The Prime Minister won plaudits earlier this month for speaking out on the issue of mental health, and the need to do more. But with the Conservative manifesto being released last week, a subtle but very significant withdrawal on one of Theresa May's promises seems to have gone unnoticed.
On the 7th of May, the Prime Minister pledged to replace the outdated Mental Health Act, introduce mental health into the schools curriculum, and appoint 10,000 more mental health staff to the NHS.
The Conservative manifesto released last week refers to each of these areas, but, crucially, it only promises to recruit "up to" 10,000 mental health staff. A Conservative government could technically appoint just one more mental health professional over the next three years and still fulfil this pledge, something that would be disastrous for a country that has faced increasing pressure on mental health services.
It may seem pedantic, but this rewording makes the recruitment figure an aspiration rather than a promise. The significance of this can be best understood by considering the Conservative party's recent track record when it comes to delivering on commitments to mental health.
The 2015 Conservative manifesto promised to increase mental health funding, ensure that there are adequate numbers of therapists "in every part of the country", and "continue to take your mental health as seriously as your physical health".
According to the King's Fund, in 2015-2016, 40% of UK mental health trusts saw their budgets cut, and in March of this year, it emerged that £800million set aside for mental health services was being redirected to other areas of the NHS. A number of clinical commissioning groups also announced cuts in mental health spending in April. Despite Conservative claims that legislation had ensured equal priority between mental and physical health, a report from the independent Mental Health Taskforce last year confirmed that there continues to be a disparity between mental and physical health services, in part due to the absence of maximum waiting times for mental health services.
Although Theresa May was home secretary and then Prime Minister during this period, it would perhaps be unfair to conflate her commitment to mental health with that of the Conservative party and previous leadership's failings. But the fact that the 2017 manifesto does not support the recruitment pledge that she made just a few days before the manifesto was released should be a huge warning sign.
If we consider her own voting record, Theresa May has a checkered history when it comes to matters of health and welfare. May voted against disability and welfare benefits and guaranteed jobs for the unemployed, affecting groups at heightened risk of mental illness. May also voted in favour of tuition fee rises that heaped financial pressure on students, adding fuel to concerns about mental health on campuses.
Theresa May has been known to change her mind on certain social and welfare issues, such as with gay rights, but her refusal to rule out cuts to disability benefits, and controversy over the 'dementia tax', do nothing to suggest that she has great concern for segments of society especially affected by poor mental health.
Despite cause for skepticism, there are several promises in the Conservative manifesto that are mildly encouraging. The manifesto pledges to provide mental health first aid training to teachers in every primary and secondary school, alongside mental health education for all children. It also promises to train a million members of the public in "basic mental health awareness and first aid". Unfortunately these are only half measures.
While 'basic mental health awareness' may encourage help-seeking, without a substantial increase in NHS mental health staff, a rise in the number of people seeking professional help is likely to lead to longer waiting lists for those most in need and a deterioration in the quality of professional care.