Learning difficulties & mental health are different: why I am not heartened by Theresa May’s mental health pledge

You may have seen Theresa May’s encounter with an angry voter in my old Oxfordshire stomping ground a couple of days ago. I should point out this sort of thing never happens in places like Abingdon. They have a Waitrose and everything.

You can watch what happened here:

Kathy Mohan seemingly wasn’t bothered about Abingdonian etiquette and so, as far as Theresa May was concerned, she was just another mental woman making a bit of scene. What the Tory leader never cottoned onto was the fact that Ms Mohan wasn’t talking about mental illness, as she repeatedly kept saying. Perhaps Mrs May took the clichéd view that it is a hallmark of them mentals to insist that they are not mental.

For Kathy, despite her DLA having been replaced with PIPs, all should be well because the Tories will put more money into mental health. That would be helpful except for the fact that Kathy repeatedly made clear she was asking about learning difficulties and not mental health. To keep insisting more money will go to mental health when confronted by someone with learning difficulties frustrated at a cut in benefit is a bit… mental.

You may feel I am bandying around such terms in a callous and unkind way, but they are terms I – unlike Theresa May – understand very well. For I do have a history of mental health issues – having had the pleasure of utilising Abingdon’s mental health service and enjoying the company of a whole bunch of mental patients in Oxford. You can read a little about that here if you like. Nor am I unacquainted with learning difficulties. Not that I have them, but I did encounter a variety of learning difficulties in my (albeit brief) incarnation as a secondary school teacher and I also have more than one family member who has dealt with them. So I am aware of the difference.

I do/did (depending on what you count as cured) have mental health problems. I do not have learning difficulties and never have done. Of those I know with learning difficulties – whilst some have suffered with mental health issues – they haven’t all. The reason for this is simple enough and is helpfully distinguished by Ian Birrell in the Guardian:

One has a reduced, or unconventional, intellectual ability that may impact on their entire life. The other has a health problem, which might be devastating and recurring but can often be treatable. The conditions, the challenges, the care needs are very different.

As Birrell rightly asks, ‘what hope is there that society will ever embrace the estimated 1.5 million people with some form of learning difficulty when even the prime minister – the person at the pinnacle of our public services – muddles them up with people with mental health problems?’

What is more, it brings home the sheer nonsense of telling someone with learning difficulties you are planning to pour more money into mental health services. It’s a bit like telling someone whose cancer treatment has been stopped that you intend to resolve their issue by ploughing money into orthopaedic surgery. There’s a chance you might get some crossover, but they are simply not the same thing and it isn’t going to do much to help the issue at hand.

The other problem, of course, is that the promise of ‘more money for mental health’ – even were that the appropriate response (which, I think we have established, it isn’t) – does absolutely nothing to tell you what they’re going to do with it. We can all pump more money into things, it doesn’t mean it’ll do anything to help.

The question isn’t whether more money is going in, it’s what the money will do and whether it is a valuable approach in the first place. For example, how does ploughing more money into amorphous mental health ‘things’ help anyone when you have abolished the student nurse bursary meaning that fewer mental health nurses will be trained? Likewise, how will pumping money into heretofore undisclosed mental health services help whilst giving nurses real terms pay cuts? This reduces the number of people who might consider going into the profession and increases the number of trained nurses leaving? Given that – excepting ECT – most mental health treatment is not delivered using expensive machines, how is Theresa May’s pledge of more money of any value?

More to the point, Ms Mohan made clear that she was not after more money being pumped into mental health. We have established the first, and most obvious, reason for this is that she was talking about learning disabilities. The second, and similarly clear, reason was because her DLA – that is the old in-work benefit for those people with disabilities – has been replaced by the ironically named Personal Independence Payments (PIPs).

It is ironic because, as the name suggests, in the pursuit of increasing independence they amount to a cut in DLA payments thus impeding independent living by drastically reducing your income. They have also become notorious for assessments carried out by private firms – themselves rewarded for reducing payments – who carry out their own medical assessments to ascertain if they believe you need PIPs. Just as Michael Gove announced that we had all had enough of experts, it seems that includes medically trained doctors writing notes indicating – contrary to the assessment of a Capita employee – you do indeed have a medical condition that requires considerable adjustments. Over two-thirds of decisions are overturned on appeal, suggesting that the private companies used to assess claims simply do not know what they are doing.

It is this that so exercised Ms Mohan and it was interesting that Theresa May simply had no credible answer for her. There was no promise of a return to DLA and no offer of support for people with learning disabilities. Instead she was simply told that there would be more money for mental health. That is no help to Kathy and of little reassurance to a long-term depressive like me. As answers go, it was all a bit mental.

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