1. UNEQUAL TREATMENT Current experiences of physical health issues of people with mental health problems and mental illness

2. The Cost of Inequality The Equality Trust The UK has the second highest level of inequality of the developed OECD countries. The social and economic impact of inequality costs the UK the equivalent over £39 billion every year. 2012 report estimates that if inequality was reduced to the average level seen in these countries, the UK could expect to: Increase average healthy life expectancy by 8 and a half months, at a value of £12.5 billion Reduce mental health illness rates by 5 per cent, at a value of £25 billion Imprison 37 per cent fewer people, at a value of £1 billion Experience 33 per cent fewer murders, at a value of £678 million The cost of dealing with social issues associated with the UK’s high inequality has been estimated at £39,312,152,414. If this was broken down to an individual level, it would show that the impact of inequality on every man, woman and child is the equivalent of £622.

3. Mental Health - Cost of Inequality in England Reducing inequality would improve people’s mental health by five per cent, valued at £24,935,601,739. The wider economic cost of mental illness in England is estimated to be £105.2 billion each year. This includes direct costs of services, lost productivity at work, and reduced quality of life. The cost of poor mental health to businesses is just over £1,000 per employee per year, or almost £26 billion across the UK economy. In 2008/9, the NHS spent 10.8% of its annual secondary healthcare budget on mental health services, which amounted to £10.4 billion. Service costs, which include NHS, social costs, and informal care costs mounted to £22.5 billion in 2007 in England.

4. Fairer Scotland? Public Health Messages Policy Agenda – Rights Agenda Deep End

5. Support in Mind Scotland Survey – What should we do? 100 returns – people with lived experience of serious mental illness and family members Most experienced more than one condition – including anxiety and depression 46% live with schizophrenia Testing: 1.Lifestyle factors 2.Access to health care 3.Carers’ Health + Carers’ perceptions of relative’s health

6. Living with day to day symptoms Stress and side effects of anti-psychotic medication mean I put on a lot of weight. Smoke excessively due to stress/anxiety/depression and get out of breath cough up catarrh, general aches and pains fatigue; tinnitus; do not have energy motivation to cook eat properly or do housework care for myself adequately involuntary movements and articulations; headaches - all of them at once! Sometimes I can't walk or talk very well, I am awful slow at thinking and doing all those things, some days I am better than others, so I take a day at a time, and thank God.

7. Living with day to day symptoms Don't have much of a life. Feel controlled by illness, medications and authorities. Can't learn to drive because of my medications. Don’t feel very fit. Persistent tiredness. If I am doing a physical job like cleaning then I feel exhausted after half an hour. I normally go to sleep at 7 pm and sleep for 12 hours. Bad habits caused by my illness can cause problems such as ear infections due to poking my ears with my spectacle legs compulsively.

8. Living with day to day symptoms I take a lot of medication and reel very lethargic. However the reason I am feeling so good is because I managed to stop smoking a year ago with the help of the NHS group and smoke line and breathing space and ECC. My main problem wit healthiest sometimes neglecting to eat properly and eating takeaways as organisation and home cooking is difficult for me with my illness I often feel so low, I self medicate with alcohol

9. Bringing about change Health promoting activities? “This reflects one of public health’s most difficult dilemmas: unless consciously designed not to, policies and actions that work for populations as a whole often inadvertently entrench inequalities.” (MHF reflecting on a Kings Fund Report into the fact that as lifestyle risk behaviours fall in the general population it is amongst higher socio-economic groups only – further exacerbating health inequalities)

10. Bringing about Change Societal shift “A critique of the health behaviour approach is that the focus is on blaming the most disadvantaged and changing their behaviour rather than seeking to create – through better social and financial environments - the conditions that enable individuals and communities to have more control over their health and wellbeing “(Gamsu, 2012).

11. Accessing Health Care – The Carer’s Perspective I would improve the GP Appointment system A more comprehensive health check to be offered to both would maybe pick up on the neglected areas. There is a tendency to offer checks for the more obvious symptoms only Build in separate appointments for carers automatically. Be more proactive In my experience most health professionals are not really concerned about side effects of psychotic medications ….they are only concerned with keeping psychosis at bay.

12. Accessing Health Care

13. Health Professional Support Service User Chart 1 Carer Chart 2 Rating 1 (very poor) 23456789 10 (excellent) % 1.95.93.9013.79.813.729.413.77.8 Rating 1 (very poor) 23456789 10 (excellent) % 16.79.502.414.39.54.819 4.8

14. View of Professionals “My son’s mental health professionals have never asked or talked about the impact of caring because they don’t always liaise with me – only in times of extreme crisis.” “Confidentiality usually prevents me from talking about my daughter. It depends on the situation and the professional at the time”

15. Addressing the issues? Routine annual physical checks for both person and the carer – as a matter of routine Check overall physical wellbeing – side effects are most debilitating feature of people’s lives in our survey Relatives are critical to people accessing health care – yet they are excluded from most decisions

16. What did our members want us to do? Connect people into their communities Raise awareness of the issues Lobby for change Develop a Healthy Living Strategy (range of activities promoting healthy lifestyles)

17. And the results are….

18. Top 8 (over 60%) Talk to politicians about wider social issues and lobby for change (73%/68%) Support people to get joined up healthcare (71%/66%) Recruit buddies or peers to help people to access facilities (65%/68%) Negotiate free or cheap use of facilities like gyms (61%/71%) Run physical activity groups (65%/63%) Awareness raising and training for GPs (59%/68%) Taster sessions of new activities (61%/63%) Inform NHS about poor quality services (57%/66%)