Predicting which constituencies and demographics will be crucial in shaping the election outcome has been one of the key discussion points this campaign. After the so-called ‘Youthquake’ of 2017, the emphasis has fallen on the younger generations once again being a hugely influential faction. While there are estimated to be 20 universities across Great Britain where the student vote could swing the election, a less talked about demographic, the mental health service users, could be even greater.
Based on 2017 voting figures, there are 43 constituencies in England alone in which mental health service users could tip the balance on December 12. Figures from NHS Digital show that almost 900,000 people in England are in contact with adult mental health services every month, meaning that, from Southampton Itchen (a constituency with a 31 vote marginal) all the way up to Blackpool North (with a margin of 2,023 votes), the service user vote could play a vital role in 2019.
Only patients convicted of committing a criminal offence cannot vote – patients on a community treatment order, under civil sections, those who are voluntary, and prisoners remanded to hospitals are all eligible to vote. Any detained patients can request for a Section 17 to leave a hospital and vote, or are also able to vote by post or by proxy.
Despite the significant numbers in this group and mental health rising up the public and political agenda in recent years, it has largely been ignored as an issue this election. Liz, a service user in North East Cambridgeshire, tells Dazed that she has felt that despite the focus on the NHS, mental health has been largely sidelined: “Mental health services are all to often seen through the lens of a tragedy,” Liz says. “And as politicians communicate their intentions with the general public through the populist issues of the day they fail to recognise there is a very dangerous disparity of care, especially in waiting times and the sheer lack of services, specialised or otherwise.”
This has played out in North East Cambridgeshire with the closure of a day centre, which offered “companionship, help, and support”, due to funding cutbacks. Though pressed on the issue over the last six years, local Conservative MP Steve Barclay has remained silent.
Anna, who lives in Hammersmith, was left waiting nine and a half months between GP referral and starting treatment in 2017, which only worsened her illness. She has similarly been disappointed by candidates in her constituency’s focus on mental health. “(I’ve asked) how they intend to address the extensive waiting times for adult mental health services but received no response. Previous interactions with my MP (Andy Slaughter) about this and other issues have been dismissed or minimised, with Brexit being used as an excuse for lack of action on healthcare and housing issues.”
“Mental health services are all to often seen through the lens of a tragedy”
Both Liz and Anna are registered to vote, and intend to vote Labour due to the party’s strong commitment to taking action on waiting times, as well as its pledge to properly fund the NHS and mental health services. This is set to be one of the most important elections in a generation, but unfortunately Liz and Anna may find themselves in the minority of service users who will have their voice heard.
A survey from the mental health charity Rethink found that 25 per cent of respondents with mental health problems found it either difficult or very difficult to register to vote. Though the survey didn’t explore the reasons behind this, there are undoubtedly many. Digital exclusion is more prevalent among those with mental health difficulties, poor mental health can make forms and paperwork a challenge, and voting just might not be a priority during severe mental distress. Healthcare professionals could provide necessary assistance to many of these people, but there are next to no formal procedures in place in services to actively encourage this.
A Freedom of Information request this writer submitted found that only 21 per cent of England’s NHS Mental Health Trusts had any policy in place to support service users to register to vote, apply for postal or proxy votes or make it to the polling booth on election day. The situation is even worse in Scotland and Wales, where not a single health board or local health board has any policy in place to support service users to vote.
What this means in practice is that for many of the staff in services run by these trusts, guidance and clarity on what falls under the remit of their role simply isn’t there. South London and Maudsley NHS Foundation Trust, one of the largest trusts, employs over 4,000 staff to provide 230 services to a local population of 1.3 million, but without policy in place, competing priorities for staff on polling day may mean providing support to vote is bumped off the list entirely. Central North West London Mental Health Trust is a rare exception, holding a voting rights policy that has been co-produced with service users and other key stakeholders.
For many of the adults accessing these services, they could potentially call on friends or family if needed to make it to the polling station, but for inpatients in mental health units, healthcare professionals should be playing a vital role. In the 2010 general election, turnout was 65 per cent, but for inpatients it was estimated to be as low as 14 per cent. A 2012 study of inpatients in Westminster – a crucial seat for 2019 – found that, compared to the population in the area, they were half as likely to be registered to vote, but even more worrying; 48 per cent didn’t realise they could vote at all.
Much of the focus during this election to improve turnout has been on encouraging young people and students to vote (latest polls indicate over half of 18-24s are ‘absolutely certain to vote’ – up 20 per cent since the election was called – suggesting these efforts are working), but it’s clear at all points the barriers to getting out to vote are much higher among service users.
“So many of the issues central to this election are things that disproportionately impact vulnerable people – just look at austerity’s impact on disabled people” – Emily Reynolds, mental health campaigner
Activists behind the Mental Health Vote 2019 campaign are working to address the lack of information and support available. Emily Reynolds, the founder of the campaign, was inspired by efforts made during the 2018 Irish referendum on abortion laws to encourage everyone eligible to vote. Once the election was called on October 30, she wanted to make sure that service users would not be disenfranchised simply for experiencing mental distress on election day. “So many of the issues central to this election are things that disproportionately impact vulnerable people – just look at austerity’s impact on disabled people – so I wanted to make sure as many people as possible were able to have their say” Reynolds tells Dazed.
Alongside other activists, Reynolds has co-produced non-partisan information resources for service users and staff, and had conversations with staff about how they can play their part in getting out the vote. It has been received positively by many: “On the whole, it’s been really supportive – largely, people have actually just been surprised. I spoke with several people who had no idea they would have been able to vote when they were in hospital – they were all pretty regretful that they hadn’t known.
There was also a good uptake on the campaign from staff, though I did notice that whilst a lot of individuals were very keen to get the information out there, they didn’t know what the protocol was for doing it within their places of work.”
Recovery colleges, housing associations that provide supported accommodation, as well as mental health units are all now displaying voter information and having conversations with service users about what plans could be put in place to enable them to vote on December 12.
We pride ourselves as a society by saying we are getting better at talking about mental health, but it’s conversations like these that really matter to ensure mental health service users are given the opportunity to use their voice in the ballot box and have it heard. This election is too important for them not to.