Edited version of contribution by New Script for Mental Health at the launch of View magazine on health, in UNISON on 26 January 2026

First big truth: distress follows inequality, not chemical imbalance.

Across our society, the evidence is now indisputable. Suicide, self-harm, problem drug use and high levels of mental distress are concentrated in the most deprived communities. Men die by suicide at far higher rates than women. People in the poorest areas are almost three times more likely to die by suicide than those in the least deprived. Antidepressant prescribing rises sharply in line with deprivation. These are not coincidences. They are the human consequences of poverty, deprivation, discrimination, and chronic insecurity.

Yet the dominant mental health narrative tells a very different story. Distress is framed as individual, located in the brain, and best treated through medication. Experiences are pathologised, medicalised and individualised. Context is stripped away. Poverty becomes invisible. Violence, trauma, and systemic harm disappear. When help fails to arrive, people are left blaming themselves. Families are left watching loved ones suffer and die from what are preventable deaths.

Second big truth: the system itself is causing harm.

The Department of Health’s response is not fit for purpose. Despite repeated strategies and action plans, delivery has been minimal. Around 80 per cent of the current Mental Health Strategy remains unimplemented, with no outcomes framework and no accountability for failure. The Protect Life 2 Strategy is not targeted by objective need, and the 2025 plan lacks timelines, clear resources and meaningful KPIs. Critical data gaps persist across the system, weaknesses highlighted in at least three major independent reports — yet still left unaddressed.

People navigating mental health services consistently describe long waiting lists, fragmented pathways and medication too often being the only thing offered. Services are quietly privatised, while accountability disappears. When things go wrong, there is little transparency and no meaningful learning. 

What should be public care becomes privatised, commodified, and increasingly inaccessible, particularly to working-class communities. Those with money are pushed into private care; those without are left waiting or simply left behind. In his article in View, on the privatisation of healthcare, journalist Tommy Greene reports that Kingsbridge private clinic charges between £440 to £485 for an initial hour-long psychiatry ‘consultation’ and £237,50 to £260 for a subsequent 30-minute review session, totalling nearly £750  for 90 minutes of health care support. He notes that this support is often with clinicians that patients could and eventually would be seeing through the public system.

We are offered apps instead of human beings, self-care instead of social care, and resilience training instead of secure housing or decent work.

This isn’t accidental. Mental health has been reshaped by a neoliberal ideology that reframes social suffering as personal pathology. Collective anger is neutralised. Structural injustice is depoliticised. As distress is decollectivized, responsibility is shifted away from governments and systems and placed squarely on individuals. We are offered apps instead of human beings, self-care instead of social care, and resilience training instead of secure housing or decent work.

Third big truth: “trauma-informed” without rights is empty. Trauma-informed approaches are everywhere in name, yet many people experience services as actively traumatising. Staff are harmed too. This is because trauma does not exist in a vacuum. Trauma and human rights violations are inseparable. When dignity, safety and worth are not upheld, harm is normalised. Focusing only on individual trauma is easier than confronting the systems that create it.

This is where moral injury comes in. Workers doing their best in hierarchical, target-driven systems are silenced, blamed, and denied the space to practise with integrity. They are asked to tick boxes rather than tell the truth. The result is burnout, vicarious trauma and a workforce carrying the moral weight of decisions made far above them.

The antidote: collective voices, collective action, real accountability.

We do not have a mental illness crisis. We have a poverty crisis, an accountability crisis, and a political failure to address these enduring crises. The alternative requires a New Script for Mental Health— one grounded in human rights, trauma-informed approaches that address power and inequality, and a clear shift away from pathologising distress. Frameworks like Give 5 show what this can look like: focusing on what systems must do, not just what individuals should endure.

Accountability is non-negotiable. That means duties of candour, independent oversight, regulation of senior leadership, and families at the centre rather than pushed to the margins. Most of all, it means reclaiming mental health as a collective issue. When voices come together — through unions, communities, and organised action — the depoliticisation of suffering can be reversed.

Mental health has been privatised, commodified and stripped of its social meaning. The work ahead is to re-politicise it, re-humanise it and rebuild it collectively. Lives depend on it.