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Bearing costs in mind

by
12 September 2014

FEW outside the medical profession know the extent of mental illness as well as teachers and the clergy: teachers, because all life passes through their classrooms; clergy, because, with good fortune, those who are distressed are often drawn to churches. The emphasis on mental health in the Chief Medical Officer's annual report on Tuesday is obviously welcome, but the statistics it contains are depressing, and the Government's response familiar. Norman Lamb, Minister in the Department of Health, said: "I want to build a fairer society where mental health is treated with the same importance as physical health." A year ago, in July 2013, he said: "We have never before placed such an emphasis on mental-health services, and I am determined to continue to drive progress towards better care for those with mental-health problems." In a Commons debate in 2012, he said: "The Government's mandate makes it absolutely clear that there must be parity between mental and physical health services." In the mean time, the Chief Medical Officer (CMO), Dame Sally Davies, reports that funding for mental health appears to be dwindling. A key part of her report is the need to shorten waiting times. After an inquest last month, a retired cleric, the Revd Alan Golton, said that underfunded services had contributed to the suicide of his daughter Rowena. She was referred for urgent treatment three times, but was told that the waiting list for cognitive behavioural therapy (one of the cheapest and most readily available therapies) was up to five months long in Manchester. The cost of the inquest would, of course, have paid for Rowena's treatment. The CMO's report quotes a 2006 study that calculates the cost of a working person's suicide to be £1.6 million.

Presumably in an attempt to get the Treasury's notice, Dame Sally concentrates in her report on the financial savings of getting people back to work quickly: mental illness costs the UK between £70 and £100 billion each year in lost earnings, benefits, and medical bills. The Government might believe (although it says nothing of the sort in public) that early intervention would simply mean more intervention, since a greater proportion of people would be treated who might "sort themselves out" unhelped. This makes no sense pastorally or economically. The CMO's report suggests that, by responding to a young person's first psychotic episode, the state might save £15 for every £1 spent over the course of the next ten years, not counting that person's lost earnings. There is no question here of singling out only the economically valuable for treatment; merely an indication that properly managed mental-health services could, over time, pay for themselves. In Christ's parable, the Good Samaritan paid for the victim's recovery. Had the problem been one of mental health, he might have ended up making a profit.

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