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Mary Wakefield

Why do we ignore the real mental health crisis?

21 September 2019

9:00 AM

21 September 2019

9:00 AM

When I first moved to London N1  four years ago, no one seemed to notice let alone discuss all the children stabbed to death in our neighbourhood. Boys from the local estates were hacking each other to pieces quite regularly, but middle-class N1 barely blinked. It was as if these two groups were, and still are, invisible to each other, though living cheek by jowl.

Four years later, it seems to me that there’s another set of players, just as isolated from the rest. Let’s call them the screaming souls in Hell.

They’re everywhere once you notice them, men and women suffering from some form of psychosis, usually homeless or on the edge of homelessness.

Everyone talks about mental health these days — for better and perhaps for worse. The young are triggered and traumatised; their parents not just busy but suffering from stress. No one much mentions the homeless and clinically ill — the paranoid, the depressed, the schizophrenics just wandering about untreated.

At the weekend, by the new juice bar, a case in point: a middle-aged man, well-groomed but with the sort of rucksack that sometimes marks out the homeless. Out of nowhere he started yelling: hoarse cries repeated every few seconds. On and on he went. The two girls waiting in the juice bar queue took it in their stride. Scream. ‘Have you tried the cold-pressed carrot shot?’ Scream. ‘No, yeah, I prefer turmeric.’ Scream.


In the park, a few hundred metres away, a younger man was lying on a wooden bench, staring at some hallucinated horror in the middle distance. Every so often he gave a terrified shriek. ‘Is he all right?’ asked my son. Just bad dreams, I said, as we joined the stream of passers-by all looking fixedly at a point just to the right of shrieker. Don’t look, don’t tell. Don’t let the crazy man see you staring. You get the hang of tactical blindness in the end. And I don’t think I’d have even remembered those Saturday screamers were it not for the third man.

On the way home we sidetracked into the local church to kill time in the play area. In-evitably, somehow, the swing doors punched open and through them rushed a barefoot forty-something, bent forward at the waist and shouting at some unseen enemy as he made for the donations box. I think of myself as someone who stays calm; treats each human with respect. So I leapt for my son, muttering ‘Homeless addict… spice zombie… might have a knife,’ and began to edge towards the outside door. But the man reached the door before me, stopped, turned and said: ‘Don’t be frightened.’ Then, inexplicably: ‘You’re a good person.’

Back when I was a child I remember the adults saying: ‘Don’t worry, he’s just a junkie.’ That magic phrase excused us from any further angst: these people bring it on themselves. Of course the homeless are on drugs. Of course they drink — why wouldn’t they? If you find it hard to resist an early evening G&T, how much more do they need a mental break? And crack’s cheap as chips these days — almost literally I think.

A few years ago I had a brief half–argument with the great Peter Hitchens when he came here for a debate about drugs. His position was that giving up a habit was relatively easy — that too much is made of the pain of going cold turkey. But what if your day-to-day life is mental torture, I wanted to know. However technically addictive a drug might be, isn’t the real temptation just to make the pain go away? This was not, according to Hitchens, an interesting point. I think it’s unarguable.

It’s impossible, in the 21st century, to escape the deadly language of ‘intersectionality’. You can tot up your disadvantages, so the theory goes, to calculate how oppressed you are. If you’re black and a woman, for example, you can score more oppression points than if you’re just one or the other. But what if, black or white, you’re the child of addicts, abused as a baby, raised in care, now homeless and suicidal? Intersect that.

There’s no saying which came first: the street-sleeping, the mental health issues or the addiction. As Adam Holloway pointed out in this magazine three weeks ago, these issues twist together. ‘Street homelessness is for the most part, a symptom or consequence of a different problem: addiction to drink or drugs, or mental illness. If politicians want to deal with it, they must accept this.’

The latest report shows that 50 per cent of all men and women who sleep rough in London have mental health problems, and when you factor out the rough-sleepers who have come here looking for work (mostly from central and eastern Europe) that number rises to 60 per cent. In Oxford, one survey found that 76 per cent of the women sleeping rough had a ‘mental health need’. It’s not at all surprising that the screamers so often end up in prison. On Monday this week Tom Winsor, the Chief Inspector of Constabulary, admitted that ‘very high proportions of the prison population have severe and chronic mental ill health intensified by years without diagnosis or treatment. And many feel hopeless, lost and abused, and that no one has or ever will care. They believe they have nothing to lose.’

Odd though it may seem in these hateful times, help is at hand. When I called St Mungo’s to find out the extent of the problem, they sent back unexpected good news. Yes, there are more street-sleepers and more mental illness, but no, it’s not being ignored. Last month, they said, the NHS Mental Health Implementation Plan was published, which promises £30 million for exactly the sort of specialist early intervention that’s needed. There will be support workers on hand who understand trauma, addiction and psychosis. Though N1 might be oblivious, for once SW1 looks like it’s on the case. ‘So don’t present this as a dismal story,’ said St Mungo’s, ‘because it’s not.’


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