"We are hiring 2 new roles called Lived Experience Experts to work with BIHR.
The role is to be a consultant to work with BIHR on our new project to look after human rights in mental health inpatient services for children and young people.
The project will involve training and workshops for:
staff working in children's and young people’s inpatient mental health units in England
people accessing these services, their families, carers and supporters.
This is part of a new project NHS England has asked us to run. They are paying for this project.
For this role you must have experience of children's and young people’s inpatient mental health services. This experience could be:
from when you were a child or young person
you may be a parent, carer or close supporter of a child or young person who has accessed these services.
Click on the buttons below to find out more and apply!"
www.bihr.org.uk/work-with-usPublic Involvement in Social Care
Researchwww.nihr.ac.uk/documents/public-involvement-in-social-care-research/27982?pr=Living standards, poverty and inequality in the UK: 2021Jonathan Cribb, Tom Waters, Thomas Wernham and Xiaowei Xu
Report
08 Jul 2021
ifs.org.uk/publications/15512This report examines how household incomes were changing in the UK up to the eve of the COVID-19 pandemic, and how other measures of household living standards have changed over the course of the pandemic. In particular, we use the latest official data covering years up to 2019–20 to provide a comprehensive picture of UK household incomes before the pandemic hit. We subsequently use more recent data to examine how the pandemic and associated restrictions on economic activity have radically affected the scope for people to earn an income in the labour market, and what the implications of the pandemic have been for measures of household deprivation. We look at how different groups have fared, with a focus on low-income households, both before and during the pandemic.
Key findings
Where were we before the pandemic?
Median household net income was finally growing steadily again prior to the COVID-19 pandemic, with growth of 3% in real terms over two years from 2017–18 to 2019–20. However, that still meant just 9% growth in total in the 12 years since 2007–08, prior to the previous recession. If the pre-financial-crisis trend of 2.2% growth per year had continued since 2007–08, by 2019–20 median income would have been almost 20% higher than it actually was.
In the run-up to the pandemic, even the very modest income growth in the middle of the distribution had eluded low-income households. Income at the 10th percentile of the household income distribution was almost unchanged over the six years between 2013–14 and 2019–20.
Looking over the whole period between 2007–08 and 2019–20, the striking pattern is how poor income growth has been right across the income distribution compared with modern British history.
Since 2007–08, incomes of poor households have been pushed up by significant reductions in worklessness. The fraction of low-income people (excluding pensioners) who live in a workless household has fallen from 45% in 2007–08 to 33% in 2019–20. This boosted incomes at a time when cuts to working-age benefit entitlements (since 2010) have pushed in the other direction.
This pattern of income growth means that overall measures of relative poverty (measured after housing costs are deducted) were essentially unchanged in recent years, at 22%, the same level as in 2007–08. However, relative child poverty has continued to creep up, and in 2019–20 was 4 percentage points higher than in 2011–12 (a rise of 700,000 children).
Absolute income poverty has gradually declined from 22% prior to the Great Recession to 18% in 2019–20. This fall occurred across all major demographic groups (children, pensioners, working-age non-parents), but was modest compared with historical changes in absolute poverty. There have also been recent gradual declines in child and pensioner material deprivation.
The fraction of non-pensioners in relative poverty who live in a working household rose from 56% to 67% between 2007–08 and 2019–20.This was due to a combination of more households with someone in work and a rising rate of poverty among such households.
Falling mortgage interest costs in the wake of the 2008 financial crisis have benefited people with mortgages, and the poverty rate for this group has fallen from 13% to 10% since 2007–08. This, combined with falls in homeownership for working-age people, and rises in private renting, means that by 2019–20 the fraction of those in poverty who were private renters has risen from 22% to 31%.
Pre-pandemic, there had been some notable falls in the poverty rates of some ethnic minorities, though for many they remain high compared with the white population (for whom it was 19% pre-pandemic). The relative poverty rate for people with Indian backgrounds fell from 26% pre-financial-crisis to 23% prior to the pandemic. The most striking change was for people with Pakistani/Bangladeshi backgrounds, for whom the relative poverty rate fell from 61% to 49%, though most of this fall occurred before 2010–12. In comparison, the relative poverty rate for black people, at 40%, was unchanged from before the Great Recession.
