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Mental health: neglected in the UK
Editorial
Science Photo Library
Mental health: neglected in the UK
See Comment page 112 See Special Report pages 117, 119, 121, and 123 See Perspectives page 127
For the Department of Health survey see http://www.dh.gov. uk/en/Publicationsandstatistics/ Publications/Publications Statistics/DH_076516
In this week’s Special Report, The Lancet publishes a series of features that take the pulse of mental health in the UK. The reports show that all is not well. The controversial Mental Health Bill was finally passed by the House of Commons on July 4. Although there have certainly been positive developments—for example, the Bill now protects children from being put on adult wards—some critics are concerned that the legislation will infringe the rights of people with mental illness. According to the second Special Report, currently, too many wards are at best untherapeutic and at worse unsafe. Access to psychological treatment is pitiful in inpatient care and in the community, despite the National Institute of Health and Clinical Excellence recommending that cognitive behavioural therapy is made available on the National Health Service (NHS). The Government’s 2007 Comprehensive Spending Review, due out in October, must provide the funds to make this recommendation a reality for adults and children. Cases of anxiety and depression in children in the UK have risen by 70% over
the past 25 years. The Government’s ambitious goal—to provide 2500 children’s health centres across the country by spring 2008—will go some way towards ensuring that the next generation is happier and healthier. Worryingly, however, these children might be growing up in an environment that is more hostile to people with mental-health problems. On July 6, a survey from the UK’s Department of Health found that fewer of the general public in England favour a more tolerant attitude to people with mental illness than in 1994. This opinion is unsurprising. Mental illnesses are not perceived to be as serious as physical ones—by the public and Government alike. Mental-health services are usually the first to be cut if the NHS is in deficit, despite the fact that one in four people in the UK will be affected by a mental-health problem over their lifetime. Ultimately, turning the tide of stigma and neglect that faces many people with mental ill-health in the UK will require a substantial shift in public and ministerial attitudes. ■ The Lancet
Will China ever come clean?
Reuters
The printed journal includes an image merely for illustration
For the Cost of Pollution report see http://tinyurl.com/2qh94g
104
The international health community rolled its eyes in exasperation last week as reports emerged of another cover-up by the Chinese Government. The UK newspaper The Financial Times was the first to report that Chinese officials had censored a preliminary World Bank report on the cost of pollution in China. The authorities apparently insisted on the removal of estimates that 750 000 people each year die prematurely in China as a result of air and water pollution, because they feared that the statistics would cause social unrest. The World Bank acknowledged that this version of the report, released at a conference in March, did not “include all of the issues under discussion”, but stressed that the final version is yet to be agreed. The Chinese Government deny the allegation of suppression. China’s history of secrecy does not lend the country’s leaders the benefit of the doubt. The country has been widely and repeatedly criticised for initially denying having an HIV/AIDS problem in the 1990s and for its woeful reluctance to share details of the outbreak of severe acute respiratory syndrome in 2003, thereby putting the rest of the world at risk. Yet what is more disturbing
about this latest allegation is that the international community had hoped that China had entered a new era of openness—The Lancet has previously praised China’s willingness to share samples of tissue infected with the H5N1 avian influenza virus. And, with the appointment of Margaret Chan as the first Chinese Director-General of WHO, hopes were further raised that China would accept a policy of transparency. On taking office in January, 2007, Chan pledged her commitment to a global initiative to “collect, collate and disseminate data on priority health problems”. It would seem that this message has yet to reach her home country. The Chinese Government should prioritise the health of its people above a desire for a spotless international reputation. It must have the courage to openly admit the public-health consequences of its overpopulated and polluted cities. Moreover, as recent history has shown, censorship of vital health statistics is counterproductive. As the ancient Chinese proverb states, “The more you try to cover things up, the more exposed they will be”. ■ The Lancet www.thelancet.com Vol 370 July 14, 2007
Science Photo Library
Mental health: neglected in the UK
See Comment page 112 See Special Report pages 117, 119, 121, and 123 See Perspectives page 127
For the Department of Health survey see http://www.dh.gov. uk/en/Publicationsandstatistics/ Publications/Publications Statistics/DH_076516
In this week’s Special Report, The Lancet publishes a series of features that take the pulse of mental health in the UK. The reports show that all is not well. The controversial Mental Health Bill was finally passed by the House of Commons on July 4. Although there have certainly been positive developments—for example, the Bill now protects children from being put on adult wards—some critics are concerned that the legislation will infringe the rights of people with mental illness. According to the second Special Report, currently, too many wards are at best untherapeutic and at worse unsafe. Access to psychological treatment is pitiful in inpatient care and in the community, despite the National Institute of Health and Clinical Excellence recommending that cognitive behavioural therapy is made available on the National Health Service (NHS). The Government’s 2007 Comprehensive Spending Review, due out in October, must provide the funds to make this recommendation a reality for adults and children. Cases of anxiety and depression in children in the UK have risen by 70% over
the past 25 years. The Government’s ambitious goal—to provide 2500 children’s health centres across the country by spring 2008—will go some way towards ensuring that the next generation is happier and healthier. Worryingly, however, these children might be growing up in an environment that is more hostile to people with mental-health problems. On July 6, a survey from the UK’s Department of Health found that fewer of the general public in England favour a more tolerant attitude to people with mental illness than in 1994. This opinion is unsurprising. Mental illnesses are not perceived to be as serious as physical ones—by the public and Government alike. Mental-health services are usually the first to be cut if the NHS is in deficit, despite the fact that one in four people in the UK will be affected by a mental-health problem over their lifetime. Ultimately, turning the tide of stigma and neglect that faces many people with mental ill-health in the UK will require a substantial shift in public and ministerial attitudes. ■ The Lancet
Will China ever come clean?
Reuters
The printed journal includes an image merely for illustration
For the Cost of Pollution report see http://tinyurl.com/2qh94g
104
The international health community rolled its eyes in exasperation last week as reports emerged of another cover-up by the Chinese Government. The UK newspaper The Financial Times was the first to report that Chinese officials had censored a preliminary World Bank report on the cost of pollution in China. The authorities apparently insisted on the removal of estimates that 750 000 people each year die prematurely in China as a result of air and water pollution, because they feared that the statistics would cause social unrest. The World Bank acknowledged that this version of the report, released at a conference in March, did not “include all of the issues under discussion”, but stressed that the final version is yet to be agreed. The Chinese Government deny the allegation of suppression. China’s history of secrecy does not lend the country’s leaders the benefit of the doubt. The country has been widely and repeatedly criticised for initially denying having an HIV/AIDS problem in the 1990s and for its woeful reluctance to share details of the outbreak of severe acute respiratory syndrome in 2003, thereby putting the rest of the world at risk. Yet what is more disturbing
about this latest allegation is that the international community had hoped that China had entered a new era of openness—The Lancet has previously praised China’s willingness to share samples of tissue infected with the H5N1 avian influenza virus. And, with the appointment of Margaret Chan as the first Chinese Director-General of WHO, hopes were further raised that China would accept a policy of transparency. On taking office in January, 2007, Chan pledged her commitment to a global initiative to “collect, collate and disseminate data on priority health problems”. It would seem that this message has yet to reach her home country. The Chinese Government should prioritise the health of its people above a desire for a spotless international reputation. It must have the courage to openly admit the public-health consequences of its overpopulated and polluted cities. Moreover, as recent history has shown, censorship of vital health statistics is counterproductive. As the ancient Chinese proverb states, “The more you try to cover things up, the more exposed they will be”. ■ The Lancet www.thelancet.com Vol 370 July 14, 2007