Parity of Esteem: Three Little Words Looking for a Larger Meaning.

Being diagnosed with a mental health condition can have an adverse effect of an individual's life chances. These can range from struggling to find or maintain work though fractured relationships to a lower life expectancy.

There is also a major impact on wider society of unmet mental health needs, for example, according to the Centre for Mental Health time off due to workplace stress cost UK employers £34.9million in 2016/17.

For the past decade there has been an emphasis of achieving 'parity of esteem', for mental illness to be accorded regard and resources matching those devoted to treating physical illnesses. In 2011 the then coalition government set out an expectation of 'parity of esteem' in its No Health Without Mental Health policy, in 2013 a similar commitment was written into the NHS Constitution for England.

To date though despite all the warm words and sincere promises delivery on the ground has been patchy to non-existent.

There is no uniform measure for how mental health services are delivered. Waiting times, an established if sometimes crude benchmark for performance in the NHS, are, apparently, impossible to correlate. Access to many services are not even subject to maximum waiting time standards.

A bigger problem is that Clinical Commissioning Groups, the bodies controlling th ding for a given area, do not have to ring fence money allocated to mental health services. The official line is that that funding should grow in line with that devoted to physical health services, often though the mental health budget is often raided to plug gaps elsewhere.

There are also some practical gaps that get in the way of parity of esteem becoming a reality. These include patchy diagnosis, GPs, usually the first medical professional someone asking support for their mental health will see have little training in this area. The days of busy doctors telling people to 'pull yourself together' may, thankfully, he mostly in the past. Unfortunately, they seem to have been replaced by one's where equally busy, if not busier ones, reach for the pill cupboard instead.

There is also the Dracula like ability of the stigma surrounding mental illness to keep resurrecting itself. Public awareness and understanding may have improved; but old prejudices did hard if they die at all.

In time for the last general election the Centre for Mental Health published its Towards Mental Health Equality report. This called on the incoming government to, amongst other things, create a cross party plan to embed an understanding of its likely impact on mental health in all areas of policy making.

This is a noble and necessary aspiration, unfortunately it's also one that is likely to founder on the rocks of official indifference. At least it is without a significant change in mind-set and actions.

Professionals, support groups and individual service users need to stop seeking salvation in a form of words. 'Parity of esteem' is as meaningless as all those other phrases that tell a marginalised group to accept less than their due and to smile as they do it.

The mental health community needs to learn from the liberation movements, that their political power exists and is embodied in their willingness to be difficult. It isn't good enough to be promised better services will be delivered on some tomorrow that never arrives; they need to be provided now.

'Parity of esteem' is meaningless, the real battle is for esteem for everyone.