Our Public Affairs and Stakeholder Manager, Tristan Westgate, looks back at a turbulent twelve months. He delves into the political impact of Covid-19, as well as other issues from 2020, and looks at what affect this will have on people severely affected by mental illness as we head into 2021.

2020. A turbulent year. And one that will undoubtedly live long in the collective memory.

As we all know, Covid-19 has defined 2020. A glance at some of the Oxford English Dictionary’s Words of the Year – ‘social distancing’, ‘lockdown’, ‘keyworker’ – confirms this. Far reaching restrictions were placed on our individual liberties, that would have been inconceivable 12 months ago. The impacts of the virus and the changes to our lives will impact politics and society for much time to come.

2020 has been particularly hard for most people living with a mental health condition. Research shows that there are approximately 10 million people who will need new or additional mental health support due to the pandemic. A survey conducted between April and May 2020 by Rethink Mental Illness showed that 79% of people with pre-existing mental illnesses reported that their mental health had got worse or much worse because of the pandemic, with 42% saying their mental health was worse because they were getting less support from mental health services. The Office for National Statistics also found that almost one in five adults in Britain experienced depressive symptoms in June 2020, which is approximately twice the number before the pandemic.

What next?

The recovery from the pandemic will be a long and winding road and the colossal debt that has been incurred will have wide-ranging implications for some time.

The Chancellor of the Exchequer, Rishi Sunak has consistently indicated that the debt will need to be paid off. How and when this will happen remains to be seen, however. Though his government has promised not to return to austerity, and tax increases are always politically painful, something will have to give, and spending cuts are likely in the medium to long term. These cuts will inevitably limit the government’s ambitions in certain areas.

Rethink Mental Illness, like many other organisations in the mental health sector, will work to ensure that mental health services receive the funding they need. It will be hugely important to ensure that the government is bold and focused on improving outcomes for people with mental health issues as we transition out of the pandemic. However, it is also important to recognise that the enormous pressures on government spending necessitated by the virus will mean that all future spending will be under a microscope.

Furthermore, in the recent Spending Review, the Chancellor promised “extra flexibility” on raising funds for adult social care via council taxes “which together with £300m of new grant funding gives them access to extra billions of pounds to fund social care”. This could be the first sign that the Chancellor is keen to rein in central government expenditure by putting the onus on local authorities to increase council tax, but the additional funding fell far short of what is needed for social care. And without adequate funding, any ambitions for wider reform will founder.

Political challenges/objectives for 2021

Vaccines

Margaret from Coventry’s coronavirus vaccination on December 8th marked the historic ‘V Day’ and ushered in the beginning of the end of the pandemic. There is now every hope that we will be on the road to normality by Spring 2021. Above perhaps any other aspect of the pandemic response, the government’s ability to now safely and effectively roll-out the vaccine, may define how the public evaluates Boris Johnson’s time at number 10 Downing Street.

Social Care

When Boris Johnson gave his first speech as Prime Minister, he said “that we will fix the crisis in social care once and for all, and with a clear plan we have prepared to give every older person the dignity and security they deserve.” This was perhaps the boldest among Johnson’s pledges on key domestic issues: fixing social care in England and Wales has proved intractable and politically perilous for both Labour and Conservative governments in recent years. Yet announcing an ambition to fix social care is the easy bit. For now, it is fair to continue to say the challenges facing the sector have not been resolved “once and for all” and a lot will have to change for that to no longer be the case.

Unemployment

The economic recession caused by the pandemic has already greatly increased unemployment and the National Audit Office has predicted that UK unemployment is likely to reach 2.6 million in the middle of 2021: 7.5% of the working age population. The Bank of England made a similar prediction, with the unemployment rate peaking at 7.7% in April to June of next year. The Bank admits that unemployment next year is very hard to predict, saying there's a small chance it could rise as high as 10%.

We know that the loss of jobs can have negative implications for mental health, with a gap emerging between those who had stable, secure work compared with those who were unemployed. Indeed, when it comes to employment status, the further you are embedded in the employment market, the more likely you are to be cushioned from the negative effects when it comes to mental health.

Welfare

At such a difficult time for many, it is vital that the welfare system is generous and robust enough to support those who have fallen on hard times. There is also a risk that pressure to rein in spending will lead to further pressure on the social security budget in the years to come. Rethink Mental Illness has recently launched a campaign to take the pressure off people who need benefits by bringing back the emergency pause on benefit conditions and sanctions which they introduced during the first wave of Covid-19.

As the country faces another difficult year ahead, we are highlighting the injustice that people supported by the social security system live in fear of losing their benefits while the nation continues to reel from the impact of the pandemic.

Race

Aside from perhaps the pervasive, and, at times, all consuming, coronavirus, the fallout from the murder of George Floyd was certainly the most momentous event of 2020. It progressed the conversation on attitudes towards race and the treatment of ethnic minorities across the world, and will hopefully, be the trigger for lasting and hugely important change.

From a mental health perspective, black people are four times as likely to be detained under the MHA, and arrested twice as often and they are put on Community Treatment Orders (CTOs) – restrictions in the community - eight times more frequently than white people.

It is unacceptable that such disproportionate outcomes are apparent for black people and it must be a priority for mental health support that this is improved.

What does this mean for the mental health landscape?

The government recently demonstrated a commitment to responding to the impact of the pandemic on mental health, allocating £500 million of new funding in the recent Spending Review. This is a hugely welcomed investment that is vital for the people living with mental illness and will support mental health services to meet increasing demand arising from Covid-19.

The two key areas where Rethink Mental Illness hope this this new funding will have most impact include the following:
• Community Mental Health Services. These services are vital in ensuring that increased need, particularly from those with pre-existing mental health conditions, is met.
• Support staff and outreach initiatives in primary care to help increase uptake of Physical Health Checks for those living with severe mental illness.

Mental Health Act

At the beginning of the pandemic, the government introduced new Mental Health Act emergency powers to the Coronavirus Act, which would have allowed some safeguards in the act to be reduced if staffing made these impossible to deliver.

Fortunately, these powers were not required by services, and we welcome the decision by the government to remove them once this became clear. While this is a positive step, ultimately the Mental Health Act needs far reaching reform.

Mental Health Act White Paper

We are looking forward to welcoming a White Paper in 2021 setting out plans for reform of the Mental Health Act, responding to the recommendations of the Independent Review of the Mental Health Act that was published two years ago.

White Papers are policy documents produced by the government that set out their proposals for future laws, legislation. White Papers may include a draft version of a Bill that is being planned. This provides a basis for further consultation and discussion with interested or affected groups and allows final changes to be made before a Bill Parliament is given a chance to vote on it.

We strongly welcome the fact that work has continued on this vital issue throughout the pandemic, with ministers Nadine Dorries and Matt Hancock both making clear their commitment to reform.