Scientific basis of mental health research

Sir, We write as a group of consultant psychiatrists in response to Matthew Parris’s article (“Mental health industry is cheating the public”, Aug 19; letters, Aug 20). There is a significant difference between those who are unfortunate enough to have severe mental illness and the examples given of individuals with some of the milder forms of neurodevelopmental differences. We know that specific medications, acting on specific neurotransmitter systems, can have therapeutic effects important for individuals and society. Our neuroscience knowledge in psychiatry remains far from complete but so is the knowledge of detailed mechanisms in much of medicine.
Measurement is also central in less severe mental ill health. For example, the “increasing access to psychological therapies” national programme was established with the help of Professor Lord Layard precisely with the intention of helping those with conditions such as depression and anxiety to recover and return to the workforce. Mandated and successful measurement systems within the national network of services demonstrate the effectiveness and value of these clinics.
Mental illness is already stigmatised and it is unhelpful for Parris to state, wrongly, that some people suffering from these conditions are choosing not to work. Far from being non-scientific, mental health is a pioneering branch of medicine in relation to measurement, clinical trials and the demonstration of what works.Professor Isobel Heyman, UCL; Professor Tamsin Ford, Cambridge University; Professor Louise Howard, KCL; Professor Wendy Burn, Chester University; Professor Henrietta Bowden-Jones, Cambridge University
Sir, Matthew Parris argues that mental health research does not deserve the name of “science”. When I worked as a clinician I shared much of his frustration with the limitations of the scientific basis of many approaches. However, in my role working for a global funder of mental health research, I have the privilege of seeing the emergence of a new generation of rigorous science-based interventions developed with and for those most in need. The first new drug for schizophrenia in more than 50 years awaits approval in the US. Researchers in the UK have developed a personalised digital avatar that allows people who hear distressing voices in their head to challenge them. There are new “snackable” digital mental health therapies that can be accessed in easily digestible bursts of three to five minutes. These are just some of the innovations that give me hope that mental health science will help to improve the lives of billions of people.Professor Miranda Wolpert Director of mental health, Wellcome
Sir, Matthew Parris raises the important point of the economic cost of the ever-expanding mental health disorders. Assuming that the government has a finite sum to spend on treating and alleviating these conditions, there will have to be some tough prioritisation. If more is to go to ADHD, an enormous growth area for no obvious reason, the public needs to understand that funding for the severely mentally ill will be reduced to even lower levels. Perhaps at some stage our nation will reach a tipping point, where economic inactivity becomes so great that we decline into an economic depression. The hope is that subsequent generations regain the passion for work.Dr Fiona CornishGP, Cambridge
Sir, As someone who was in the Sydney courtroom, I am afraid Trevor Woolley (Aug 19) is too charitable to Robert Armstrong (“Declassified memos suggest Thatcher misled MPs over spy” Aug 17). Asked if he and the prime minister had agreed to let Chapman Pincher write his book, Their Trade is Treachery, he dismissed this as a very ingenious conspiracy theory and quite untrue. He denied that anyone in government service to his knowledge knew in late 1980 that Pincher was writing his book.
Documents withheld for 37 years — despite three court orders for full disclosure — reveal that there had indeed been such an agreement in June 1980 and that the government received the synopsis of the book in December 1980. Even the most indulgent occupant of an Oxbridge common room might have choked on their port at the truth of these answers.David HooperSolicitor for Peter Wright and Heinemann; Abergavenny, Monmouthshire
Sir, Building higher (news, Aug 17; letter, Aug 20) will further threaten an already embattled group: existing lessees in low-rise blocks of flats. They have no control over unscrupulous, underfunded and uninsured corporate landlords who can embark on shoddy “upwards” development, seeking to make a quick buck. If things go wrong they leave existing lessees clearing up the mess left by negligent building work.
