After working in her field for 30 years, this psychiatric-nurse-turned-counsellor knows the danger of austerity

I have worked in the health and social care sector for over thirty years. Throughout this period, I have witnessed first-hand the steady decline of health and social care provision in my locality. Worryingly, this observed deterioration currently appears to be accelerating at an alarming rate.

My first encounter with health and social care began when I trained as a psychiatric nurse in 1984. At this time, there was a radical shift in mental health service provision with the aim of transferring people with long-term mental illness from institutions into forms of care in the community. This ideology has failed on many levels. There are large numbers of people with mental health conditions who are not able to access the services and treatment that they need. Individuals with severe mental health issues are ending up in A&E wards because of “system failure”.

Everyone should be able to get access to a hospital bed close to home whenever they need it. This should be viewed as a human rights issue. However, because there are a lack of beds in mental health wards, people are being transported to different areas of the country in order to be admitted.

The unfortunate consequences of such inadequate service provision means that the most disenfranchised people in society are now more at risk than ever. They do not get the care they need, and thus they are often a danger to themselves, and sometimes to others. The gradual move away from a more collective society is resulting in punitive outcomes for many of its people.

Following my psychiatric nurse training, my next period of learning involved studying for a BSc Hons degree in Public Health. This is where my political activism really took hold. The content and direction of this subject covered the impact of “health inequality” and highlighted how systemic failure of health and social care service provision impacts on the very poor and disadvantaged.

Since obtaining my degree, I have worked in the community for many years, holding several jobs that have involved working in moderately to severely deprived ward areas. Wolverhampton is a city made up of 20 wards and many of these are severely deprived, so I have witnessed the plight of the disadvantaged continually. Income inequality acts to disempower individuals and families by way of stigmatisation and alienation, as well as materially. This was, and still is, visible on a daily basis in this city.

The less wealthy are more predisposed to societal problems, such as increased teenage pregnancy, unemployment, mental health issues, crime, etc. The list goes on and on. My observations since the inception of a Conservative-led government have led me to conclude that the problems encountered by the dispossessed are increasing exponentially and becoming more prevalent in areas of severe deprivation.

On a day to day basis, I witness further societal fragmentation and decline. I understand the complex facets of mental health because my training has equipped me with this understanding and knowledge. The increase of mental illness is, in my opinion, unprecedented. Many people do not seek medical treatment for a variety of reasons; homelessness, stigma and disempowerment are all contributory factors along with many other variables. Ultimately, this is having a catastrophic impact on individuals, families and communities, with inadequate public service provision being the main culprit. Public service provision has been diminishing for many years and cuts to services are more austere now than they’ve ever been. This is having a devastating impact for those people who are caught up in a cycle of poverty and neglect.

To conclude, I feel that while austerity measures are becoming ever more severe and further cuts are being made, the overall impact for those most in need is absolutely shocking. Societal breakdown is a very provocative term to use but it seems to me now, that while we are living under our current governing system, this outcome is inevitable. It will have dire consequences for everyone but particularly for those who are most disenfranchised. These findings are not the result of rigorous research but are based on personal experience.