All Crazy Now – Mental Healthcare In The UK

By: Andrew_McKillop

Post Traumatic Stress Disorder
Returning to the UK, more exactly Scotland after many years in France I could call this a move from TSD Land to PTSD Land and the facts and figures back that claim. France like all other aging or mature democracies such as the UK is struggling with the unstoppable growth of Altzheimer's disease victims, with the curve suggesting the incidence of this disease will be claiming 750 000 new victims per year by the 2020s. Also having a fast-growing (by EU standards) population and a growing number of childhood cancer victims, as well as adult victims, the French national health spending implications are somber, but what happens to surviving victims of Altzheimer's disease, the treatement of which is improving and extending life expectancy of victims? In Britain, a UK Medical Research Council report of late October provides some of the answers.

The UK annual budget deficit and therefore “borrowing requirement” placed at around 75 billion pounds for 2014-15 are employed almost daily in the Westminster verbal fistfight between the Tory-Liberal Democrat governing coalition and the opposition Labour party which seems to have definitively dropped its “New Labour” label of a few years ago. In any case Labour, if it surprisingly gets back to power in next year's general elections will have to fill the spending gap on the politically stressful subject of the UK National Health Service.

This is now the English NHS which definitely does not include the Scottish NHS. Devolution happened already for national healthcare spending, and a rare subject of agreement of the Tory-Lib Dem-Labour parties is that Scotland made a dangerous and irresponsible spending pledge on its own NHS, possibly meaning that Scotland will have to borrow or tax another 5 billion pounds  a year by 2020. Scaled on a population basis this would be equivalent to England's NHS needing an extra 50 billion pounds a year  The UK Health minister speaking about his English NHS, says that if the Tory health reforms are adopted by “whatever government follows us next year” England's health spending would only have to find another 8 billion pounds a year by 2019-20.

Dementia and Schizophrenia
Post-Altzheimer's dementia is the whistle blown by the Medical Research Council following a long term survey of about 2 milllion persons. Medically (or epidemiologically), mental stress has moved on in recent years. Once upon a time cancers were the major threat to future health budgets of countries with NHS systems like the UK, and for private health insurers in other countries, but Britain like several other aging developing countries now also has a fast-growing number of dementia victims as the sequel to Altzheimer's disease.

Long term survivors of Altzheimer's face increasing dementia, sometimes called undifferentiated dementia. This was a major study subject for psychologists like Eugen Bleuler, the first to define schizophrenia almost exactly 100 years ago, who argued that undifferentiated dementia can include a range of “paired states” of schizophrenia, like paranoia-megalomania, but a possible shift from then-unknown Altzheimer's disease, to dementia, was not taken into consideration. Reasons of the time included much shorter life expectancies.

The threat to British health and healthcare spending needs now includes post-Altzheimer's dementia without the possibly more-treatable schizophremic condition intervening. As some media accounts noted, dementia is moving like Altzheimer's disease steadily down the age ranges, now quite often affecting persons in the 45-60 years age bracket. Social health trauma now includes three poorly-known and hard to treat clinical and sociobiological conditions – schizophrenia, Altzheimer's, and dementia. For the UK MRC this healthcare threat, and its usually very late diagnosis = making treatment more costly and less effective – must be taken at least as seriously as the cancers.

All these medical conditions have some common features such as chronic forgetfulness and the inability to accept the notion of time and therefore the changes brought about by time, making the future either inexistent or fear-laden because it is unknowable. This is also a low-level but widely spread social stress factor shown by a visit to any large bookstore in the UK. Among the non-fiction works in the History section as much as a half of the new and best-selling books are about why or how World War I happened, and in the economics and current affairs category the 2008 financial crisis “for Dummies” is treated by a large range of authors. Almost none of these works say “it can't ever happen again” but even worse, plenty say we can't predict these things so how can we prevent them?

