A country in which reflection and curiosity about oneself is encouraged would be a wiser, kinder place”. Psychoanalysis provides a safe and confidential space in which people can explore their feelings and thoughts, and it changes lives. While clinical trials have previously been thin on the ground there have been a number of important ones in recent years, and the clinical evidence base is growing. There is good evidence to suggest that psychoanalytically informed therapies should be more widely available. Readers may also be interested to know that data from the NHS’s psychological therapies programme dataset demonstrates that psychodynamic psychotherapy helped patients to recover in fewer sessions on average (5.7 sessions) than CBT (5.8 sessions), the most widely available therapy.

As Rustin notes, talking is not a cure-all. No one treatment will work for everyone but where there is good evidence that a treatment can have a lasting positive effect, it should be made more widely available. If this helps to make Britain a kinder, happier place then that surely can only be a good thing. At a time of increasing stress and uncertainty, we could all do with more kindness and happiness.
Gary Fereday
Chief executive, British Psychoanalytic Council

• Mike Hunter makes an excellent point (How should the government overhaul mental health laws?, 10 October) when he highlights the practice of sending people miles away from home for treatment. Borderline personality disorder is a condition that attracts considerable stigma with many trusts, especially in Wales, declining to follow Nice guidelines. Where trusts decline to provide local services the care of vulnerable people is auctioned to the lowest bidder and vulnerable people can spend years in overly restrictive treatment, far from family and friends and far from teams who know them and can bring them home. Of the 3,500 “locked rehab” beds (a term with such a vague definition it can cover anything), 2,500 of these are in the private sector, which charge a fortune and receive little of the scrutiny NHS services operate under. We can pat ourselves on the backs for closing the asylums, but let’s not think for one second that the practice of compelling distressed people to live in institutions in the countryside is over.
Keir Harding
Wrexham

• Your timely supplement on mental health (10 October) invites comments on priorities for reforming the 1983 Mental Health Act. The contributors are health professionals and campaigners. Where are the social workers, who, for the past 30-odd years, have been instrumental in implementing the legislation? Throughout the supplement, consideration of the role of social workers in mental health is entirely absent. Are we being airbrushed from history?
Rob Davies
Pontesbury, Shropshire

• Tom Francis writes (Hello, can anyone help me?, 10 October) that Samaritans can offer “complete anonymity and complete confidentiality”, however, the organisation’s controversial new safeguarding policy instructs volunteers to break that confidentiality in some situations. For more than 60 years Samaritans has been brave enough to stick to its founding principle of absolute confidentiality, and trust in that promise has been important to callers. One of the reasons that some callers now get an engaged signal may be that volunteers (I have been one for 25 years) are resigning or being sacked because they cannot agree with this fundamental change and abandonment of a principle that is enshrined in clause 3.1 of Samaritans’ constitution as “unconditional confidentiality”.
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