Have you ever heard the expression "Parity of esteem"? If so, you might still want to read on. If not, you really should read on if only because you will be hearing rather more of this budding sound-bite. Before I move on to parity of esteem in the context of healthcare, it is better to start with the origins of the expression.
In sociological terms, "Parity of esteem" broadly equates to equality of opportunity. One of the earliest origins of the expression was in 1964 when the newly elected Labour Government of Harold Wilson elected to ditch the 11 plus exam. It was felt that introducing a comprehensive secondary education for all would bring greater parity of esteem. In other words, the new comprehensive education would promote greater equality of opportunity for school children up and down the United Kingdom.
But what of it's use since then? It is interesting to note that "Parity of esteem" as a concept underpinned the peace processes in both South Africa and Northern Ireland. Given the magnitude of change achieved by the latter, we begin to appreciate just how important parity of esteem is. So we have established the importance of this expression in the fields of education and political change. But what of health outcomes?
It is here that parity of esteem starts to assume a really important standing. The Health and Social Care Act of 2012 cited the principle of "Parity of esteem" in valuing mental health equally with physical health. The implications of that are enormous and worthy of further inspection. Specifically, this Act required by law that those with mental illness would have:-
1. Equal access to the most effective and safest care and treatment,
2. Equal efforts to improve the quality of care,
3. Allocation of time, effort and resources on a basis commensurate with need,
4. Equal status within healthcare education and practice,
5. Equally high aspirations for service users and,
6. Equal status in the measurement of health outcomes.
The Report which spawned the new Act of Parliament was entitled, "Whole-Person Care: From rhetoric to reality - Achieving parity between mental and physical health". It was produced by the Royal College of Psychiatrists who had been commissioned by the then Minister of State, Norman Lamb. Without going in to the minutiae of detail, the Report highlighted what many of us already knew; that mental health services were a distant second to their counterpart services in physical health. Despite this legislation being passed four years ago, it is evident that there has been little change thus far.
Organisations such as Time for Change (http://www.time-to-change.org.uk/) campaign for people to pledge to play their part in ending the stigma which continues to dog mental health. The legislation is one thing but stigma is another. So no matter how well intentioned the Act of Parliament, it will come to very little unless we all play our part in recognising and acting upon the age old problem of stigma. If you know someone with a mental illness, you will sadly know what I mean.
The Report refers to holistic care in a refreshing recognition of the importance of treating the whole person. So goes the saying, "All health starts with mental health". This being the case, why does our civilised society continue to place mental health at the bottom of the heap? It really makes no sense at all and yet it goes on regardless.
The key point here is that mental health is everybody's problem http://betweendenbighandkeele.blogspot.com/2013/07/mental-health-societys-problem.html
The statistics which underpin this are truly frightening. People with a long term mental illness will typically die 15 years earlier than those without a long term mental illness. The cause of death is usually physical with heart disease, respiratory disease and suicide being the main culprits. Smoking among people with mental health problems is rife and yet very few of them are accorded the same advice to stop. This is not because they don't want to stop smoking. This is as plain a health inequality as there is. We know that men are less likely to access their GP than women which explains why men under the age of 45 are particularly prone to dying from suicide. It is chilling to reflect that men tend to be very successful because of the extremes they go to.
Yet as I write this, acute beds for mental illness crises are still woefully inadequate and the talking therapies which are known to be of massive help remain painfully underfunded. And I look around me to see a national government intent on marginalising the vulnerable and local government doing likewise. When Enoch Powell made his Water Tower speech in 1961, he was ushering in the end of the institutionalised care epitomised by the Victorian Asylums. I wonder what he would think if he could see where we are today? Not because the Asylum model was right because it so obviously wasn't. But because the great hope of "Care in the Community" has done very little to address the one thing which so plagued the Asylums - stigma.
Funding to mental health services has dropped alarmingly in recent years but it is arguable that although funding remains important, the attitude of society is the real key. Only by talking about this and keeping it at the forefront of national debate will change come. Change will come but we would all be the richer if that change came sooner rather than later.
