The elderly man who sits in front of me, terrified he is developing dementia.
The new mother who can't stop crying and is utterly overwhelmed by the baby asleep in her arms.
The teacher who admits to planning their third suicide attempt in terrifying detail.
The teenager who is brave enough to roll up her sleeves and show me where she is cutting herself with a knife.
All of these patients have mental health problems. They all worry about one thing.
"But Doctor," as they turn eyes on me that are frightened and vulnerable, "what about the mental health legislation??!"
Said no patient ever. The government's announcement in the Queen's speech that significant resources will be devoted to reforming mental health legislation went down like a damp squib. No patient or family member who has experienced mental health services in recent years is likely to rate this as the biggest problem they faced. The current mental health act is often used as a last resort, in serious cases where the patient is at real risk of hurting themselves, and their symptoms are so severe they can't agree to have the help they may need. The vast majority of people with mental health problems never get near the mental health act, or legislation. Most are managed by their GPs, with help from crisis teams, community psychiatric nurses, charities, and loved ones. Some need dedicated teams and hospital consultants, or to spend time admitted to specialist units.
The legislation that is or isn't involved is rarely on their minds. What is on their minds, is the thing that was missing. In their election manifesto the Conservatives pledged to increase NHS spending by a minimum of £8 billion in real terms over the next five years. This didn't make the cut for the Queens speech. Neither was funding mentioned for mental health, just an intention to "prioritise" it.
If anyone in the government talked to patients with mental health conditions, or those working with them, they wouldn't talk about legislation and prioritising. They would talk about cuts. About lack of staff and lack of funding. That patients with depression cannot access the talking therapies that are the recommended treatment so often end up with medication as there is no other option.
New mothers and pregnant women who are already vulnerable, are made more so by the lack of midwives during their pregnancy. The short hospital stays, and early discharges. The absence of help with breast feeding. The stretched health visitors. The overbooked GP, so by the time their post natal depression is picked up, it has done irreparable damage to their health. The child with anxiety who is self harming, but repeatedly rejected by the Child and Adolescent mental health team. Not because they don't need help, but cuts and lack of resources mean these services have had to put such stringent criteria in place that barely anyone can be seen.
When you don't treat pregnant mothers, and you don't treat children, you make generations who are more at risk of developing mental health problems later in their lives. That certainly doesn't save money, and it doesn't save lives either.
There is no equality between the provision for physical and mental health. None at all, and a promise to review legislation pours scorn on the hundreds of thousands of people who suffer every day.
What mental health needs, is funding. What mental health needs is to be taken seriously and not used as the latest political fad. It needs all those involved to put their #headstogether and challenge this shameful waste of resources.