We live in strange and worrying times. As I write, another building society has been nationalised.
The US government is pouring $700bn of public money into its failing banking system to prop it up, and all over the developed world, political differences are being buried because of the state of financial emergency.
The effects on Sussex Partnership foundation trust are at the moment peripheral - some costs are going up, and the book value of our assets has gone down. But we will see increased referrals soon. Sadly, increases in suicide rates are likely as personal financial positions worsen, debts grow and jobs disappear. As tax revenues decline, we should expect to see public services being pinched.
It is always interesting to see how leaders act in times of crisis, and how long they go on behaving as though nothing is happening. Trying to keep things normal is admirable, but most post hoc analyses show that taking action sooner rather than later can avert a catastrophe.
During past times of austerity, the overall health of the nation has actually improved, with people taking more physical exercise and growing their own vegetables to augment what little was in the shops. But now, with prices rising, people are beating the credit crunch by going to bargain supermarkets for bumper packs of own brand crisps.
Bans on advertising
Someone I know who works in advertising tells me that their company is pitching for a multi-million pound advertising campaign to combat child obesity. An admirable aim, but rather than telling people what to do, wouldn't it be better to ban junk food advertising and make personal training, healthy cooking and eating free in every school?
Fat is not just a feminine issue; it is a deeply political and psychological one. Fat people are not happy to be fat, they do not really believe they are big boned, but they will not change the habits of a lifetime just because someone tells them to.
We all know how many psychiatrists it takes to change a light bulb - only one, but the light bulb has to want to change. In Western countries, fat is associated with poverty, because custard creams are cheaper than kiwi fruit, and if you have had a bad day, rather than going home to cook a nourishing stew, it is easy to kid yourself that yet another takeaway pizza or bargain bucket is a treat.
Telling poor kids to eat better and exercise more when their parents do not know how to cook, when school cookery lessons have all but disappeared, when school dinners have been privatised and so they only have enough money for chips, when they get an hour of PE a week and the rest of the time the playing fields are being used by tomorrow's elite athletes will be both ineffective and cruel. Jamie Oliver has just returned to this fight, and good on him for it.
Mind the gap
This is world mental health month, and our theme is the close link between physical and mental health.
People with serious mental illness live on average 15 years fewer than the rest of the population, which is a national scandal. While suicide is a factor, they mainly die early from preventable physical diseases.
Our aim must be to ensure supportive access to physical activity, lessons on cooking healthy food on a tight budget, and effective smoking cessation to everyone we provide services to. This will add both life to years and years to life for some of the most marginalised people in society.