Written by the New Psychotherapist editorial team
There’s no doubt that the national conversation around mental health is increasing in volume. With Theresa May last year launching an independent review of mental health provision and recent high-profile campaigns backed by Princes William and Harry, our profession’s voice must also be heard.
As the voice for psychotherapists in the UK, we are working with MPs to set the agenda on therapy. We want to expand and develop the psychological therapy treatments available to patients, while also identifying cost savings to the public purse – a goal shared by Johnny Mercer, Conservative MP for Plymouth Moor View. Among other roles, Mercer is Vice-Chair of the All Party Parliamentary Group (APPG) on Mental Health and a member of the Health and Social Care Committee. ‘I’m interested in redesigning health care,’ he says. ‘If we can treat people with mental health problems earlier using talking therapies, the cost is much lower, but the chance of them getting better is higher.’
One example of our policy work is our response to the draft National Institute for Health and Care Excellence (NICE) Guideline for Depression in Adults. UKCP has serious concerns about NICE’s flawed methodology and lack of commitment to patient choice. A meeting with NICE representatives resulted in an unprecedented second consultation on the Guideline. Since the consultation ended, we have worked with a coalition of organisations opposed to the Guideline, with the UKCP Policy Team playing a critical role in lobbying MPs and Peers. This resulted in a letter co-signed by 31 MPs and Peers outlining their fears about the Guideline. As well as Mercer, signatories included Norman Lamb, former Minister for Mental Health, Dr Sarah Wollaston, Chair of the Health Committee, and Luciana Berger, former Shadow Mental Health Minister.
UKCP believes all key decision-makers in government, parliament and other public bodies responsible for health policy need a clear understanding of the effectiveness and economic value of talking therapies. To this end, we have linked up with seven other leading psychotherapy and counselling organisations to form the Talking Therapies Taskforce. Together, we aim to set out the economic case for talking therapies, create a national system to collect data on its efficacy, and formulate a workforce development plan and associated training programme – all evidenced by large quantities of NHS data.
As part of our long-term plan to bring the issue of talking therapies to parliamentarians, we want to ensure cross-party support for our campaigns. A vocal proponent of improving mental health support provision, Johnny Mercer is a firm believer in talking therapies – an advocacy born from personal experience, both in his formative years and as an ex-army captain. As a boy, Mercer had obsessive compulsive disorder. ‘It dominated my life,’ he says. ‘I had a horrible time, and I think that if more people talked openly then about mental health, it would have helped me enormously.’
Although the conversation around mental health has got a lot better, much still needs to be done, believes Mercer. ‘We still have some way to go in defining what it means for sufferers, looking at how to keep people well, and making sure that people – particularly men – don’t have to be extremely poorly to access treatment.’
Mercer was recently struck by the lack of men at a meeting of the APPG on mental health, which regularly calls on government ministers, NHS organisations, health professionals, research bodies and people with experience of mental illness to give evidence. ‘I was the only man there and yet there is a huge issue around masculinity.’ Despite encouraging recent statistics, suicide remains the biggest killer of men under the age of 45.
As a society, we are increasingly examining and rejecting notions of ‘toxic masculinity’, in which men feel they must conform to repressive and aggressive ideals of what it means to be a man – and Mercer sympathises with this. ‘The whole culture around masculinity needs to change. I see people who do things they think are masculine, yet those things are at odds with what I see as masculinity; it is an inner strength, rather than an outer strength that’s on view for everyone to see.’
Through his time in the army, Mercer has direct experience of a traditionally masculine environment. He joined in 2001 at the age of 20. ‘I have seven brothers and sisters and four of us ended up serving. It was an opportunity to see the world, make friends and have a good time. But in the back of your mind you always know that you may have to go into conflict.’
Mercer was deployed to Afghanistan in 2006 and 2008–2010. Aspects of serving in a conflict were mentally challenging, he says. ‘The basics around warfare don’t change – being frightened, having to show courage, having to lead people. My number two guy was killed and that was really tough. You just get on with it and deal with it later. For some people, that may be when they get home and for others, for example, those who struggle with PTSD, it could be years later.’
Although mental health care is improving all the time for veterans, more needs to be done, he says. ‘When I was in the army, Trauma Risk Management – where you could go to talk about mental health – wasn’t taken seriously. Times have changed – there are people in our military psychiatric units who do an incredible job – but there is still some way to go.’
Closer to home, Mercer is working hard to improve the mental health of his own constituents. The lack of male role models in his constituency concerns him. ‘I was struck by statistics about young people growing up in homes in Plymouth where there is no father figure. Their role models are only in the media or online. That is a big problem, because people only see the best side. A lot of our young people, men in particular, are missing out on seeing that it’s okay to have a bad day, and to talk about how you’re feeling.
‘I can’t over-emphasise the role of social media in changing our society,’ he continues. ‘What happens online for younger people can completely define their day – even who they are as an individual. You see tragic cases of people taking their own lives from cyber bullying. If we work harder on mental health and wellbeing that will change.’
Mercer is calling for a more joined-up approach to mental health; one that encompasses the economic and social structures of society. ‘We need to reconfigure how we look at wellbeing – it includes things like having a job, good housing and social networks,’ he says. ‘Yes, we try to tackle these problems in isolation, but no one talks about how they affect mental health. I think that’s the key to changing understanding.’
So where do anti-depressants fit into this picture? As part of the UKCP’s work with the All-Party Parliamentary Group on Prescribed Drug Dependence, we are creating a guidance document for therapists working with users of prescribed drugs. This project will help to raise awareness of the alarming growth in the UK of prescribed drug dependence, and a big part of the solution is securing better public access to talking therapies. Mercer, for one, is wary of the over-medicalisation of mental health treatment: ‘It’s about preventing people thinking that, when they have a mental health problem, there is simply a medical, pills-based solution to how they feel – which is largely what people expect from their doctor,’ he says. ‘This fundamentally misunderstands the issues around mental health. Yes, there is an aspect to it that you can address by taking medication. However, we need to tackle the root causes of what is giving you that anxiety. What is stopping you sleeping? What is causing your depression? We talk about a parity of esteem between mental and physical health – that’s more than just a sentence. It has to mean something.’
Mercer is also clear on the importance of early intervention to address mental health problems. ‘That is the game changer. It saves providers money and the chances of patients getting better are so much greater.’
By working with Mercer and other MPs, UKCP is determined to ensure that talking therapies form a vital part of this early intervention. Watch this space for updates on our campaigns as we take our mission – and the voices of our members – to parliament.
This article was originally published in the autumn edition of the New Psychotherapist. You can read the rest of the magazine here.
Follow Johnny Mercer MP on Twitter @JohnnyMercerUK.