Moving towards equality in an unequal world

In this guest blog, Bipolar UK’s CEO Simon Kitchen explains what Bipolar UK is doing to help make the world a fairer place for people with bipolar.

The theme of this year’s World Mental Health Day on Sunday 10 October is ‘mental health in an unequal world’, and there’s no denying that for people with a serious mental health condition, inequality is a reality. In 2012, the Health and Social Care Act 2012 pledged to create a ‘parity of esteem’ between mental and physical health by 2020. Yet only 11% of the NHS budget goes towards mental health provision, even though 23% of diagnoses are mental health conditions.^[i]

An unequal world for people with bipolar

Bipolar is a serious mental health condition characterised by significant mood swings. Someone with bipolar can experience highs (hypermania or mania), lows (depression) and mixed states (where symptoms of depression and mania occur at the same time) in between long or short periods of stability.^[ii]

Bipolar is a common condition. It’s impossible to calculate an exact number, but we estimate that over a million adults^[iii] in the UK have bipolar. That is roughly 30% more than the number of people who have dementia^[iv].

As a charity, our mission is for everyone with bipolar to live well and fulfil their potential. With the right treatment and support, this is achievable yet so often individuals don’t get the right treatment and/or support. And the consequences of this are all too real: 23% of women on employment support allowance have bipolar,^[v] and the average reduction in life expectancy in people withbipolaris between nine and 20 years.^[vi]

The Bipolar Commission

As well as the many services we provide , including a thriving eCommunity and our in-person and online Peer Support Groups, we launched the Bipolar Commission at our online conference this year. Through this widespread engagement exercise with thousands of people living with bipolar, their families and experts, we are identifying challenges in the healthcare system so we can present recommendations for change.

The overarching aim of the Commission is to dramatically reduce the number of lives lost to suicide in the bipolar community each year. At present, someone with bipolar has a suicide risk that’s at least 20 times greater than someone without bipolar,^[vii] which is higher than someone with major depressive disorder. The full report will be presented at next year’s conference on World Bipolar Day (30 March).

Delay in diagnosis

Looking at the initial findings of the research, one of the statistics that jumps out is the average delay of 9.5 years between people first contacting a health professional about symptoms and getting an accurate diagnosis of bipolar. Unsurprisingly, 60% of people said this delay has had a significant impact on their life.

So what’s causing the delay? Bipolar is often misdiagnosed as depression – in fact, many studies suggest that roughly a third of all depressions have a bipolar course when followed over time.[viii] And, less commonly, bipolar can get misdiagnosed as another serious mental illness, such as schizophrenia or a personality disorder.

Bipolar UK’s recommendations for change

The Bipolar Commission has already identified that to facilitate the change needed to help improve the lives of those with bipolar, there needs to be:

• earlier and more accurate diagnosis 
• quicker and wider access to psychiatrists 
• specific crisis care for people with bipolar  
• improved awareness of effective self-management and peer support
• specialised psychological therapy for people with bipolar  
• a system that gets people on the right medication and dosage quicker.    

And once all the findings of the Bipolar Commission are available early next year, we’ll be adding to this list and sharing the recommendations as far and wide as possible. Only then can we move towards equality and improve the lives of people with bipolar.   

[i] https://www.kingsfund.org.uk/projects/verdict/has-government-put-mental-health-equal-footing-physical-health

[ii] NHS Website: https://www.nhs.uk/mental-health/conditions/bipolar-disorder/symptoms/

[iii] Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England 2014

[iv] In 2019, there were 850,000 people with dementia in the UK: https://www.alzheimers.org.uk/about-us/policy-and-influencing/dementia-uk-report

[v] Adult Psychiatrist Morbidity Study 2014

[vi] https://www.ox.ac.uk/news/2014-05-23-many-mental-illnesses-reduce-life-expectancy-more-heavy-smoking

[vii] Literature Reviews, L. Plans 2019 / Pompili M, Gonda X, Serafini G, Innamorati M, Sher L, et al. (2013)

[viii] https://www.apa.org/news/press/releases/2012/10/bipolar-disorder