Dear Mr Health Secretary

Hi Mr MP.

Thank you for your prompt response, I appreciate it.

I am unfortunately now compelled to write again and complain about the Health Secretary's comments today.

"there has been an overdiagnosis of mental illness"

In the coalition government of 2010-2015 there was  a consensus reached across the major parties of "parity" of service and seriousness between mental health.

I have had the misfortune of poor mental health in the past several years. it started having escaped an abusive marriage and following it up immediately with a loss of a wonderful father during the pandemic.

I worked throughout, and whenever I was unemployed I relied on my savings rather than the state. And the above statement is deeply out of touch.

If you don't like us, don't represent us. I didn't deserve to hear such horrid comments. There has been a rise in cancer diagnosis. Are we over  diagnosing cancer too?

Could it possibly be that in real terms people have housing instability, financial and food instability and are suffering for it? Could it possibly be that people are living with chronic conditions that aren't getting diagnosed and are having other impacts on their mental health?

I have friends and colleagues who have been diagnosed with mental illness, and in each case, they can tell you why. If it is something such as depression and anxiety, it can be stemmed to something such as domestic abuse, or loss. We've just come out of a pandemic and I can tell you that the lack of empathy is breathtaking. Did we have such cruelty towards veterans of the world wars? People having PTSD because they lost their loved one on a trolley in A&E isn't something to sniff at. 

      The problem I see is that people who had it good in the pandemic who didn't lose a loved one or face furlough, or income insecurity have a distain for those who did. The pandemic was a hugely traumatic event for the nation, and it affected everyone in different ways. We were not all in the same boat, we were in the same storm. Some of us cannot fathom that someone else had it harder than they did.

I left a contract in March 2020, and I was meant to start my new one the next week I was to be a Management Accountant at the Tate. That week was lockdown one. I was informed that they were going to delay the role for a week, whilst they figured it out. that week, turned into months, I had to get another role whilst the government figured out furlough, and whilst furlough was a wonderful thing that saved so many people from destitution, I'd already gotten another job so it didn't help me directly. But what I didn't ever forget was the singular horror, not just of what was on the television but my daily life. Could I afford food? How long before my savings ran out? What to do? Those 6ish weeks have been burned onto my brain, because I was also in my first tentative months of freedom from an abusive marriage, I was separated, so still subject to my ex husband's abuse, just less frequent. I had horrendous mental health and it was circumstantial. Now I can say my circumstances are much better, but it took years to get out of depression. And thousands. I did therapy for years. I still do. The NHS did their level best for me, but that amounted to a few pills and a few doctors notes when I couldn't get out of bed. I am fine now. But I remember with absolute clarity what it means to not be able to get out of bed. I remember 2021 when I had absolutely no business working, my divorce came through the beginning of March, so my ex husband "dialled the crazy to 11" (the police would eventually be called) then in April my father got sick with his final illness, but it was COVID so I was restricted to how much I could see him.  But I knew there was "nobody coming to save me." so I worked. I still maintain to this day, if I had taken a year off, the entire 2021 and not worked that "stitch in time" would have saved 9. But I didn't have the money to do so and I don't come from a family or a background that claims benefits, so I wouldn't even know how to begin.  You live off your savings, not the government. I have so many friends who are still going through it, abusive relationships, chronic pain, family loss, (sometimes all 3) and all still work. Wes Streeting's comments assume that everyone is a scrounger and that is the life view he is trying to make the evidence fit into.  I assume everyone wants the best for themselves. 

      No one in their right mind wants to live off the government long term. So anyone who does is not in their right mind. Get them the help they need rather than castigate them. People want to work, how dare he say we're "over diagnosed" and "written off" Trust me, if you've gone to your GP to get signed off its the last resort. Remember, people only try and "run the gauntlet" of trying to get a GP's appointment if they are actually ill.  I remember when I had to do it the first time. I had a mental breakdown at work and started crying in the middle of a meeting because of the abuse I was facing in my marriage. Wes Streeting thinks we're all scroungers, and if you think that of the general population, you shouldn't be in politics. You're infantilising people. We are not your children. You can't scold and threaten us. The same people who you're calling "over diagnosed and written off," are the same people who if they held down a job during the last general election would be your "hard working taxpayers" I have had the misfortune of sitting in both camps over the past few years and I am grateful everyday for my health. We also often conflate the fact that mental illness is a chronic condition with most people on benefits have chronic conditions, instead of correlation we see causation. Those on benefits are the sickest in our society. If someone says that they can't work because they are depressed... I am inclined to believe them, if you want to spend 10 years of your life on job seekers and incapacity benefits because of depression... that's 10 years you will never see Paris, the sunrise on safari in Namibia or sip cocktails in the Caribbean. There are so many beautiful things in life that mental poor health robs us of, and those are but three. In fact if you have so much as a flat tyre if you are on benefits I suspect that's a one way trip to indebtedness. So why would I begrudge them when I have the luxury of work and therefore the ability to see those things? Everything is about work, is helping depressed people who are retired less important? Or do only purple haired 35 year olds with liberal arts degrees get depressed? 