The relative poverty rates of different age groups and household types have also changed in recent years. Most notably, the relative (AHC) poverty rate for lone-parent households fell from 52% pre-financial-crisis to 41% in 2010–12 though it rose back to 47% in 2017–19, below its pre-recession level but still very high compared with other groups. Younger adults (aged 18–24) saw rising relative poverty during the Great Recession, but a better recovery, reaching 24% in 2017–19, compared with 27% pre-recession. On the other hand, 55- to 64-year-olds have seen rising relative poverty, up to 21% pre-pandemic compared with 17% in 2010–12, at least in part due to a higher state pension age for women.
The labour market during the pandemic
Although there were large rises in the proportion of people not working at least one hour a week in 2020, there was very little rise in unemployment and economic inactivity (where people have no job at all). By 2021Q1, 1.3 million more adults (aged 19–64) were not working at least an hour a week compared with 2019Q4, whereas only 0.3 million more adults were unemployed or economically inactive. The furlough scheme has kept unemployment from rising sharply during the pandemic.
Despite the large falls in the number of people working at least an hour a week, the number of households where no one was working has risen only modestly. This is particularly important for 19- to 24-year-olds, many of whom live with their parents. Even excluding full-time students who moved back home when universities and colleges shut, the share of 19- to 24-year-olds who lived with their parents rose from 45% in 2020Q1 to 50% in 2021Q1 – an increase of around 200,000 people. As a result, whilst the share of young adults who were not working rose by 10 percentage points by 2021Q1, the share living in a household where no one is working rose by just 1 percentage point – no more than the general population.
Looking at the (relatively small) increase in the number of households where no one has a job (i.e. all adults are unemployed or inactive), there are a number of groups where rises are more concerning: single-adult households without children (who by definition do not have a working partner to support them), and Pakistani and Bangladeshi people (who pre-pandemic were particularly likely to be single-earner households). These groups had relatively high levels of poverty before the pandemic. The share of lone parents who were not working also rose sharply, though this reflected an increase in furlough rather than unemployment and inactivity.
People who continued to work through the pandemic experienced real earnings growth that was fairly similar to the immediate pre-pandemic years, and much higher than in the aftermath of the Great Recession. Real earnings growth has been supported by low measured inflation during the pandemic.
Average earnings growth during the pandemic has tended to be stronger for public sector workers and for workers with lower levels of education, the latter perhaps in part due to a significant rise in the National Living Wage in 2020. Conversely, there is some evidence that younger workers (aged 19–34) have seen weaker growth in earnings. This may be due to the lack of vacancies: those earlier on in their career are more likely to move employers more regularly and this is often a source of wage growth.
Financial difficulties and deprivation during the pandemic
The start of the pandemic saw rises in some measures of deprivation. But these rises were temporary, leaving deprivation measures in early 2021 similar to, or on some measures below, their pre-pandemic levels. For example, the proportion of people reporting they were in arrears on at least one of their household bills rose from 6.6% in 2018–19 to 8.1% in April–May 2020, a 22% rise, but then fell back to 7.0% by March 2021. Food-bank use also rose from 1.7% of the population in February 2020 to 1.9% in April–May 2020, before falling back to 1.4% in early 2021.
Expectations of becoming financially worse off a month from the time of interview were very high at the beginning of the pandemic, with 17% of the population expecting this in April 2020, but then quickly declined, and remained lower through to 2021. These expectations did not translate into more people reporting current financial difficulties. These trends reflect the huge uncertainty faced by many at the onset of the pandemic, which was eased by the government support measures that were introduced.
Households that were in relative income poverty prior to the pandemic (measured between 2016 and 2019) saw the largest rises in deprivation at the start of the pandemic. In comparison, households that were not in poverty pre-pandemic saw little change on most of the measures. The proportion of poor households behind on their household bills rose from 15% in 2018–19 to 22% in April–May 2020, compared with a much smaller rise from 5% to 6% for households not in poverty pre-pandemic. By March 2021, the proportion of those in poor households behind on their bills remained higher, at 20%, than it was pre-pandemic.
The group most clearly struggling, particularly at the start of the pandemic, was self-employed people who had lost all work by April 2020. The proportion of this group reporting being in arrears on household bills rose from 2% pre-pandemic to 13% in April–May 2020. There was also a rise for furloughed employees but it was much smaller and less persistent into early 2021. The self-employed who could not work in April 2020 were also a group that reported a big rise in the fraction experiencing financial difficulties, from 16% pre-pandemic to 24% by April–May 2020.
