Examining the Impact of Austerity Policies on Mental Health in the UK

This report, originally published in Disability & Society, examines the detrimental effects of the UK Coalition government's austerity policies on mental health services and service users. It argues that despite commitments to improve mental health provision, austerity measures have significantly reduced funding, placing increased pressure on already under-resourced services. The report explores the impact of government policies, including welfare reforms and cuts to public services, which have exacerbated social inequality and led to a worsening of mental health. It highlights the increased financial strain on individuals, rising demand for services, and the closure of hospital beds, alongside a critical perspective on dominant discourses around mental health. The author contends that these policies are directly leading to worsening mental health in the UK and calls for a move away from the dominant medical model that pervades mental health, emphasizing the need to address social and structural determinants of mental health.

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’srecentcommitmentto
improving mental health provision masks the extent that their policies of auster-
ity have already broughtharm to those same services.Government-driven poli-
cies have led to significantly reduced funding within mentalhealth,increasing
pressure on a system that was already chronically under-resourced.Further,peo-
ple who are experiencing mentaldistress,and mentalhealth service users,have
been especially vulnerable to the harmsof the currentausterity programme,
including being atthe sharp end ofthe assaulton public services and welfare
spending.This piece discusses the impactof austerity,exploring the effects of
governmentpolicies and with a criticalperspective of the dominantdiscourses
around mentalhealth.It argues thatby exacerbating socialinequality,govern-
mentpolicies are also directly leading to worsening mentalhealth in the United
Kingdom.
Keywords: austerity; welfare reform; mental health; United Kingdom
In his speech to the UK LiberalDemocratannualconference this year,the Deputy
Prime Minister,Nick Clegg,surprisingly focused on mentalhealth.Clegg high-
lighted plans forhow the governmentwould in 2015 startputting treatmentstan-
dards on a parwith treatmentfor physicalhealth.This is an attemptto fulfilthe
‘parity ofesteem’commitmentoutlined in the government’sNo Health without
MentalHealth strategy (HM Government2011).This strategy aspires to give equal
value to mental and physical health. New National Health Service waiting standar
for mentalhealth willbe created for the firsttime,meaning thatthose who require
‘talking therapies’ will be seen within six weeks; whilst those labelled as experien
ing a firstepisode of psychosis willbe seen within two weeks.In addition to this,
an extra £120 million of funding is to be allocated to mental health services over
next two years (Wintour2014).
Additionalfunding formentalhealth services is ofcourse welcome,as is an
acknowledgementof the failure of the mentalhealth system to deliver timely sup-
portto 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 impacton mentalhealth,mentalhealth services and service users.
Life under austerity is growing increasingly tough for the vastmajority of people,
and mental health is one of the casualties of this era.Greater numbers of people are
being placed under increased financialstrain 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 pressureson servicesmean thatthe supportavailable to
people is reducing when demand is sharply increasing (O’Hara 2013).
Government-driven policieshave led to the NationalHealth Service making
real-term reductions in investmentin mentalhealth services and have exacerbated
the situation in a sector thatwas already subjectto chronic underinvestmentin ser-
vices for both young and older people alike (Thornicroftand Docherty2014).For
instance,a reportpublished in November 2014 by the House of Commons Health
Committee demonstrated severe problems throughout the entire system of child
adolescentmentalhealth services.Whilstdemand has been rising,there have been
widespread reductions in funding (House ofCommons Health Committee2014).
Early intervention services are generally funded by localauthorities;however,as a
result of increasing financial pressures brought about by austerity measures,60% of
localauthorities have eitherreduced orfrozen theirchild and adolescentmental
health services budgets since 2010–2011 (YoungMinds2014).
Children and young people are experiencing large increases in waiting times
for supportand also increased referralthresholds,to the extentthatsome child
and adolescentmentalhealth services willonly acceptreferrals when the young
person has attempted to commitsuicide atleastonce (House of Commons Health
Committee2014).It is fundamentally unacceptable thatyoung people have to be
at the pointof killing themselves before they can actually access support.They
are beingfailed by a system thatis causingthem increasedharm by only
responding to those who are in extreme distress.This also meansthatgreater
numbersof young people end up requiring in-patienttreatment(with all of the
associated damage thathospitalisation causes)when this could have been avoided
if they were given supportsooner.Ultimately there willbe young people who
take their own lives as a result.
Adultmentalhealth services are similarly under increased strain.For instance,
within acute settings the closure of more than 1700 hospital beds from 2011 to 2
has led to warnings thatthe demand forcrisis services is faroutstripping supply
(McNicoll2013).Localauthorities have seen widespread reductions in the number
of adults receiving state-funded socialcare support,and mentalhealth socialcare
supporthas beenparticularlyhard hit (Fernandez,Snell, and Wistow 2013).
Although there hasbeen significanthistoricalunderinvestmentin mentalhealth
services (Bailey,Thorpe,and Smith 2013),the path ofausterity thatthe 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 impacton people,increas-
ing poverty and reducing the social safety nets that are in place. People experien
mental distress, including mental health service users, are some of the key group
people thathave been hardesthit;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 benefitreforms (including the bedroom tax).The introduction
of a new and much harsher sanctioning regime in 2012 (where benefits are stopp
for a set period for failure to comply with requirements of the jobseekers allowanc
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 a
key reason for why there has been an explosion in the use of food banks (O’Hara
2013).
476 K. Mattheys

