Addressing mental health care? – I’m often lost for words

It is only in the last five years that I have discovered I had been living with a side order of dyslexia for most of my life. My brain often struggles to transpose the words I read into the words I try to say. This is particularly the case with new words, or words used in a new context. For example, during the Covid pandemic, I would dread having to report at our Board meetings or ask questions about our ‘nosocomial’ infection rates. Likewise, during the recent junior doctors’ industrial action, at first, I struggled to find the correct way of saying ‘derogation’. With both these examples, I now have no problem remembering how to pronounce these words correctly.

Other words I habitually mispronounce. The most noticeable and most used, is ‘exponential’ – which I often insert a ‘d’ into, so it become ‘expodential’. Every time I do, J will gently remind me there is no ‘d’, and every time my mouth and brain become disconnected and ‘exponential’ become mangled once more. It is a shame, as it is a great word and in a rapidly changing turbulent world, it captures the speed and pace of change exceptionally well.

I was thinking about this as I read two different, but related reports last week. The first was The Lancet Neurology paper, the Global Burden of Disease, Injuries and Risk Factors which was published last week. You can find it here. The paper noted that globally, a range of neurological conditions as diverse in range as migraine, stroke, dementia and Parkinson’s disease is now the leading cause of ill-health. Although the report draws upon 2021 data, it is the most comprehensive study of its kind to date.

The report makes for a challenging and frightening read. The number of folk living with, and/or dying from disorders of the nervous system, has risen dramatically over the past 30 years. Almost unbelievably, some 34% of the world’s population (3.4 billion people) were affected in 2021. The rate continues to rise exponentially. In the UK, one in six people have some form of neurological condition. Nearly three million of this group live with the after-effects of a stroke or traumatic brain injury. My mother is one of the 944,000 people living with dementia. By 2030 (just six years away) this number is expected to rise to one million.

Today, the fastest growing neurological condition is the nerve damage cause by diabetes, perhaps reflecting the exponential rise in Type 2 diabetes; a statistic also reflecting the rise in folk living with obesity. Whilst for many of these conditions there is no cure, this is a great example demonstrating that many of these conditions are preventable. The report noted that modifying 18 risk factors over a person’s lifetime could reduce the number of people having a stroke, reduce the risk of early onset dementia, and tension-related headaches. Currently, the latter complaint, tension headaches, affect two billion people worldwide.

The most common causes of tension headaches include stress, sleep problems and a high caffeine intake. It is always good to be able to learn something new along the way, and writing this blog I discovered the paradoxical problem of taking painkillers too often or for a long time can result in headaches, called rebound headaches. So, perhaps save those paracetamol tablets for when you really need them. Tension headaches usually last no more than 30 minutes, and most folk should be able to carry on with their everyday activities.

The second report I read last week, published by the Department for Work and Pensions (DWP), set out the figures for folk, who have been deemed incapable of carrying out everyday activities, and importantly, are also unable to work, because they are living with a mental health problem. The DWP data showed that two million people are receiving universal credit health benefits, an exponential rise of 400,000 in just one year. Some 69% of these folk have been judged unfit for any work. The health assessments undertaken revealed some interesting, but also challenging facts.

Nearly 70% of all claims were for people who had mental and behavioural disorders. This compared to 48% of claims that also involved back and joint problems, and a fifth where there was heart disease noted as well. This is data that illustrates the growing (exponentially) problems faced by so many experiencing mental health problems who can’t work, but it fails to show what the impact might be on individuals, their families, and the communities they live in. What helps put this into perspective for me is the knowledge that there are nearly two million people on waiting lists for mental health treatment and care in England.

If access to effective mental health care was more readily available, many of these folk might be able to return to productive employment, which would be good for them and our wider economy. In 2023/24 the UK government spent over £265 billion on paying pensions and benefits, nearly half of which was in benefits. During the same period, the spend on health care was £245 billion. If nothing more is done to help those people, who can’t return to work for whatever reason, these costs will riseexponentially year after year. However, if nothing more is done, the real costs will be those faced by the many individuals who continue to not have their mental health needs met in an appropriate and timely way.