This also applies to non-senile dementia/ At least until recently few medical specialists thought there might be links between dementia, Altzheimer's and schizophrenia over time and through different stages of perhaps the same syndrome, with powerful and dangerous implications for public health. Likewise the study of schizophrenia has significantly moved away from the “iatrogenic theory” of mainly biomedical and medication causes or triggers to the many environmental  social and cultural causes of this increasing illness. Loss of formerly consensual values in society summarized by what philosophers call our ontological and epistemological crisis – and the loss of values can be individual or social, religious, political or other.

The UK MRC's report on the coming major British healthcare challenge of dementia, with forecasts of new annual victims extending into the hundreds of thousands by the 2020s, steered away from linking this new public health threat with culltural and moral erosion, or the “deletion of social paradigms” but as already noted did not favour the “iatrogenic theory” of mainly biomedical, neorobiological and biochemical causes, a diagnostic and treatment route that has only had qualified successes with schizophrenia and Altzheimer's disease. As we know, the paradigms circulating in society are the simplest and most condensed building blocks of society. Losing contact with these values, or denying and “de-learning” them obviously damages the individual and society because these values are integral and basic to the existence of the individual in society – they are the  “packages of values” which structure society and civilization.

Uncertain Remedies
In the UK, early diagnosis of various forms and types of cancers has now become politicized, with the UK Labour party making it an election pledge, claiming it can obtain the additional 2 billion pounds a year needed to bring down average waiting times for screening results to a few days rather than weeks or months. But as the UK MRC noted in its late October report on dementia, almost nothing exists at present in the UK for the diagnosis of the disease, leaving it up to individual sufferers, their families and friends or family doctor to take the first action.  

Like Altzheimer's, dementia is very long-term and less amenable to treatment that certain types of schizophrenia. Even the existence of the disease has a more powerful stigma attached to it than cancer which is now “socially acceptable”. The UK MRC report noted this serious handicap in coming to grips with the very rapid and almost certainly unstoppable growth in the number of British victims because the attached stigma is driven by social confusion as to what the disease means, and fear among the families of victims that dementia is a mainly hereditary condition.

One frequent complaint of dementia victims is they are accused by society, or groups in society of seeking to “evade” or “escape” from reality, meaning society. This is a common feature of schizophrenia with an often intense rejection of time and the future, but in a diluted form this is a major method of “evading society” and the denial of both the past and the future is now a feature of “the public mind” in western society.

Manipulating “the historical narrative” to re-create the past, while denying the future due to fear of the future, confusion and disorientation, is also conflated with or added to the antique and well known social-cultural myth of “eternal return”. Return to a mythical golden past is preferred, as the destination of time travel, rather than a cold and uninviting future. Some dementia sufferers profiled in British media at the time of the MRC report said they had been accused by the malevolent or uncaring of “dreaming about golden ages”, to explain their observed forgetfulness and disorientation.

The essential point is that western concepts of time and history are value-based as much as empirical or facts-based, which lends a little credence to Francis Furukawa's “death of history” theory. Certainly not used by him in his theory, the damage or destruction of western society's values may well have also damaged western conceptions of history. It was urgent not to know., but thn the syndrome moved on to not being able to know. To be sure, the UK health debate on growing dementia will avoid analysis of “paradigm failure” and the escape from reality, as additiona generators of the growing mental health problem, but we can suggest they have a major role.

By Andrew McKillop

Contact: xtran9@gmail.com

Former chief policy analyst, Division A Policy, DG XVII Energy, European Commission. Andrew McKillop Biographic Highlights

Co-author 'The Doomsday Machine', Palgrave Macmillan USA, 2012

Andrew McKillop has more than 30 years experience in the energy, economic and finance domains. Trained at London UK’s University College, he has had specially long experience of energy policy, project administration and the development and financing of alternate energy. This included his role of in-house Expert on Policy and Programming at the DG XVII-Energy of the European Commission, Director of Information of the OAPEC technology transfer subsidiary, AREC and researcher for UN agencies including the ILO.

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