Suing building control inspectors or these landlords brings no financial relief to such lessees, who cannot obtain insurance against these risks. Ironically the landlord could, but is under no obligation to do so. The government should plug this glaring gap in consumer protection.Andrew ColvinLondon W13
Sir, Professor Alan Smithers (Aug 19) is right to call for the scrapping of the requirement for all young people to pass GCSE maths and English. While well intentioned, this particularly disadvantages those aged 16 to 19 with special needs and those with English as an additional language. At present the Education and Skills Funding Agency requires schools and colleges to run Level 2 maths and English programmes for those without a GCSE qualification, taking a minimum of four and three hours respectively. Such conditions add to the pressures of staffing at a time when there are considerable shortfalls in the recruitment and retention of teachers. Further, there are often behavioural and attendance concerns over pupils forced into frustrating GCSE programmes having repeatedly failed their exams. The new education secretary should review this urgently.Neil RoskillyTrustee, Diamond Learning Partnership Trust
Sir, Like Alec Thomas (letter, Aug 20) I can see the point of resits. I too was able to go to agricultural college but later trained to teach English and went on to be an examiner for the one subject I had failed at school: English literature.Peter InsonFormer head teacher, East Mersea
Sir, One reason for the rise in Neets (not in employment, education or training) is the demand for a grade 4 in maths for almost every job (“Why sweet 16 quickly sours in rural Britain”, Libby Purves, Aug 20). In the belief that harder exams would make pupils cleverer, trigonometry, quadratics and simultaneous equations were put on the foundation maths paper. As a result students who are numerate are excluded from applying for a whole host of jobs, simply because they did not achieve the arbitrary grade 4 at GCSE. This deprives capable people of jobs they could do well.Corinna JonesTeacher, London SW19
Sir, Libby Purves concludes her interesting article highlighting the issues and difficult choices that those aged 16 face by remarking that they will be ill equipped to face a tricky old world. They would seem to have a lot on their plates — and these are the youngsters that the Labour Party is keen to enfranchise.Cristina FearonStourton, Wilts
Sir, Your editorial (“Gravy Train”, Aug 16) and subsequent letters (Aug 17) are right that the pay rise for Aslef train drivers should have come with conditions on changed working practices. It is also a missed opportunity to change pensions, which have not changed for train operating company staff in the 30 years since rail privatisation: their pensions are still “final salary”, still with a retirement age of 60. These pensions in effect add another 25 per cent to Aslef salaries.John RalfePensions consultant, Hognaston, Derbyshire
Sir, Carol Gilmour (Aug 20) requests recipes for the fauna and flora associated with rewilding. They are readily available. Badger hams have long been a country delicacy (now only available as roadkill). Their preparation involves soaking for six hours and baking for up to three. Should an explosion of turtle doves return them to the game list, they could be treated like pigeon, eg in a port wine casserole. Bring it on!Julian CritchlowDitcham, Hants
Sir, Your piece on leftover fabrics (“Why good old-fashioned surplus fabric sets the trend”, Aug 19) reminded me of the Fent Shop, opposite the back entrance to Woolworths in Huddersfield, which was very popular in the 1950s and 1960s. Fents were the leftover pieces of newly woven cloth left on the loom, and were claimed by home weavers to clothe their children. Larger leftovers were sold in this shop and I made several skirts at bargain prices.Mary LewisLondon W5
Sir, Our mother was a stickler for the correct usage of words and my sister and I were reprimanded if caught using any alternative to “lavatory” (letter, Aug 20). The word toilet, she would remind us, was meant for fixing one’s face or hair. I am now a frequent visitor to the state of Georgia; my use of the word lavatory was initially met with bemused looks, and as my mother is no longer here I feel safe enough to conform and use their preferred term: “rest room”.Elaine LaneyCocking, W Sussex
Sir, As well as being marked down for jam bleeding in to the sponge, Victoria sandwiches (Aug 20) are also marked down (or even disqualified) for visible rack marks and cream fillings.I know as I am one of the judges.Judith GeorgiSaxmundham, Suffolk
Sir, Two London-centric bumper stickers (letters, Aug 13-17) still make me smile: “Stop Knocking Neasden” and “Do you suffer from Acne? Move to ’Aringey”.Brian HartTowcester, Northants
Sir, You report the winning gag from the Edinburgh Fringe (Aug 19): “I was going to sail around the globe in the world’s smallest ship, but I bottled it.” Sathnam Sanghera, in his Notebook in the same edition, offers a far better joke: “Describe yourself in three words. Lazy.”John RudofskyClaygate, Surrey