‘A man without a vote is a man without protection,” said Lyndon Johnson, the 36th US president. This is true, though whether a man (or anybody) who does vote receives protection is up for debate. But it’s never a bad idea to put one’s fists across one’s face when a blow is coming.
A blow is possibly coming. Not, as David Cameron and his speechwriters would have us believe, in the shape of a third world war. (Is there a law for alluding to the third world war to win an argument in the same vein as Godwin’s law when referencing Hitler? There should be.) But Brexit throws up the possibility of losing certain protections. And isn’t it always said, too, that the mark of a society is the way it treats its most vulnerable citizens?
If there’s one thing more likely to come up in columns than Lynton Crosby’s dead cat or that aphorism about a special place in hell for women who don’t help other women, it is that one in four of us will experience mental illness. If not you, then your mother, sister, brother, father. That aunt you never really liked but who made the best lemonade and had a nice garden to enjoy it in.
Awareness of that one in four statistic has helped to establish that mental illness doesn’t equal weakness; and that those who experience it must often call on huge resources of strength to deal with trials that others couldn’t imagine. But I hope it won’t invite a Twitterstorm to write that those who need mental health treatment are among the most vulnerable in society. Not all of the time, but in times of difficulty they will need protection. I speak from experience on this (although it pains me to say it, re: internalised and externalised stigma).
During the 2015 election, the Conservative party flirted with pulling us out of the European convention on human rights (ECHR), and said we didn’t need the Human Rights Act: we could do everything in-house (the supposed UK bill of rights). Michael Gove and Theresa May – now keeping her head down ahead of a prospective Tory leadership contest but nominally for remain – were key proponents. The plans to pull out of the convention were scrapped by Cameron, but that decision could be reversed in the event of Brexit.
Pulling out of the EU would not trigger an automatic exit from the ECHR - the ECHR is not part of an EU treaty - but the event of a leave camp win would probably lead to Cameron’s removal. Enter: Gove, May and others who advocate leaving the ECHR could rise to the top of the party. That is where the danger lies.
People with mental illness need the protection of the European court of human rights in Strasbourg, and of the Human Rights Act. In a 2003 case, a woman sectioned under the UK’s Mental Health Act found that her adoptive father, who had sexually abused her as a child, had been named her “nearest relative”. As noted in the case documents, the woman was “extremely distressed by her knowledge that Mr B [her adoptive father] as ‘nearest relative’ has access to confidential information about her”. Taking her case to the European court of human rights and raising the right to family and private life (article 8 of the convention) was her means of challenging the Mental Health Act ruling and provided the legal means to remove her abuser as her “nearest relative” – a course of action that was unavailable otherwise. The Mental Health Act was later amended to allow such challenges.
Scandalised by the story of a 16-year-old locked in a police cell because no mental health beds were available? A bill is currently going through parliament to limit the time a mentally ill individual can be detained in a police cell. The case of MS v UK, brought by a man who spent three days detained in a cell before moving to a ward – ruled by the ECHR to be a violation of article 3 (inhuman and degrading treatment) – acted as a catalyst for this bill. These are just two examples of the ECHR providing important precedents for the treatment of people with mental illness.
It isn’t just the rights of people with mental illness that are under threat. Brexit could spell disaster for an already absurdly underfunded NHS – creeping privatisation, loss of workers, less cash. Mental health already gets the slimmest slice of NHS pie (around 11% of the total budget).
Luciana Berger, the shadow minister for mental health, tells me that “the NHS is too important, and mental health services are too vital, to throw into the chaos of Brexit”. Leaving the EU, she says, “would pose a serious risk to the wellbeing of the NHS itself, but also to those who rely on it”.
Simon Wessely, the president of the Royal College of Psychiatrists, echoes Berger’s comments when he tells me that “in the event of a Brexit, [the NHS] will most likely run out of money even faster than now. And it will certainly run out of staff.” Wessely also stresses that the medical science benefits that come from EU membership – funding, collaboration, talent – are imperative to mental health care. “So much so”, he adds, “that I don’t believe there is a single scientist who does not think that being in the EU makes it easier to develop new treatments for mental disorder, and then to make them available.”
It is therefore crucial that people with mental health difficulties vote to protect themselves. The remain camp has been pushing a voting drive aimed at young people (who tend to be pro-EU) due to their historically low turnout rates. In the 2015 general election, young people’s turnout was the highest ever, at 58%. But to put that into context, in the 2010 election just 14% of mental health inpatients in the UK exercised their right to vote.
I’ll be honest. I wasn’t sure whether people sectioned under the Mental Health Act had a vote. This is down to my own ignorance but mostly because society has consistently disenfranchised and denied opportunities to those with mental health difficulties. The 1949 law preventing those under psychiatric care from voting was repealed only in 2006.
Its with this in mind that Central and North West London NHS Foundation Trust produced a voting awareness campaign for mental health patients. (A small study in 2010 found that even mental health workers weren’t clear on whether inpatients could vote, and assumed those under section could not.) The trust campaign literature explains that those under civil sections 2 and 3; those lacking capacity; voluntary inpatients; and those under community treatment orders are all eligible to vote. (Those detained after criminal conviction are not).
The trust also highlights that it is important for “mental health patients to have a voice”. Struggling with mental health difficulties can lead to a person feeling detached or isolated. This can certainly be the case on an inpatient ward. Engaging in politics can offer a window on the world in a place where often the windows open only a couple of centimetres due to safety concerns.
Not that long ago I was on an inpatient ward, and the one session I thought most productive was the current affairs group in which we gathered around newspapers to discuss topics of the day. It was the most passionate I ever saw my fellow patients. I hope that all of them know about their right to vote on 23 June. Even the ones I thoroughly disagreed with.
- This article was amended on 9 June 2016. An additional paragraph was added to clarify the ECHR and EU’s relationship.
