Trains, planes, buses and brains
Transport must do more for mental health, says Transport Minister Andrew Jones.
The relationship between mental health and transport goes deeper than many people realise.
Last week, Professor Ed Bullmore, Head of Psychiatry at Cambridge University, published an article with the title, ‘Why brains and airports have a lot in common’.
He said the best way to understand how the different parts of our brain are wired together is by thinking of how airports are connected by flights.
The different parts of most people’s brains are wired together similarly to how airlines link big airports such as Heathrow or Schiphol.
While in other people’s brains, though they have no fewer connections, those connections are routed as if they are flights between many smaller airports.
The difference helps explain some mental health conditions such as schizophrenia.
Professor Bullmore’s use of transport as a metaphor is a brilliant way of talking about the brain.
Transport is important for mental health
Yet we are here today (25 February 2016) because we know that mental health and transport are linked by more than metaphors.
There’s a real-world connection, too.
The stats say that 1 in 4 of us will experience a mental health issue this year.
It might be phobias, anxiety, OCD, depression, panic disorders, dementia or one or more of many other conditions.
You’ve already heard moving accounts of the experience of living with conditions such as these.
And about how, so often for people with mental health conditions, good transport can help a full, timely recovery or just make life that bit better.
Transport offers freedom to visit family, go to the shops, travel to volunteer or to museums, and transport offers the hope that can be found in the chance to study or to work – all the things that make for a normal life.
So it’s a real pleasure to join you for what is probably the first, and almost certainly the biggest, gathering of transport and mental health advocates ever held in Britain.
Transport needs to catch up
And it’s about time we met.
Because when it comes to serving those with poor mental health, transport has some catching up to do.
To see how much, look at the progress the transport industry has made in meeting the needs of those with physical ill health.
Take the bus industry – one of my areas of responsibility.
Today nearly 90% of buses are equipped to serve physically disabled people, with wheelchair space, priority seats, handrails, and devices to help people get on and off.
But on mental health, there’s sadly been nothing like that kind of progress.
Even someone with the best mental health will sometimes find public transport stressful and bewildering.
Just ask anyone who’s been at Clapham Junction train station during rush hour.
Or anyone who’s boarded a bus in an unfamiliar town, not quite knowing where to get off or even whether you are travelling on the right bus going in the right direction.
Or anyone who’s had to dash from one airport terminal to another in time to catch a flight.
And then there’s the familiar feeling of rising panic whenever the ticket inspector enters the railway carriage, even when you are sure you have a valid ticket.
No wonder someone who experiences anxiety, panic attacks, memory loss or a host of other possible conditions can feel unable to use public transport.
I had a lot of sympathy with one person with a mental health condition who said:
You might afford the bus, but the bus company’s website doesn’t give fares. To find out the fares you have to speak to the bus driver or phone the company. Just thinking about either brings on a panic attack. The dread of getting on the bus with insufficient fare is overwhelming.
So what are we going to do about problems like these?
What we must do
First, we need to recognise that transport’s problem with mental ill health is a symptom of a wider problem.
Across much of our society and our economy, mental health has not received the same level of attention as physical health.
It might be because mental health is less visible.
It might be because people don’t understand mental ill health and how common it really is.
Or it might be because of the stigma that still lingers around mental health, a stigma that for physical health we long ago dispelled.
The good news is that things are changing.
During the coalition government we passed the Health and Social Care Act 2012, to make sure the NHS treats mental and physical health conditions equally.
And thanks to the work of organisations like those here today, such as the Mental Health Action Group, Mind, and Anxiety UK, that change is gathering pace.
The BBC, which is covering our Summit today, has just finished its mental health season.
And last week both the Duchess of Cambridge and First Lady Michelle Obama wrote high-profile articles on the importance of proper treatment for mental ill health.
So bit by bit, we are breaking down the stigma and misunderstanding around mental health.
What transport has done already
But now we need that change to come to the transport sector, too.
And there are some early signs of encouraging progress.
First Bus have introduced a Better Journeys Card which is designed to give people a discrete way of alerting the bus driver to any special assistance they may need. The card contains messages such as please help me find a seat, please count out my change with me and, please be patient, I have a hidden disability.
These cards remind us that, so often, it’s skilled and helpful transport staff who make the biggest difference to passengers.
So I am pleased that, on the railways, Virgin Trains has been working with the Alzheimer’s Society to deliver specialist training to station staff, which has meant that a number of its stations are increasingly dementia-friendly.
And many airports have been making progress too.
Most airports now offer familiarisation visits to those who would benefit from them before they fly.
Gatwick has said that, so far, 80% of its front-line staff have undergone Dementia Champions and Dementia Friends training, and the airport has introduced its own bespoke NVQ Level 2 Certificate in the Principles of Dementia Care for customer-facing staff.
Meanwhile, Manchester Airport has recognised how stressful the security search process can be for children with autism. So it has special wrist-bands for children to wear to alert staff that they need a search procedure suited to them.
These are great examples of the difference that transport operators can make when they think about those with mental health needs.
And the person who said they were worried about boarding the bus without knowing the fare might be pleased to hear that we are going to make a new law.
As part of our Buses Bill, all bus operators will be required to make data about routes, fares and times open and accessible.
It will allow app makers to develop products that passengers can use to plan their journeys, and give people the confidence to take the bus.
Transport industry pledge
But we need the industry to keep taking action of its own accord, too.
For one thing, there’s a good commercial case for it.
If 1 in 4 of us will experience a problem in any given year, and if 1 in 20 of us experience a long-term mental health condition during our lives, then those with mental health conditions constitute the UK’s largest single sector of disabled people, and a transport industry which excludes these people is missing out on millions of potential customers.
Yet the many transport firms represented here today show there’s a lot of good intent out there.
The government doesn’t want to impose a one-size-fits-all solution on the transport industry.
It’s about getting to know your customers and taking action in the most effective way for your sector.
That’s what I’d like you to think about this afternoon.
And if you have a good idea, we’ve provided pledge cards that you can fill in to record what you are going to do.
So in conclusion, change is coming in transport.
People want a better service, more attuned to their needs.
Those with mental health conditions have as much right to travel as anyone else.
And making the improvements these passengers want needn’t be expensive.
It’s often just a question of listening, being flexible, and giving staff the right kind of training.
If we get it right, our transport networks will be better for some of the most vulnerable people in our communities.
So make your pledges.
This summit isn’t a one-day-wonder.
It’s an issue that will keep rising up the agenda.
And that is what will make life better for us all.