Disability & Society | Assignment

CURRENT ISSUES
The Coalition, austerity and mental health
Kate Mattheys*
Department of Geography, Durham University, Durham, UK
(Received 11 December 2014; final version received 12 December 2014)
In the United Kingdom, the Coalition government’s recent commitment to
improving mental health provision masks the extent that their policies of auster-
ity have already brought harm to those same services. Government-driven poli-
cies have led to significantly reduced funding within mental health, increasing
pressure on a system that was already chronically under-resourced. Further, peo-
ple who are experiencing mental distress, and mental health service users, have
been especially vulnerable to the harms of the current austerity programme,
including being at the sharp end of the assault on public services and welfare
spending. This piece discusses the impact of austerity, exploring the effects of
government policies and with a critical perspective of the dominant discourses
around mental health. It argues that by exacerbating social inequality, govern-
ment policies are also directly leading to worsening mental health in the United
Kingdom.
Keywords: austerity; welfare reform; mental health; United Kingdom
In his speech to the UK Liberal Democrat annual conference this year, the Deputy
Prime Minister, Nick Clegg, surprisingly focused on mental health. Clegg high-
lighted plans for how the government would in 2015 start putting treatment stan-
dards on a par with treatment for physical health. This is an attempt to fulfil the
‘parity of esteem’ commitment outlined in the government’s No Health without
Mental Health strategy (HM Government 2011). This strategy aspires to give equal
value to mental and physical health. New National Health Service waiting standards
for mental health will be created for the first time, meaning that those who require
‘talking therapies’ will be seen within six weeks; whilst those labelled as experienc-
ing a first episode of psychosis will be seen within two weeks. In addition to this,
an extra £120 million of funding is to be allocated to mental health services over the
next two years (Wintour 2014).
Additional funding for mental health services is of course welcome, as is an
acknowledgement of the failure of the mental health system to deliver timely sup-
port to people who need it. However, this also completely ignores how, since the
Coalition Government came into power in 2010, its policies of austerity have had a
highly negative impact on mental health, mental health services and service users.
Life under austerity is growing increasingly tough for the vast majority of people,
and mental health is one of the casualties of this era. Greater numbers of people are
being placed under increased financial strain and this is impacting on their mental
*Email: [e-mail]
© 2015 Taylor & Francis
Disability & Society, 2015
Vol. 30, No. 3, 475–478, http://dx.doi.org/10.1080/09687599.2014.1000513

health. Also increased pressures on services mean that the support available to
people is reducing when demand is sharply increasing (O’Hara 2013).
Government-driven policies have led to the National Health Service making
real-term reductions in investment in mental health services and have exacerbated
the situation in a sector that was already subject to chronic underinvestment in ser-
vices for both young and older people alike (Thornicroft and Docherty 2014). For
instance, a report published in November 2014 by the House of Commons Health
Committee demonstrated severe problems throughout the entire system of child and
adolescent mental health services. Whilst demand has been rising, there have been
widespread reductions in funding (House of Commons Health Committee 2014).
Early intervention services are generally funded by local authorities; however, as a
result of increasing financial pressures brought about by austerity measures, 60% of
local authorities have either reduced or frozen their child and adolescent mental
health services budgets since 2010–2011 (YoungMinds 2014).
Children and young people are experiencing large increases in waiting times
for support and also increased referral thresholds, to the extent that some child
and adolescent mental health services will only accept referrals when the young
person has attempted to commit suicide at least once (House of Commons Health
Committee 2014). It is fundamentally unacceptable that young people have to be
at the point of killing themselves before they can actually access support. They
are being failed by a system that is causing them increased harm by only
responding to those who are in extreme distress. This also means that greater
numbers of young people end up requiring in-patient treatment (with all of the
associated damage that hospitalisation causes) when this could have been avoided
if they were given support sooner. Ultimately there will be young people who
take their own lives as a result.
Adult mental health services are similarly under increased strain. For instance,
within acute settings the closure of more than 1700 hospital beds from 2011 to 2013
has led to warnings that the demand for crisis services is far outstripping supply
(McNicoll 2013). Local authorities have seen widespread reductions in the number
of adults receiving state-funded social care support, and mental health social care
support has been particularly hard hit (Fernandez, Snell, and Wistow 2013).
Although there has been significant historical underinvestment in mental health
services (Bailey, Thorpe, and Smith 2013), the path of austerity that the United
Kingdom has taken is exacerbating this situation.
The radical changes to the welfare system in the United Kingdom, central to the
Coalition Government’s strategy, are having a damaging impact on people, increas-
ing poverty and reducing the social safety nets that are in place. People experiencing
mental distress, including mental health service users, are some of the key groups of
people that have been hardest hit; for instance, in the targeting of disability and ill
health-related benefits. Reforms have also included cuts in tax credits and child tax
credits, and housing benefit reforms (including the bedroom tax). The introduction
of a new and much harsher sanctioning regime in 2012 (where benefits are stopped
for a set period for failure to comply with requirements of the jobseekers allowance)
has had severe consequences. Sanctions, alongside benefit delays and financial diffi-
culties related to the bedroom tax and abolition of council tax relief, are viewed as a
key reason for why there has been an explosion in the use of food banks (O’Hara
2013).
476 K. Mattheys