Consistent with the larger rises in household worklessness for some ethnic minorities, there is evidence that ethnic minorities suffered greater economic hardship during the pandemic. The proportion of people belonging to ethnic minorities who are in arrears on bills rose from 12% in 2018–19 to 21% in April–May 2020 (compared with a rise from 5% to 6% for white people) and there were also increases in people from ethnic minorities reporting financial difficulties. By early 2021, there was a partial recovery for ethnic minorities, with 15% behind on their bills, but the gap remained wider than pre-pandemic.
Changes in deprivation for 18- to 24-year-olds actually look better than those for older working-age people (aged 25–64) on some measures, particularly regarding foodbank use, which fell for young adults from 6% pre-pandemic to 3% in April–May 2020. This is likely to be because their incomes have been supported through the furlough scheme and there has not been a rise in household worklessness for this age group during the pandemic as many have been living with their parents.
“Why don’t they
ask us?”
The role of communities in levelling upwww.youngfoundation.org/wp-content/uploads/2021/07/ICS-WHY-DONT-THEY-ASK-US-compressed.pdfAddressing inequities in mental health
research exacerbated by Covid-19www.centreformentalhealth.org.uk/sites/default/files/publication/download/CentreforMentaHealth_FitForPurpose.pdfDemanding Equity for the Lived Experience Professions
UK Based Grassroots Collectivelxprevolution.co.uk/Equal access to the knowledge table – the challenge of co-producing applied social care researchPublished: 07/07/2021
Author: Pete Fleischmann
www.researchinpractice.org.uk/all/news-views/2021/july/equal-access-to-the-knowledge-table-the-challenge-of-co-producing-applied-social-care-research/Through Pain Unbearable and Impossible to Name
Posted on 8 July 2021 by Bradley Astra Aldridgewww.nsun.org.uk/through-pain-unbearable-and-impossible-to-name/Content note: this piece deals with themes of rape, sexual abuse by a family member, and violence and discrimination toward people who are homeless.
Take the bus once a week past the homeless shelter you once stayed at. You can’t afford a real supermarket, one with the giant lights overhead and the infinite selection of not-yet-rotting produce and more brand names than anyone knows what to do with; you can afford this. You can afford the foodbank that requires a referral from a social worker. You can afford to sit in the back and guess who is on the bus for what reason: the men in clean shirts on their phones, their disdain for present company well evident; the women in dresses and sandals and sunglasses, getting off in the parts of the neighbourhood aiming toward gentrification, filled with restaurant patios; the women with visible scars and visible injuries, hands wrung anxiously, avoided by the women in dresses; the men with clothes caked in dirt and hostile expressions, their presence complained about by the respectable on Twitter.
Get recommended news stories about crime in the city. Get recommended news stories about crime in in public spaces. Get recommended news stories about crime on public transport. It’s the same story filtered through a projector, screaming in huge letters across the sky: HOMELESS PEOPLE ARE RUINING THE CITY FOR REAL PEOPLE, FOR RICH PEOPLE, FOR PEOPLE WHO HAVE HOMES TO RETURN TO, WHO HAVE FAMILIES TO RETURN TO, WHO HAVE SOMEONE WHO LOVES THEM, WHO WILL NEVER EXPERIENCE THE TERROR, THE DISPOSABILITY, THE INHUMANITY, THE SELF-REPULSIVENESS, OF BEING THE OBJECT THAT BRINGS DISGUST TO FRUITION IN THE FLINCHING AWAY HANDS OF OTHER PEOPLE, OF NOT EVEN HAVING A SAFE PLACE TO SHOWER OR BRUSH YOUR TEETH, OF LONG SINCE HAVING FORGOTTEN YOU HAVE STARTED TO SMELL – AND THESE PEOPLE, THESE RICH PEOPLE, THESE MIDDLE CLASS PEOPLE, THESE PEOPLE WITH CLEAN FINGERNAILS AND LOVING SPOUSES, THEY DON’T WANNA HAVE TO SEE YOU WHEN THEY WALK THROUGH THEIR PLAYGROUND, THEIR BACKYARD, THEIR STAGE, THEIR HOME. IT’S THEIR CITY, AND YOU ONLY LIVE IN IT. YOU ONLY WANDER THROUGH IT IN SEARCH OF A BATHROOM. YOU HAVE NO RIGHT.
