Before the Covid-19 pandemic we were in the midst of a mental health emergency, one which our health system was failing utterly to deal with. Waiting times for assessment and treatments were unacceptably long and access to services operated on a post-code lottery basis. Services were fragmented and lop-sided. Funding, at a mere 5.3% of Stormont’s health budget was a drop in the ocean of what was required.
Working class communities were disproportionately impacted, where rates of mental ill-health and suicide were over three times greater than more affluent areas. Small scale reforms introduced were never going to reach the measure required to radically transform the system.
Covid-19 has demonstrated just how unprepared our public services are for public health emergencies. For decades, we have experienced a sustained attack on the institutions protecting universal health and well being. The NHS and the welfare state, developed post-World War II as guarantors of a basic human rights, have been systematically undermined by an ideology prioritising the private greed of the few over the welfare of the many.
People and planet have been ravaged in a drive to concentrate wealth resulting in global warming, environmental destruction, human displacement, unprecedented levels of income inequality, extreme poverty and immiseration for millions of people globally.
An economy which deliberately disconnects people from themselves, each other, their communities and the natural world is causing huge levels of emotional distress, trauma, pain and suffering world-wide. Yet, the dominant narratives explaining mental ill-health, and which guide state policy, do not allow for an analysis of how the social, political and economic conditions in which people are living condition mental health.
Public policies continue to ignore, even at times exacerbate, the determinants of poor mental health such as violence, disempowerment, discrimination, social exclusion and poverty.
The psychological impacts of Covid-19 and its aftermath are likely to be on a scale not experienced in our lifetime. Covid-19 has triggered widespread death and loss, an unemployment crisis coupled with extreme poverty and destitution, increased domestic violence, relationship breakdown and burnout among essential workers. Those most vulnerable in our society pre-pandemic, due to a toxic mix of austerity, rampant greed, privatisation and structural discrimination, are now those at greatest risk, not alone from Covid-19 but from how the state responds to this crisis.
In the words of the UN Special Rapporteur on the Right to Health, Professor Dainius Puras, “little short of a revolution is needed in mental health”.
Lockdown pressed the pause button – even if temporarily. Space and time have opened up to think, to reflect and to imagine. Alongside the actual virus, the old failed systems have been placed under a microscope and scrutinised. Local communities in many areas rallied to support the most vulnerable amongst them, often in advance of state action. There is now a widespread view that we cannot and must not return to the old way of doing things. We can take this time to imagine the world differently. Nowhere is this more needed than in how we understand and respond to emotional distress and trauma. In the words of the UN Special Rapporteur on the Right to Health, Professor Dainius Puras, “little short of a revolution is needed in mental health”.
This series of three inter-connected webinars will create a space to explore what this paradigm shift should look like and how we can work together to bring it about. They will bring together those whose experience of mental health care underpins their activism, carers and advocates, along with those working in mental health and suicide prevention services.
Each webinar will produce a set of proposals for change which will form the basis of a new vision for a human rights compliant approach to mental health – one with dignity, respect and connectedness as its cornerstones.