      One thing that gives me comfort that Wes Streeting has the arrogance to forget. "This too shall pass" life is cyclical. Sometimes you have good times, sometimes you have bad. All will pass. Sometimes those bad times will overwhelm you, and you will need help, help of friends, family and yes sometimes the state.  As someone who has come out of her own bad times I have realised that some people think that their current ascendancy is permanent. Without wishing bad things on the honorable member, life can humble you in a second. My father was fit and healthy this time 4 years ago... and he was dead before the summer was over. I remember looking at the Queen with pity when she buried Prince Phillip  in April of that year, and then having to do the same thing for my dad not even 4 months later. The stage people are in in their life is not your concern, you didn't put them there, and as you are not a medical doctor you cannot help them. I also find it disparaging to the medical profession. Ever overworked and underpaid, I have friends who are doctors and I actually headed up the business partnering department at the Royal College of General Practitioners, so I know a thing or two about GP's. They are just trying to do their best, no one is looking for an easy answer, they have limited time and resource and they just want to do right by their patients. If someone comes in presenting symptoms of depression, then that's what they'll be treated for. They won't be treated for angina because that's not what is presenting. Don't insult doctors because "over diagnosing" implies incompetence on their part and they sure as hell aren't incompetent.

I know so many people who are depressed and working. I know how hard I worked when I was depressed. I know how hard it was to crawl my way out. I wish I'd had the luxury or the presence of mind to take a year out so I too could be called "over diagnosed and written off" I needed that time. I know what it has cost me in terms of money, relationships and suffering to work whilst ill. I know what its like trying to hold down a fast moving, high pressured job whilst also combating memory loss, chronic fatigue, physical manifestations such as Costochondritis (chest inflammation) I remember having my first panic attack after a board meeting (which had actually gone well) and spending a night in A&E and then having to go back to work the next day. I remember tasting fear in my mouth, all day everyday sick to my stomach and taking to my bed and sleeping to escape pain and fear.  It is apparently that cruelty that Wes Streeting wishes on others, I meanwhile do not. I wish better for others than for myself. He should be ashamed of himself. "jabbing the poor" is back in vogue I suspect. The politics of division never wins. Pulling oneself up by their bootstraps is so often recommended by someone who's never done it. There are still years of my life of which I have very little memory. From 2018-2024 I can remember very little, my brain has deleted all that to help me cope with the almost constant merry go round of horrors I faced.

I don't believe in "walking a mile in another man's shoes" will give one empathy. Often people going through a period of ease think themselves a GP, having had one conversation with a person and a right to pass judgement on their whole life. I want Wes Streeting to go 5 years in my shoes. From 2018-2023 especially. I would absolutely love to see if he would have the audacity to go on national television spouting such tripe at the end of it.

      I have a question that I would appreciate answering, if you can. What was that for? Do we want people telling others that people with mental illnesses are "over diagnosed?" Casting doubt on the validity of diagnosis? I am an accountant and like GP's many people think they can do my job because they can add and subtract. They can't. Just like Wes Streeting can't be a GP because he hasn't gone to medical school. "Dr Google" doesn't mean you can diagnose someone or confirm or deny the validity of a diagnosis. I also don't believe that there are "experts" saying there is an over diagnosis. GP's barely have time to do referrals, let alone peer review.  Could it be that my generation are more articulate, and therefore more likely to get the care they need because they correctly advocate for themselves? I know for a fact that getting care in the NHS is for the sharp elbowed. Or GP's are better trained in medical school to see the signs of poor mental health? If you want the mental health budget to go down, you need to do things about housing, policing, the economy, 