Try to pretend you don’t feel anything when you see the giant words emblazoned: NO FIXED ADDRESS, the implication unstated but perfectly understood. The true crime is homelessness. The true crime is the proximity of filth next to cleanliness, of the inhuman next to the exalted. The solution is to make the inconvenient people disappear. The solution is to stick them in institutions, in prisons, in anything but subsidized housing next to the nice, normal people who want to keep their hands clean. Poverty as treachery. Poverty as social disease. Poverty as the tumor that must be excised for the health of the tissue worth saving, the healthy humans, the subjects deserving of empathy. Try not to ask yourself why this narrative only ever originates from the same news outlets that push stories on how the police are the only thing capable of saving the real, respectable people from the indignity of having to bear witness to a suffering not their own.
Imagine that this is not how people see you. Imagine that the stain has been washed off. Imagine that you never sat on the pavement while the paramedics laughed and refused to place you in an ambulance and take you to the hospital, to offer care to a homeless body, a corrupt body, a worthless body, an unnecessary body. Imagine that it didn’t strike you as strange even then: the way your friend’s voice rose in a crescendo of disbelief and outrage, the way you couldn’t quite believe it, couldn’t quite emphasize with their pain. As if you had value. As if you were a human being. As if you were worth saving.
Imagine that you are your scholarship. Imagine that you are your grades. Keep telling people about how well you did in your Existentialism class. Keep telling people that you’re going to learn Greek. Maybe if you read enough books, you’ll finally be human. Maybe if you go to university long enough, you’ll forget what it was like to hear a cornered man scream like a wounded animal. That’s always how they did it, at the shelter, they would lock the dissenting individual in, close the doors and call the police, and they would say so euphemistically and polite, “The lobby’s not available right now,” and everyone paced through the common area like the caged animals they were, and you’d get restless, you’d get afraid, you’d get uncomfortable, and they’d let you out the back of the building, and you were smart enough not to walk to the front, not to see that face, not to hear those screams, not to know that it could happen to you to.
Try to forget how your rape kit went. Try to forget how it was not to be a person, to be a lump of flesh, to be screaming and screaming and screaming, and the metal continues on its emotionless journey, because you are a homeless man. Because you don’t feel pain. Because it didn’t really happen. Because you’re batshit crazy.
Imagine that you are not psychotic. Imagine that you have never been psychotic. Imagine that you do not know what it is to feel pain. Imagine that you don’t silently register all the jokes, all the careless remarks, all the implications of everything you’ve ever read about what it is to be A Mentally Ill Person. A Mentally Ill Person is human. A Mentally Ill Person could be anyone. A Mentally Ill Person is your friend, your co-worker. A Mentally Ill Person looks vaguely troubled in those ads giant companies are always placing to remind us that regular, real people can get depressed. They never have homeless people in those ads. There’s never anyone screaming, there’s never you getting slammed into a wall by the police when you got sectioned, there’s never the text: MENTAL ILLNESS CAN HAPPEN TO ANYONE and then a picture of some homeless guy. That’s not who those ads are for. Those ads are for the real people, the normal people, the ones who suffer so silently while doing their jobs and going home to their families. You have a family, right?
Remember the last time you saw your family. Remember every moment your fingers have hovered above your phone every time you’ve thought about calling them (you still know the number, you’ve never forgotten it) and saying, I’m-sorry-and-I-was-stupid-and-I’ll-stop-saying-I-was-raped-if-it-means-you’ll-love-me. Think about the deep, irrevocable sorrow you experience every time you see a woman pushing a stroller or a guy with a baby strapped to his chest in one of those fabric carriers, the baby’s eyes roaming innocent and curious over the city landscape. And you are only ever some stranger downtown. And you don’t get to be loved.
Make a list of everyone who talks to you. Make a list of everyone who believes you got raped. Make a list of everyone who says I’m-so-sorry when you share what was intended as funny anecdotes of shelter living. Make a list of people who treat you like Any Other University Student.
