A taste of things to come

I have never really shown a great interest in politics nor had a huge enthusiasm for politicians or the policies of their parties other than what has affected national and local health services which impact on members of the public. However, I am finding myself increasing interested in politics especially in the aftermath of the recent UK local elections and given the national (and global) economic down turn, I wonder where the stopping point will be for the endless stream of cuts and closure of services. Social issues and health problems of any society are inextricably linked to its economy and we will undoubtedly, if not already witness a raft of problems from alcohol and drug abuse to mental health decline and social issues within our communities. Job losses are no joke and incredibly difficult to reconcile with particularly in light of bankers' bonuses and ill-judged, mispent taxes diverted to the affluent and over-indulged 'on of us' brigade. People have become disillusioned with politicians and their 'promises' as evidenced by the usual poor turnout in elections. Hard to imagine that any country can be represented by allegedly only 10% of the voting population. Hoorah for democracy eh?!

A professional workforce is vital to any country and needless cuts can turn out to be more expensive than any cost-saving initiative by its government. The health of these professionals is even more important and given the general economic climate, we need to look after and support the professionals not only for addressing the skills & knowledge shortage now but for preventing a further brain drain as a result of talented and unique individuals looking elsewhere for opportunities making the UK a poor competitor in global business, science, technology and innovation. Protecting the health & well-being of those remaining in jobs is equally important as those who are fortunate enough to have work are often having to extend the remit of their job description, work very long and unreasonable hours and accept the loss of many employee rights for fear of losing their job. The social and health consequences is going to be devastating and recent events are only a taste of things to come.

I vividly remember visiting my father at his hospital workplace as a child and being a Consultant, I was duly shown around the key places including the doctors' common room. I remember the smoke-filled rooms with their bars serving copious amounts of alcoholic drinks to the visibly tired and overworked junior doctors who were looking distinctly ragged from being on call all night and having to work through continuously through the next day. Not much seems to have changed in the levels of stress in the workplace, nor in drinking behaviour among the middle-class professionals if the current statistics are anything to go by. The current concern and emphasis on teenage binge-drinking is masking and overshadowing an even bigger problem among the professionals who are consuming on average, one or two bottles of wine per person every night. This is surely a daming indictment on this society which is clearly failing a significant percentage of its workforce. The focus on curbing antisocial behaviour emanating from binge-drinking has deflected attention towards teenagers and young adults. But there is a large percentage of older adults who drink at home after work simply to unwind. There are those of course within this group who are drinking far in excess of their daily allowance simply to cope with unemployment or block out the worry of it, the constant threat of redundancy and mounting debts. The Citizen's Advice Bureau (CAB) recently reported that the single, largest group of the population seeking help with debt counselling and mental health services is the young, professional workforce.

The profile of the A&E patient presenting with alcoholic stupor does not readily fit the middle-class professional . But with an increasing incidence of alcohol-related liver disease including liver cirrhosis in the age groups as youngs as the 20s and 30s (previously rare), not to mention the numerous other health risks of excessive consumption, more needs to be done to educate and inform on the health risks associated with alcohol. More importantly however, the culture of work in Britain, with its unhealthy workloads, a skewed emphasis on presentation and packaging rather than on substance and value as well as an obsessive love of money and profit has to surely change and very soon, before it is too late.

This must address important issues related to the breakdown in the family unit, working patterns, stress in the workplace and in the community, support networks at work and in society, effective management at work, and lambast any excessive workload policy for those remaining in work, in an attempt to tackle this worrying trend.

Adapted from 'Shan's Shout' column previously published in Mental Health Practice journal December 2007; Vol 11(4): 11

Mental Health Practice is a Royal College of Nursing publication.