       I remember my last appointment with my GP was about a year ago, I don't get along with anti-anxiety medication very well, the side affects make me physically sick. I knew what was making me anxious, I was in an intolerable working environment and, so when my GP said lets change your medication, to see if there is anti anxiety medication out there that will make you not sick. I asked him not to, because I am a person with high personal accountability, and agency.  I didn't want to be signed off work (he wasn't offering it)   I came to my GP with a "3 month plan" where I would check back in in 3 months but I was going to get a new job, exercise more, and eat what is mainly a pescatarian diet (incidentally) but come off the anxiety medication. The reason I'd been able to do so was I had invested in life coaches, counsellors and put in an intense amount of financial and emotional resources into getting better that most people don't have and also the side affects of those tablets are truly awful, no one talks about that, people talk of "popping pills" like its an easy way out, but forget that side affects can really mess with you. I wanted something like exercise which had 0 negative side affects. However I have recommended exercise to several friends, you have to be in the frame of mind to receive it, otherwise it doesn't work, you also have to make it enjoyable. The gym isn't for everyone, I go and I find it intimidating, so I know, with empathy and kindness that there are no "easy solutions" because even exercise, for someone converted such as myself, can seem impossible.  The combination of those 3 had me from calling Samaritans, and living in a constant state of fear, and not being able to hold down food to not needing to go back hopefully, forever. 12 months later I can say I am no longer mentally ill neither depression nor anxiety or any other thing and this is coming from someone who 12 months ago considered herself to be disabled with depression because I'd had it for 5 years straight.  Meanwhile... I worked. 

      There is not enough support for people who are mentally ill whilst working for that I do agree with him. I would use Employee Assistance, a common workplace benefit of a team of counsellors. In 2023 my abusive ex husband reared his ugly head again whilst I was working 19 hour days. I was told I used them too often and that I breached their fair use policy and to go and see a GP. I was seeing a GP. But anytime I'd mention to these counsellors that I was also seeing a paid for counsellor once a week, (I used it as a semi crisis line a bridge between my counsellor or Samaritans, Samaritans is when I was having suicidal ideation.) they'd cut the call short because I had a counsellor. So they wanted me to just use my paid for service, when I clearly needed them at that point in time. Often at 3am, often in tears. Am I meant to call my counsellor at 3am?   I clearly was using the counsellor as often as I could afford,(that's £240 a month by the way, not a luxury everyone can afford)  but I needed more help, because I was working whilst ill. So I was using all resources at my disposal. And I was criticised for doing it. I still have the email that said I breached "fair use policy." What would Wes' smart answer be for me? I was working, using my private funds to seek counselling support because I knew the NHS waiting times wouldn't get me the support I needed. I was speaking to my GP/nurse practitioner/social prescriber on both medicines that could help and I had a life coach and a counsellor. But if your ex husband decides to stand outside your house until the police are called because he apparently owes you £19.68 from 2 years ago that can induce an anxiety attack. I don't get to pick that, and my GP is correct in diagnosing that. I worked throughout that, like a good little taxpayer. All whilst going through what could best be described as "chronic bereavement" i.e. through a stroke of bad luck, I lost my dad in 2021, aunt 1 in 2021, aunt 2 in 2022, my grandma in 2023 and my brother in 2024. I went to grief counselling... whilst working, for my dad and aunt 2 (aunt 1 was a complicated woman and can easiest be described by her son, my cousin, barring the entire family from the funeral for an unknown, uncommunicated, perceived slight, so forgive me that I didn't go to grief counselling for losing her)  and because my dad passed in 2021 my aunt 2 passed in 2022 I wasn't expected to mourn my father's passing still because my aunt 2 passing was more recent. Despite both dying from cancer. (Aunt 1 died from a stroke) And this was from a bereavement charity. Oh and by the way you only have 12 weeks of bereavement counselling. They didn't understand the cultural issues that made my circumstances even worse than just the initial loss so  I didn't go back for my grandma or brother, despite my brother being a victim of knife crime from a drug addict. It was truly horrendous circumstances.   But I worked. I was depressed all those years because I just kept losing people (this is all on one side of the family, which made it worse, the amount of people who could comfort you got smaller each time.) Who would of guessed that life would take such a turn? The odds of losing that many people in such a short time are ridiculously small. So yes, I was depressed, and I worked and I needed support and I paid for vast amounts of support. But I needed more. 