Through gritted teeth, through clenched fists, through pain unbearable and impossible to name, remember what the accessibility advisor told you at the start of your first year: You Don’t Owe Everyone That. You don’t owe them the Recovering Troubled Youth That’s Such A Good Kid Narrative. You don’t owe them the polite, political outrage, the sensible and respectable conversion of every unspeakable horror, every ineffable trauma, into something clean and sterile, something smiling and lifeless, something that doesn’t cry or bleed.
Try to ignore the fact that you want to owe it to them. Try to ignore the fact that you want to stand up and scream. Try to ignore the fact that all you want to do is cut off the professor during the video chat and scream YOU’RE TELLING ME THERE’S NO POVERTY IN THE WEST WHEN YOU HAVE A CAREER? WHEN YOU HAVE A DEGREE? WHEN YOU’VE NEVER BEEN UNCERTAIN IF YOU SHOULD ANSWER “YES, I DO SEX WORK” ON THE SURVEY YOU’RE GETTING A MCDONALD’S GIFT CARD TO FILL OUT BECAUSE A WORKER AT YOUR SO-CALLED SHELTER IS RAPING YOU AS A CONDITION OF YOUR STAY, AND THE SURVEY DID SAY SEX EXCHANGED FOR SHELTER MEETS THEIR DEFINITION OF SEX WORK? You want to tell anyone who has ever studied anything that they’ve never seen it, that they know nothing, that they’ve never had it in their veins, that they’ve never breathed air and you’re paying them thousands to tell you what oxygen is.
Try to remember that crap you read in one of those therapy books, one for the doctors and nurses and not the crazy people. Try to remember they said it’s characteristic borderline-personality-disordered thinking to believe the helping professional has never been raped, has never been abused, has never suffered. Try to believe it; still, remember when you looked for peer worker jobs online and the search engine mistook your use of Mental Health for something a little more substantial, remember exactly how much a money a part time psychiatrist makes, try not to imagine how different your worlds are.
Remember that it’s rude to talk about money. Remember that rich people don’t like to be informed of the names and faces of the corpses compiling the crushed bottom of the mountain they live on. Remember money doesn’t matter anyway. Remember that you can deep breathe your way out of anything. Remember the hospital doctor who laughed when you said you were suicidal because your life was difficult and not because you’re depressed. If Everyone, it was said – by those with more education than you, Could Become Suicidal Simply Because Their Life Was Difficult, Than Everyone Would Be.
Try to imagine it. Try to do the math. Try to ask yourself if everyone has gotten raped by a family member they trusted and adored and then got raped by a youth worker at the shelter they ran to for safety. Try to imagine that everyone on Earth has become psychotic. Try to imagine that every random stranger you see inoffensively making their way down the pavement is one too many missed olanzapine doses away from chattering incomprehensibly, from the death of rationality, of personhood, of beingness, that has eaten you.
Remember it through prisms and mirrors, through flashbacks and generous nightmares. Remember your voice rising in pitch and fury when you realized the social worker didn’t believe you. Remember the exact moment your soul cracked, the moment you realized all empathy is conditional, the moment you learned that unmet family members unseen and unknown can be vile, awful abusers; known and respected coworkers can’t. Remember how it felt to have your illusions shattered, to walk into the shadow-world of inhumanity, to become a non-thing with no rights and infinite privileges. The privilege to have the worker at the hospital recoil in disgust from your bleeding hands and demand you put on the wristband yourself. The privilege to sound insane when you insist to the guy working the nightshift at the convenience store that the 24-hour McDonald’s is closed. The privilege to puke on the pavement when you think of the name of the worker who raped you, of his face, of his hands, of his smile, like that of an animal on a nature documentary that has just killed something, of the predator uncondemned.
Hope, viciously and without remorse, that they still remember you at that shelter, for you remember them. You remember the redness of the eyes of that one weekend worker, how she pretended not to cry and looked at you like you were broken glass when she knew, remember how it spread through the ranks of the staff like a virus, and even though These Allegations were a forbidden topic of discussion, you knew, you always knew, you could tell who’d been asked in hushed tones and who hadn’t, a man who played ping pong with your rapist flinching back from your eyes when he’d noticed you’d been staring, and he was so obvious about it, so obtrusive, and you thought then of how sophisticated he was, how smooth, the original, the unforgotten, the eternally remembered and never nearly enough despised, the man with the smile and the washed away blood on his hands, how he always knew what he was doing, how he evades punishment and retribution the way all those elegant middle class bodies walking through downtown avoid giving homeless people change.
