Christmas is a time for joy, celebration and bringing together family and friends to share this merriment. While taking nothing away from this much needed festivity, spare a thought for those who are less advantaged – particularly those with mental health problems.
Mental illness transcends all ages and backgrounds. Almost one in four adults have a mental illness at some point in their lives, such as stress, anxiety, depression or psychosis.
An individual's emotional health can also have a great impact on physical health, and poor mental health can lead to problems such as alcohol and drug abuse.
And so, at a time when the rest of the nation is busy celebrating, there are many who just cannot, rather than will not, be able to do so because of their mental ill health. Indeed their inability to join in on the fun can exacerbate their isolation. The environment we live in plays a crucial role in the genesis of mental illness. Austerity is certainly not good for mental health; it affects those in lower income brackets, and those at particular risk of mental disorders, the hardest. Public spending cuts have hit some of the most vulnerable sections of society – those in receipt of social care or on pension credits, and disabled and unemployed people.
So where might someone go, if their mental health is failing? NHS commissioning for mental health services has been nothing short of a disaster and an abject failure in many places.
The Independent Mental Health Services Alliance found that high demand and mounting financial constraints has resulted in the average deficit of NHS mental health trusts increasing by 6.3% over the last two years. The King's Fund concluded in its analysis of services across England that around 40% of mental health trusts experienced a cut in income in 2013-14 and 2014-15.
A leaked report by a government taskforce uncovered the scale of the crisis in England's mental health services..
But here's the double whammy. In austere times, commissioners do not pump more money into the system; rather they tend to raid mental health budgets to plug the growing deficits in the acute hospital sector.
Despite the crucial importance of mental health services, they have always been the poor relation in any health system in general and the NHS in particular. These services, which are underfunded, demoralised and struggling with demand, are not to be seen and preferably not to be heard.
This may sound dramatic, but the reality is that there has been long-term neglect in addressing the many problems that most NHS mental services and their patients are faced with – access to timely appointments, access to local beds, services that are joined up and in one place like other NHS services are, and enough doctors and nurses in the system. The list goes on.
The scale of the mental health challenge has been underestimated. NHS England has set out its plan for achieving recommendations made in its Five Year Forward View for Mental Health (pdf) to improve mental healthcare by 2020-21. It has committed to transforming mental health services with an extra £1bn a year. Those at the coalface know this is yesterday's money – demand is ever increasing, and the historic deficit in funding can only be addressed if politicians and senior managers can have frank conversations.
Back to Christmas then. Though this is a challenging time for those with mental illnesses, statutory and voluntary organisations are there to support these individuals and therefore it is vitally important to ask for help.
Despite the pressures on the system, services are there for those who need urgent help or are facing a crisis – the doors won't close to them.
And for those with less serious issues, there are measures that can be taken without resorting to statutory and voluntary services. Family, friends and individuals can watch out for abnormal behaviour, such as panic attacks, and try to restore calmness by getting away from noisy, busy places and doing breathing exercises.
Avoid having an argument, the tension will almost certainly ease.
Finding a place for shelter, a warm meal, and ensuring youngsters are protected are not impossible goals, though at times it might seem like that.
Depression and stress can make one unnecessarily pessimistic, although simple measures such as not indulging in alcohol and drugs or spending within means can reduce the plight of those who are not in a good place.
An uplifted spirit will bring back that joy and hope, and trigger off a feelgood factor that can be the springboard to happiness. Good mental health brings with it a whole lot of goodies in Santa's stocking, because after all, physical fitness and wealth are meaningless without it. And let's hope Santa has something for struggling mental health services.