Many individuals have been affected by multiple welfare reforms, and it is thos
on the lowestincomeswho are mostheavilyaffected.Around21% of the
population of the United Kingdom live below the government’s official poverty lin
and virtually allof the welfare reforms are targeted atthis group of people (Duffy
2013).The localauthorities thathave been hardesthit are also those in the most
socially deprived areas,and so the reforms are serving to exacerbate pre-existing
social and spatial inequalities (Beatty and Fothergill 2013; Whitehead 2014).
The current austerity programme is increasing levels of mental distress.There is
a clear link between social deprivation and mental health,with poverty,income and
debt all strongly associated with poor mental health (WHO and Calouste Gulbenki
Foundation2014).There are well-established and known consequences to people’s
mentalhealth from living in poverty,unemploymentand underemployment,and
from living in areas with high levels of deprivation.By exacerbating social inequal-
ity, government policies are directly increasing inequalities in mental health.
Since 2010 there has been a 23% increase in prescriptions foranti-depressant
medication in the United Kingdom (O’Hara2013).This is indicative of a growing
situation in which people increasingly feelunable to cope.It is also reflective of
dominantdiscourses around mentalhealth,in which the socialand structuraldeter-
minants are marginalised in favourof a focus on the individual(Morrow 2013).
Instead ofconsidering the impactof socialdeprivation on people’s mentalhealth,
and how reducing socialdeprivation mightimprove mentalhealth and well-being,
the path instead is to look to neurochemistry,focusing on whatis wrong with the
individual instead of what is wrong with society. Structural explanations are ignor
in favour of an approach that tries to fit people’s experiences into a box that can
labelled in the same way as,say,diabetes or heartdisease.This is a pathologising
approach which suggests both thatsomething is wrong with the person and that
something iswrong with theirexperience,behaviourand perceptions(Beresford
2005).
It is also precisely because of this dominantmedicalapproach thatthe govern-
mentcan espouse a commitmentto ‘improving mentalhealth’ withouthaving due
regard to the impactof the policies thatthey themselves have implemented.These
policies are demonstrably worsening the lives of many,placing people under such
financialand emotionalstrain thatthis is leading them into crisis.These dominant
discourses also lack any incorporation ofcriticalperspectives,including evidence
from a vastliterature ofsurvivoraccounts reflecting on how the currentmental
health system is oppressive,and coercive,and often does notprovide the type of
supportthatpeople wantor find helpful(for example,Campbell2002;Lee 2013).
‘Talking therapies’may be of benefitto somebut are not a one-size-fits-all
approach;this cognitive behaviouralfocus again fits neatly into this medicalised
approach,wherethe problem isfirmly rooted within theindividual.Although
increasing funding for mental health services is a positive step, improving those s
vices would require a move away from the dominantmedicalmodelthatpervades
mentalhealth.A ‘more of the same’ approach is nowhere near enough to fix this
problem.
Disclosure statement
No potential conflict of interest was reported by the author.
Disability & Society 477

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