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Schizophrenia: The next big challenge in public health

For too long the mental health service has been seen as the poor relation in the NHS. DAVID BELL hopes that Jeremy Corbyn can help change this

JEREMY CORBYN has long been known in his Islington constituency as a champion of mental health issues, and his appointment of Luciana Berger as shadow health minister with special responsibility for mental health is a welcome move.

The mental health service has for too long been the poor relation in the NHS. Under-resourced and underfunded generally, nowhere has the lack of resources figured more heavily than in the treatment of psychotic illnesses like bipolar disorder and schizophrenia which still today attract little in the way of public sympathy.

The prospects of a person with schizophrenia being able to return to mainstream society are as bad as ever and too many people with this condition are still living in our prisons and homeless hostels.

But it needn’t be so. Since the introduction of the modern anti­psychotic drugs, the outcomes for people with schizophrenia have changed drastically.

Before we had these drugs 80 per cent of people with a diagnosis of schizophrenia were confined in one of the large institutional asylums, sometimes for years at a time and sometimes forever.

The new drugs enable most people with schizophrenia to live successfully in the community and today only about 5 per cent of people with schizophrenia are in hospital at any one time and the average length of stay is measured in months rather than years.

However, although clinical outcomes have improved greatly, the social outcomes, the return to mainstream society, is still severely hampered by societal attitudes to this difficult condition.

Today in the UK only about 13 per cent of people with a diagnosis of schizophrenia are in any kind of work and yet we know that most people who have experienced an episode of the condition will recover a high level of functioning given access to high-quality care and treatment.

The reasons for this disparity between clinical and social outcomes are complex.

Some would blame stigma on the part of employers, however, in truth the problem is probably more complex than that.

The problem is that there exists in Britain today an overarching mindset among sufferers, professionals and public alike that sees permanent unemployment as being the natural state for people with schizophrenia. We must challenge that attitude.

Living with Schizophrenia believes that if we are to make any headway on this issue, government must dispense with the arcane doctrine of mainstreaming of mental health services.

Schizophrenia is such a distinct condition with unique features and challenges that it must be dealt with by specialists who know their subject inside out and not by generalists who deal with the entire spectrum of mental health conditions.

We believe that the next Labour government should develop a plan for achieving true recovery in schizophrenia.

The core of this plan must be based around dissolving the obstacles that currently exist to people with schizophrenia getting into employment. Here’s how we see it working:

- Appoint a schizophrenia “tsar” with access to government at the highest level and charged with the creation and implementation of a national schizophrenia strategy with the concept of recovery at its core.

- Establish a central schizophrenia monitoring service to collect and collate anonymised data on outcomes of all patients with a diagnosis of schizophrenia.

- Constitute an industry task force, under the direction of the schizophrenia tsar, involving trade unions, employers’ organisations and recruitment experts to address the issue of stigma in employment and consider how recruitment and employment practices should change to facilitate more people with schizophrenia entering the workplace.

When the welfare state was created by the Attlee Labour government in 1946, it had a very clear mission to defeat the five great evils of the day — want, ignorance, idleness, disease and squalor.

Today, as far as people living with schizophrenia are concerned, disease and idleness are still as much part of their everyday lives as they were in 1946.

There are today about 280,000 people with a diagnosis of schizophrenia living in the UK, and only a minority of them are in any kind of work.

This represents an ongoing failure to allow this large group of people who have so much to contribute to their society to access meaningful employment.

Living with Schizophrenia calls upon Labour to make a fresh commitment to providing pathways back into mainstream society for all those afflicted by this condition.

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