Policy must recognise that poor mental health in carers is not down to chance

Quite rightly, we have seen a movement in the UK that has focused on ensuring people know that poor mental health is something that can affect anyone. While I have always welcomed this, now, in my role as a county councillor I am constantly seeing people whose circumstances are leaving them on the brink. And I wonder if, somehow, we have arrived at a point where mental health is too easily explained as being down to chance – thus absolving agencies of any responsibility to try to prevent people from falling into crisis that were completely preventable were they just given compassion and help.

There are a group of people whose situation is entirely not of their making, who work long hours often with physically draining tasks, with pay way below the minimum wage, sometimes going years without a day off, with no prospect of promotion and no opportunity to look for an alternative role. People within this group are often pushed to the limit by circumstances and the bureaucratic processes that accompany them.

I am talking about unpaid carers. Nine million people in the UK provide unpaid care to family members or friends with long-term illnesses or disabilities. Their unpaid labour is estimated to save the government £132bn per year, but it takes a significant toll on their wellbeing.

The fact that unpaid carers act out of love seems to be a reason to take them for granted. Poverty is often an accompanying part of their lives, with carers forced to give up their job to provide the care and, of course, the person receiving the care for will often be without an income too. Carer’s allowance is the main carer’s benefit and is £67.60 for a minimum of 35 hours, the lowest benefit of its kind. The State of Caring 2021 report found that one in five unpaid carers are worried they may not cope financially over the next 12 months and one in four carers (23%) may not have enough money to cover their monthly expenses.

The difficulties are often compounded by the fact that the financial cost of caring does not come cheap. Carers spend an estimated £1,370 a year on average on services or equipment for the person they care for. Their physical health is also impacted with 61% said they had suffered physical ill health as a result of caring. With these pressures it’s hardly surprising that over half of carers (52%) feel anxious or stressed about their finances and 72% report suffering mental ill health as a result of caring. Like poverty, isolation is often part of caring – eight in ten people caring for loved ones say they have felt lonely or socially isolated.

When you look at the circumstances carers are in, and the complete lack of interest the state takes in their plight it if hardly surprising that carers are at significant risk of suicide. Although there is currently no systematically collected evidence to indicate how many carers have died by suicide or homicide-suicide, a recent review, by the University of Exeter identified unpaid carers as a high-risk group for suicide, with many carers thinking, making plans for, and attempting suicide.

For some carers, suicidal thoughts are accompanied by thoughts of killing the person for whom they care and deaths by homicide-suicide have been reported. Among those who have contemplated suicide, research suggests that one in six carers are likely to attempt suicide in the future and one in ten have already attempted suicide. High-lethality methods have been reported in carers’ suicide plans and attempts

There are also risk factors for suicidal ideation that are unique to carers. These include: dissatisfaction with the caring role; wanting a reprieve from caring; experiencing conflict with family or health and social care professionals over the care provision; and not having an identity or role beyond caring (such as a paid job or volunteering). It’s also very difficult for carers to express these feelings for fear of judgment and guilt about betraying their loved one. There is also fear about setting in motion a set of unintended repercussions that will be to the detriment of the person they care for like their removal.

When Labour were in power, the government published The National Carers Strategy, which set the ambition that by 2019: “Carers will be universally recognised and valued as being fundamental to strong families and stable communities. Support will be tailored to meet individuals’ needs, enabling carers to maintain a balance between their caring responsibilities and a life outside caring, while enabling the person they support to be a full and equal citizen.”

Not only has this ambition not been realised, but under the Conservatives carers have been pushed further from the agenda. The government did announce a consultation for a new carers strategy in 2016, but instead produced an Carers’ Action Plan that expired in 2020. In 2012, Barbara Keely brought in a private members’ bill on the identification of carers. This was not supported. The result is that we have millions of people carrying out invaluable caring work completely unacknowledged, and so there is no way of services knowing who might need support.

Navigating council systems is difficulty and stressful. In any case, post-austerity funding for things like respite care has dried up as local authority budgets come under more pressure. Respite care was often used by carers to allow them to do things like visit their GP, hardly a break, but now something they won’t be able to do. Carers are all too often not in a position to consider their own mental wellbeing and this is why we need to.

Policies – national and local – need to recognise carers and the job that they do. We cannot pretend poor mental health in this group is down to chance – it isn’t. We must support people caring and invest some of the £132bn a year they save the taxpayer in them.