As a society we are facing a mental health crisis. Years of under-investment in services is now catching up with us. Every week it seems there is another article in the news, another survey published, more statistics released, seeking to put a number on our anxiety and misery.
As a GP, I hear the message frequently: we must put mental health on an equal footing with physical health. So why is this proving so challenging to put into practice?
Part of this must stem from the fact that many people are ‘invisible’ to those who commission and design mental health support services.
This year the London Assembly Health Committee, which I Chair, is devoting a significant chunk of its time to trying to understand the mental health challenges faced by groups of people who are, for whatever reason, still marginalised in our society.
Last month, we held our first session with representatives from LGBT communities.
Why this group?
The evidence tells us that, while being lesbian, gay, bisexual and/or transgender is not a mental illness, people from LGBT communities are disproportionately affected by depression, are more likely to self-harm and are more likely to think about, and attempt, suicide than the general population.
The people at our event spoke passionately, and at times angrily, about the discrimination they experienced, sometimes on a daily basis: some were being spat at, assaulted, verbally harassed and had their identity ignored and erased by healthcare professionals, when they tried to seek help. One individual said, “There’s a narrative that things are getting better…but there’s still a huge amount of bullying and there’s still a huge amount of trauma.”
Attendees also spoke about the need for hope and for communities to come together and recognise that good mental health is both an asset to be taken care of and a basic human right – “We need to stop seeing LGBT issues as minority issues and labelled as something that doesn’t concern us, and move into a space where LGBT issues are really understood as a human right, an inclusion issue that will define the type of society we are and that we want to be.”
So what needs to change?
First, we need to recognise that mental health doesn’t exist in a vacuum. Having a home, a job, a supportive social network, and being accepted by wider society all help to build a person’s sense of self-worth and resilience.
This means that mental health issues aren’t just the preserve of mental health doctors and nurses, but of everyone responsible in shaping public policy, from housing to planning to the environment. The Mayor must ensure that health considerations are woven into his strategies right across the board.
The Mayor also needs to listen to the voices of people and groups who are directly affected by poor mental health in London and give them a say in his plans. And he needs to persuade others – notably, people responsible for commissioning and funding services – to do the same.
There are people doing great mental health work in the community and this work should be recognised, celebrated and championed by the Mayor.
The Mayor has made some big promises on improving mental health for all Londoners. But these promises must be translated into practical action, and it has to start now. Talking about the issues is important. But talking is the easy part – what comes next?
The London Assembly Health Committee will be making a number of recommendations to the Mayor in the lead up to his new Health Inequalities Strategy.
We strongly hope to see our views taken into account in this far-reaching and critical strategy.
If you would like to watch a webcast of the LGBT mental health event click here.
Dr Onkar Sahota AM is Chair of the London Assembly Health Committee.