ON Monday November 2, a campaign called Equality for Mental Health was launched with over 200 high-profile signatories.

The chief executive of Mind, Paul Farmer, said: “We need to see urgent and significant investment in mental health services so that the one in four of us experiencing mental health problems can get the help and support they need.”

One person able to give a view of mental health services from both a professional and, uniquely, a personal view is Linda Gask who is emeritus professor in primary care psychiatry and the author of a remarkable memoir which was released this year called The Other Side of Silence.

With over 34 years working in the NHS, Gask has a viewpoint few share as she is a user of the services as well.

She has carried out work for the World Health Organisation and has a special interest in helping health professionals to develop better communication skills and help GPs liaise more effectively with mental health teams.

Gask is therefore well placed to comment on the current crisis in mental health and it is fitting that her touching memoir attempts to lessen the stigma surrounding mental health problems as well as increase understanding.

It also acts as a window into the long-standing problems within mental health and the impact these problems have on patients, loved ones and professionals.

Gask says The Other Side of Silence was “initially to try to make sense of what happened in my life. I began writing about my father’s death and then that developed into a memoir of my experiences and particularly my problem with depression.

“There were considerable parallels between what had happened to me in my life and my patients.

“We had experienced similar problems and I had been helping others as I both received help and tried to help myself.

“It gradually began to seem there was something important to say about depression, not as an illness but as an experience that people, including myself, try very hard to understand and make sense of.

“Writing the book was therapeutic but I wanted to write something in which I could share some of the knowledge and experience I had gained both from my time as a doctor and a patient so that it might be helpful to others too.”

The aims of the book are twofold: “First I wanted to help people who have or who are still living with depression feel less alone and a little more hopeful,” says Gask.

“I’ve heard from medical students with mental health problems who say it has enabled them to see there is a role for them and that it is possible to be successful in a career despite having episodes of depression.

“Second I wanted to really challenge the stigma within mental health care. Many mental health care professionals have significant problems with their own health, but don’t seek help for fear of being seen as weak.

“In my experience as a consultant, I found the NHS one of the worst employers I had to deal with in ensuring people had the right support in getting back to work.

“I’ve experienced negative attitudes from managers and a fellow consultant during my career. This leads me to believe that not only do mental health staff need much more support in getting the help they need, but that unless stigma towards staff is challenged, stigmatising attitudes that service users experience will never be tackled.

“Health professionals need to be more honest with each other, their patients and society and stop going along with the myth they are somehow invincible.

“Other people in positions of authority in the community need also to stop the pretence of immunity.

“When Bob Hawke, the Australian Prime Minister, came out and publicly admitted his alcohol problems the world didn’t crumble.

“Instead people began to talk more about the problem and services were expanded with increased funding.”

With the NHS in crisis, pressure regarding bed availability as well as the erosion of community support, Gask has important points to make regarding the causes of the crisis and the impact on those with mental health problems.

She explains: “Throughout my career I cannot say things have ever been ‘ideal’ in terms of mental health care.

“It has always been underfunded, although there have been times such as in the early 2000s when a real effort was made to address some of the gaps in services.

“This is now the worst time in my living memory for people with mental health problems to access the care they need — even worse than during the Thatcher government.

“The mentally ill have become invisible and the belief put forward by Iain Duncan Smith that their problems can be solved by getting a job is simplistic but cruel and, as we know, potentially fatal.

“Services have been cut further than ever before. In response to this, the threshold for getting care is raised.

“Therefore, a person has to get more unwell before they can access help. A young woman developing anorexia will only get help when her body mass index is dangerously low, when it will be much harder to help than if she gets therapy earlier, and result in far greater suffering for her and her family.

“If a person doesn’t get help early enough for a relapse of a major mental illness they may only access care at the point they are detained under the Mental Health Act and indeed there has been a considerable rise in such detentions.

“At the same time GPs cannot get the help they need for people consulting them with more severe mental health problems than they can manage.

“This must be addressed if we are to do anything about the increasing suicide rate. The majority of people who are taking their own lives are not in touch with mental health services but many of them do see their GP.”

Gask also points to the crisis in services for young people as the area which requires urgent action and should be prioritised.

“In my career in adult psychiatry I saw so many people who would’ve benefited from help in their teens, when many experience their first episodes of anxiety, depression or psychosis.

“These services need to be provided for the age range 12-25. The current model is for child and adolescent mental health services to provide care — if at all — until the age of 18 and then there is a cliff edge where services are discontinued and the young person is often deemed not to ‘meet the threshold’ for care by the community mental health teams. The result is disaster for all concerned. Services are delivered in a way that suits organisations and the professionals who work in them.

“Improving care for young people should be the first priority in preventing the onset of potentially lifelong mental health problems.”

The Other Side of Silence is revealing with regards to inequality and the lack of services to meet the needs of deprived communities.

Gask says: “We know social deprivation plays a major part in determining whether a person experiences mental illness and our deprived communities have greater need. Mental illness itself compounds this because of the impact it has on a person’s life — sometimes leading to social exclusion.

“However, our deprived communities are never funded to the level they require in terms of social and mental health care — which then further contributes to the problem.”

These are some of the issues the campaign Equality for Mental Health needs to tackle. As Gask has pointed out, urgent actions are required.

Cuts, lack of access to appropriate services and general attitudes towards the mentally ill continue to have a huge impact on some of the most vulnerable in our society.

• The Other Side of Silence by Linda Gask (Vie Books) is available in all good bookshops. Ruth F Hunt is the author of The Single Feather (Pilrig Press).