In sociological terms, "Parity of esteem" broadly equates to equality of opportunity. One of the earliest origins of the expression was in 1964 when the newly elected Labour Government of Harold Wilson elected to ditch the 11 plus exam. It was felt that introducing a comprehensive secondary education for all would bring greater parity of esteem. In other words, the new comprehensive education would promote greater equality of opportunity for school children up and down the United Kingdom.
But what of it's use since then? It is interesting to note that "Parity of esteem" as a concept underpinned the peace processes in both South Africa and Northern Ireland. Given the magnitude of change achieved by the latter, we begin to appreciate just how important parity of esteem is. So we have established the importance of this expression in the fields of education and political change. But what of health outcomes?
It is here that parity of esteem starts to assume a really important standing. The Health and Social Care Act of 2012 cited the principle of "Parity of esteem" in valuing mental health equally with physical health. The implications of that are enormous and worthy of further inspection. Specifically, this Act required by law that those with mental illness would have:-
1. Equal access to the most effective and safest care and treatment,
2. Equal efforts to improve the quality of care,
3. Allocation of time, effort and resources on a basis commensurate with need,
4. Equal status within healthcare education and practice,
5. Equally high aspirations for service users and,
6. Equal status in the measurement of health outcomes.
The Report which spawned the new Act of Parliament was entitled, "Whole-Person Care: From rhetoric to reality - Achieving parity between mental and physical health". It was produced by the Royal College of Psychiatrists who had been commissioned by the then Minister of State, Norman Lamb. Without going in to the minutiae of detail, the Report highlighted what many of us already knew; that mental health services were a distant second to their counterpart services in physical health. Despite this legislation being passed four years ago, it is evident that there has been little change thus far.
Organisations such as Time for Change (http://www.time-to-change.org.uk/) campaign for people to pledge to play their part in ending the stigma which continues to dog mental health. The legislation is one thing but stigma is another. So no matter how well intentioned the Act of Parliament, it will come to very little unless we all play our part in recognising and acting upon the age old problem of stigma. If you know someone with a mental illness, you will sadly know what I mean.
The Report refers to holistic care in a refreshing recognition of the importance of treating the whole person. So goes the saying, "All health starts with mental health". This being the case, why does our civilised society continue to place mental health at the bottom of the heap? It really makes no sense at all and yet it goes on regardless.
The key point here is that mental health is everybody's problem http://betweendenbighandkeele.blogspot.com/2013/07/mental-health-societys-problem.html
The statistics which underpin this are truly frightening. People with a long term mental illness will typically die 15 years earlier than those without a long term mental illness. The cause of death is usually physical with heart disease, respiratory disease and suicide being the main culprits. Smoking among people with mental health problems is rife and yet very few of them are accorded the same advice to stop. This is not because they don't want to stop smoking. This is as plain a health inequality as there is. We know that men are less likely to access their GP than women which explains why men under the age of 45 are particularly prone to dying from suicide. It is chilling to reflect that men tend to be very successful because of the extremes they go to.
Yet as I write this, acute beds for mental illness crises are still woefully inadequate and the talking therapies which are known to be of massive help remain painfully underfunded. And I look around me to see a national government intent on marginalising the vulnerable and local government doing likewise. When Enoch Powell made his Water Tower speech in 1961, he was ushering in the end of the institutionalised care epitomised by the Victorian Asylums. I wonder what he would think if he could see where we are today? Not because the Asylum model was right because it so obviously wasn't. But because the great hope of "Care in the Community" has done very little to address the one thing which so plagued the Asylums - stigma.
Funding to mental health services has dropped alarmingly in recent years but it is arguable that although funding remains important, the attitude of society is the real key. Only by talking about this and keeping it at the forefront of national debate will change come. Change will come but we would all be the richer if that change came sooner rather than later.
It would be good if the DWP also took account of Parity of Esteem since they appear to pay little attention to mental health issues.
ReplyDeleteI couldn't agree more. The current system has taken us back to a pre-Victorian position. If more people voted, I'm sure we wouldn't be faced with this nonsense.
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