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Should a diagnosed mental health problem qualify you for free prescriptions?
Posted by
13th Feb 2016

One thing I hadn't realised until recently was that if you lived in Wales, Scotland or Northern Ireland, you get free prescriptions on the NHS. This got me thinking, which turned into researching, which turned into annoyance, which turned into blogging. Although I was jealous of the fact that, if I lived in another country directly linked under the same government I'd get free medication, I knew that that was another topic for another time. What got me was what I found when I searched for who, if anybody, was applicable for free prescriptions within England, this was the list:

- Treatment for cancer; note this includes treatment for the effects of cancer, or treatment for the effects of a current or previous cancer treatment.
- A permanent fistula requiring dressing.
- Forms of hypoadrenalism such as Addison's disease.
- Diabetes insipidus and other forms of hypopituitarism.
- Diabetes mellitus, except where treatment is by diet alone.
- Hypoparathyroidism.
- Myxoedema (underactive thyroid) where thyroid hormone replacement is necessary.
- Myasthenia gravis.
- Epilepsy requiring continuous anticonvulsive medication.
- A continuing physical disability which means you cannot go out without help from another person (1)

Surely they can't be serious? They have ten different categories and yet mental health doesn't even get a look in. The last point could have been stretched to cover it seeing as mental illness can be debilitating, but then they whacked the "P" word in there.

I can hear the critics already saying that the people on the list above would most likely die without the medication provided but I feel this is a very narrow minded and misguided view that comes with a hint of stigma attached to it. There is still a very noticeable gap between the age at which someone with severe mental health problems die and those without. One study by Rethink mental illness found that those with serious mental health issues can die as much as 20 years earlier than the general population. The study then goes on to show that it's not just death that we should focus on. Mental health can lead to a number of other physical problems. They stated that people with mental illness are three times more likely to develop diabetes and twice as likely to die from heart disease (2) as well as developing side effects from the medication and addictions such as cigarettes, all of which decrease your life expectancy. We can already see the irony in the fact that mental health doesn't qualify for the freebies even though they are three times more likely to develop an illness that does. Then there's the other ironic side to the coin where people with poor physical health are at higher risk of experiencing common mental health problems (3). So you may have a physical problem that is covered by the categories above BUT if you then experience mental health problems linked to this, you have to pay.

To get out of the never ending cycle of mental health leading into physical and vice versa, I started looking into when mental illness was considered a disability. Luckily the lovely people at Mind had already done the research for me. I was looking at the definition and terms of disability in conjunction with the Equality Act, 2010. This act is essentially "116 separate pieces of legislation into one single Act. Combined, they make up a new Act that provides a legal framework to protect the rights of individuals and advance equality of opportunity for all." (4).

Under the Act the term disability covers a much broader area. It states that if you have an impairment that is either physical OR mental and this has a substantial, adverse and long term effect on you normal day-to-day activities, you are considered to have a disability (5). This is a good start. It's included mental health. To define, substantial effect means your mental health problem has more than a small effect on your everyday life. This means thinking about:

- how long it takes you to do something, compared a person who does not have your mental health problem
- the way you do things compared with someone who does not have your mental health problem
- the total effect that your mental health problem has on your ability to do daily activities (such as doing cooking, cleaning, doing the shopping, using a computer, using public transport).

Adverse effect means your mental health problem makes things more difficult for you and long term effect means you have a mental health problem that has lasted at least 12 months, likely to last 12 months or is likely to happen repeatedly.

It also states that even though you may be currently stable or taking medication, the Act looks at what your behavior would be like WITHOUT the medication. Therefore, the law is looking at how your condition affects you when you're not getting treatment or medication (5) and covers you even if you are.

So, if this Act can state that everyone with ongoing mental health problems can be classified as disabled, whether they have ongoing bad mental health or just sporadic episodes, then why can't they then be considered for free prescriptions? Why can't that last bullet point have the very restrictive word physical taken out of it to include those with underlying mental illness that requires medication every day. If those with a mental illness can be considered disabled in one area of the law then I'm sure it can be transferred to another. Even if this is a bit of a flimsy argument, combine this with the fact that those with poor mental health have a high chance of also developing poor physical health should be argument enough. I'm constantly hearing how the NHS should be looking into prevention of illness instead of the cure as it saves money in the long run. The medication doesn't prevent the mental illness itself, and there is no cure, but it will help prevent a torrent of other things.

Should a diagnosed mental health problem qualify you for free prescriptions? The short answer is yes.





(1) http://www.nhs.uk/nhsengland/Healthcosts/pages/Prescriptioncosts.aspx

(2) http://www.rethink.org/media/810988/Rethink%20Mental%20Illness%20-%20Lethal%20Discrimination.pdf

(3) http://www.mentalhealth.org.uk/content/assets/PDF/publications/fundamental_facts_2007.pdf?view=Standard

(4) http://www.equalityhumanrights.com/legal-and-policy/key-legislatures/equality-act-2010/what-is-the-equality-act

(5) http://www.mind.org.uk/information-support/new-legal-publications/disability-discrimination-the-mind-guide/what-is-a-disability/


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