       I don't appreciate having mental illnesses that I have genuinely suffered from castigated in public. I have spent thousands on getting better. I used all 3 sectors, private sector counselling and life coaching, the NHS for medical diagnosis and the charity sector for bereavement support. I only accessed all that because I am incredibly resourceful. I have a presence of mind and sense of purpose, and I don't mean any harm or disparagement when I say this, that not many people have. I was relentless in my quest to get better and if I'd had 1% less motivation I'd still be there. But I am now outside of the life circumstances that made depression and anxiety possible. Before I had those conditions I had little understanding of them and too would have said something stupid, like "just snap out of it" or "everyone has good and bad days" until you really experience the "chronic" in the term "chronic health condition" you can't know how debilitating it can be. Until you have life circumstances that give you that illness you can't possibly understand the horrors. I truly thought I'd never get out of my circumstances, I considered both death and emigration. (both a type of moving on) and through unrelenting will and a sense of purpose that I would never let life beat me I can write to you today. But as I have taken great pains to tell you. People from the outside looking in have no idea. People pity cancer survivors, but not the mentally ill. You don't ask what got them that way. Could be the environment, could be abuse, could be loss. But rather than tackle the causes, you want to say something smart. Work isn't the measure of success you think it is. the goal isn't to get people back to work as soon as possible, it is to get people better and working sustainably.  I worked because I couldn't afford not to. However I believe it has cost me mightily I basically have no memories from 2018 to about September last year, that is almost 20% of my life. But I worked, and because I worked the government doesn't care about my pains. It only cares about how much the NHS costs, or the benefits bill costs. Not that I lost so much of my best years because of circumstances beyond my control. You want to make the mentally ill the scapegoats for the benefits bill and the healthcare bill. How cruel. You are no more justified in doing so than telling people to stop breaking bones "on purpose" because A&E is expensive.  There are no easy answers because the mind is a complex thing. These "culture war comments" picking on the sick and disabled need to stop. Leaders don't pick on the weak they support them.  People think work is good for people with depression and anxiety, and dependent on what happened to you to cause the depression or anxiety, it can be a very good thing, or a very bad thing. There's no "one size fits all" and no one looking in can really understand your circumstances. It has to come from you.

I can say all this as someone who had mental illnesses for several years and come out the other end, but also as the sister to 2 brothers who were addicts. You can only help someone so much. One of them (the alcoholic) turned his life around... but only because he wanted to. The other, didn't and ended up being stabbed to death. Its been 5 years since my brother turned his life around. I still do not know what made him do it, he didn't tell anyone he was "going to do it" he just did it and I'm just grateful for it. All I know is if you knew him in 2019 you'd call him "over diagnosed" but he's now the "hard working taxpayer."   As I have said, life is cyclical.  So be careful when you use words like "over diagnosed" as mental illnesses such as depression and anxiety, are chronic conditions, they are not, for most people, terminal ones. 

      I sometimes wonder if the political classes were raised on the same "working class" values as I was, because my mother raised me to say "if you don't have anything nice or helpful to say, don't say anything at all."

      It would have helped the Health secretary from seeming cruel and out of touch. It would have also saved you an email. It it exactly this incompetence that my last email was complaining about. I am so thoroughly sick of it. As I said earlier, if you don't like us, the general unwashed population of constituents, please, don't represent us. I'd hate to be in Wes Streeting's constituency and find out my local MP who is also the health secretary, looks at me at my worst time of life with disdain. 

This is a letter to express outrage, I don't hold you accountable for the ill judged comments of the health secretary, nor do I expect him to receive enough outrage to apologise. I do, however think its instructive to remind that actually most people who have chronic conditions work and only those who are suffering the most are economically inactive. But there are worse things in life than being economically inactive. Perspective, humility and grace are important, and that's hard to factor into a healthcare system. Incendiary mental health comments such as his are all fun and games until someone is swinging from a rope. May I remind him that a consequence of poor mental health can be suicide. And that suicide is the biggest killer for men under 40. Whilst I don't blame him directly for suicides, harmful comments like his only add to the environment where people don't get help because they are castigated. So cheap potshots when talking about such serious subjects are beneath him.

Grace and Courage

Annetta Mother Smith