In the United Kingdom, the Coalition government’s recent commitment to improving mental health provision masks the extent that their policies of austerity have already brought harm to those same services. Government-driven policies have led to significantly reduced funding within mental health, increasing pressure on a system that was already chronically under-resourced. Further, people who are experiencing mental distress, and mental health service users, have been especially vulnerable to the harms of the current austerity programme, including being at the sharp end of the assault on public services and welfare spending. This piece discusses the impact of austerity, exploring the effects of government policies and with a critical perspective of the dominant discourses around mental health. It argues that by exacerbating social inequality, government policies are also directly leading to worsening mental health in the United Kingdom

There is limited global evidence exploring perceptions of dementia among people with intellectual disabilities. This article presents findings from the first known study where an inclusive research team, including members with intellectual disability, used photovoice methodology to visually represent views of people with intellectual disabilities and dementia. Drawing on Freire’s empowerment pedagogy, the study aims were consistent with global photovoice aims: enabling people to visually record critical dialogue about dementia through photography and social change. We investigated the benefits and challenges of photovoice methodology with this population and sought to identify perspectives of dementia from people with intellectual disabilities. Data collected identified issues such as peers “disappearing” and the importance of maintaining friendship as dementia progressed. Although reaching policymakers is a key aim of photovoice, this may not always be achievable, suggesting that revisiting Freire’s original methodological aims may lead to improved outcomes in co-produced research with marginalized groups.

Since 2010, the UK has pursued a policy of austerity characterised by public spending cuts and welfare changes. There has been speculation – but little actual research – about the effects of this policy on health inequalities. This paper reports on a case study of local health inequalities in the local authority of Stockton-on-Tees in the North East of England, an area characterised by high spatial and socio-economic inequalities. The paper presents baseline findings from a prospective cohort study of inequalities in mental health and mental wellbeing between the most and least deprived areas of Stockton-on-Tees. This is the first quantitative study to explore local mental health inequalities during the current period of austerity and the first UK study to empirically examine the relative contributions of material, psychosocial and behavioural determinants in explaining the gap. Using a stratified random sampling technique, the data was analysed using multi-level models that explore the gap in mental health and wellbeing between people from the most and least deprived areas of the local authority, and the relative contributions of material, psychosocial and behavioural factors to this gap. The main findings indicate that there is a significant gap in mental health between the two areas, and that material and psychosocial factors appear to underpin this gap. The findings are discussed in relation to the context of the continuing programme of welfare changes and public spending cuts in the UK.

Successive UK governments since 2010 have adopted policies of austerity characterized by public spending and social security cuts.There has been little qualitative research exploring the effects of these policies on inequalities in mental health. This article presents findings from a case study of Stockton-on-Tees, a local authority in the North East of England with exceptionally high spatial and socio-economic inequalities. Qualitative interviews were undertaken with people experiencing mental health problems in different areas of the local authority, alongside interviews with key stakeholders. The findings offer an insight into spatial inequalities in people's lives, and the impact of deprivation on mental health. They suggest that austerity measures are having a damaging impact on individuals and communities in the most deprived areas of this unequal place, whilst leaving those from less deprived areas relatively unscathed-with the exception of increased job insecurity. The cuts in social security are impacting on health through both material and psychosocial pathways including increased financial hardship and chronic stress. The intrusion of the state into people's everyday lives was such that the notion of the "home as an asylum" was broken, giving many no respite from the draining day-to-day experiences of poverty. The findings are discussed in relation to the continuing program of welfare changes and public spending cuts in the United Kingdom, including avenues for further research and key recommendations for policymakers. KEYWORDS health inequalities, neighborhood effects, social determinants of health, social policy

In response to the 2007/8 financial crisis and the subsequent ‘Great Recession’, the UK government pursued a policy of austerity, characterised by public spending cuts and reductions in working-age welfare benefits. This paper reports on a case study of the effects of this policy on local inequalities in mental health and wellbeing in the local authority of Stockton-on-Tees in the North East of England, an area with very high spatial and socio-economic inequalities. Follow-up findings from a prospective cohort study of the gap in mental health and wellbeing between the most and least deprived neighbourhoods of Stockton-on-Tees is presented. It is the first quantitative study to use primary data to intensively and longitudinally explore local inequalities in mental health and wellbeing during austerity and it also examines any changes in the underpinning social and behavioural determinants of health. Using a stratified random sampling technique, the data was analysed using linear mixed effects model (LMM) that explored any changes in the gap in mental health and wellbeing between people from the most and least deprived areas, alongside any changes in the material, psychosocial and behavioural determinants. The main findings are that the significant gap in mental health between the two areas remained constant over the 18-month study period, whilst there were no changes in the underlying determinants. These results may reflect our relatively short follow-up period or the fact that the cohort sample were older than the general population and pensioners in the UK have largely been protected from austerity. The study therefore potentially provides further empirical evidence to support assertions that social safety nets matter - particularly in times of economic upheaval.