Try not to get too self-righteous as you remember that you, also, are now a real, rich person, such as those you once despised. Yeah, yeah, you’re on benefits. Yeah, yeah, that’s below the poverty line. But you have a certain kind of mystique you’re trying to generate, more broke-student than formerly-homeless-man-on-benefits. You like to imagine you’re lightyears now from where you once were, as if the magic of denial can transform the messiness of pain into something pure and clean, something that’s never been touched or hurt or wounded, something safe and whole. And so, you only look back for a moment, for a second, for an instant, for a glimpse, as the bus goes past the shelter you once stayed at. And you almost go insane from the sheer force of it, from knowing that beyond that glass now plastered with posters about COVID-19 and masks, you once lived a whole life now lost, a thing you can no longer experience or feel or taste, an image of an image, a degrading photocopy, a monument to a war that’s only over for you. Be grateful that when the bus lurches forward, dragging you to your new life.
The Health and Care Bill: what does it mean for mental health?www.centreformentalhealth.org.uk/blogs/health-and-care-bill-what-does-it-mean-mental-health9 July 2021
By Andy Bell
This week the Government published its long-awaited new health care legislation, the Health and Care Bill. The 232-page bill makes some significant changes to the way the NHS is organised and how it plans health services. It abolishes clinical commissioning groups, which since 2013 have had responsibility for planning health services in local areas, replacing them with sub-regional integrated care systems. It places stronger duties on these new organisations and the NHS trusts that provide most of our hospital and community health services to collaborate, both with one another and with local councils providing social care services. And, perhaps most controversially, it gives sweeping new powers to the secretary of state for health to intervene in NHS decision-making, for example in relation to closing or reconfiguring hospitals.
The bill’s implications for mental health services are profound and important
There is very little in the bill specifically about mental health services. Reforms to the Mental Health Act will come in a separate bill following the recent consultation on the Government’s plans to reform that legislation in line with Sir Simon Wessely’s 2018 Independent Review.
Nonetheless, the bill’s implications for mental health services are profound and important. Like all health and care services in England, mental health services will continue to be provided mostly by NHS trusts in conjunction with local authority social care and public health services. But decisions about how much money is spent on mental health care, what services are funded and who provides them will be made by newly created integrated care boards, which will govern integrated care systems.
The idea of integrated care has many potential benefits for both the public’s mental health and for mental health services
There will be about 50 of these new bodies across the country, with a population of about a million each, and they will will take responsibility for all health services in their areas from next year. They already exist in ‘shadow’ form – as ‘joint committees’ of existing organisations prior to being set up formally under the bill now in Parliament. And in that form they are already being given responsibility for implementing many aspects of the NHS Long Term Plan, including the expansion of community mental health services.
The idea of integrated care has many potential benefits for both the public’s mental health and for mental health services. Too often, people experience mental health care as dis-integrated, especially from physical health care. Fragmented services are especially commonly cited as a concern for people of all ages with ‘complex’ needs that require support from more than one agency at a time. Bringing support together and encouraging collaboration rather than competition between public services may help to reduce some of the fragmentation and gaps people face.
There is nothing in the bill that ensures mental health will be given equal precedence with physical health in integrated care systems
But the proposed new system has risks as well as possible benefits. By moving decision-making from more local clinical commissioning groups to much larger integrated care systems, local communities will be further away from the centres of power in the health care system. At present, there is nothing in the bill that ensures mental health will be given equal precedence with physical health in integrated care systems – and without such assurances, history suggests it is at risk of being marginalised. Finally, while the bill makes clear that integrated care boards are required to tackle health inequalities, there is little suggestion of how they will be held to account for how far or how well they do this.
Further, the bill provides little reassurance that local government services such as public health (including drug and alcohol treatment) and social care will have equal standing with health services in the new arrangements. While integrated care boards will include local government representation, they are not required to align with local government boundaries, and with local government funding falling further and further behind NHS spending, the inequality between the two grows year by year. Yet improving the public’s mental health and delivering modern mental health care depend on a well-functioning and equal partnership between the NHS, local councils, communities and a range of other agencies.
We will be scrutinising the bill closely and making recommendations to Parliament for how it may need to change to support mental health and tackle inequality and injustice.