Laurie Penny: Stigma isn't the worst part of the crisis

Coming out is hard to do, especially in a live parliamentary debate. Last week, the Labour MP Kevan Jones appeared to swallow tears as he told the House of Commons that he had a history of depression. Sarah Wollaston, Tory MP for Totnes, spoke of her post-natal depression, others of anxiety, obsessions and panic attacks. It takes guts to discuss mental ill-health in many workplaces, never mind the Commons, so let's drop the delusion that having mental health problems makes you weak.

However, as new figures reveal that up to three-quarters of people with clinical depression, bipolar disorder and other conditions aren't receiving any care, stigma isn't the only problem. For many, including close friends of mine negotiating the bloodless, Dickensian disability benefits system, stigma comes somewhere behind poverty, austerity and institutional indifference in the obstacles placed in the way of recovery. One in four people will at some point experience mental health problems – but they will experience them very differently depending on whether or not they are a wealthy professional.

Context is everything, and social context is usually overlooked when mental health is concerned, despite poverty and unemployment being the biggest predictors of mental distress. Since 2010, national mental health services have been stretched like the skin of a balloon under a boot. A system which was once far too hands-on has become too hands-off, abandoning patients it once smothered in large institutions.

People now have the right to refuse treatment, but no right to receive it. Most of those who would previously have been treated in hospital now survive on drugs and disability benefits, marginalised by poverty and prejudice rather than by physical removal.

David Cameron's raging juggernaut of public-sector cuts means a service that was already at breaking point begins to groan and snap. Harsh new eligibility tests are extended to everyone receiving sickness benefits, and the test is not designed to be easy for people with mental health problems to pass. Sometimes, the stress of being made to fill out long forms and sit through gruelling interviews under threat of financial ruin triggers major relapse or even, allegedly, suicide.

Meanwhile, unemployment is soaring, and a Royal College of Psychiatrists report urges that cuts be "mitigated in a context where demand for care will probably increase". Translation: austerity is kicking the crutches away from mental healthcare just when workless, homeless, deeply depressed people need it most. If you think you hear alarm bells, it's not all in your head.

Overcoming prejudice against mental health sufferers at work is one thing: forcing them into work they're not well enough to cope with is quite another. Yet that's just what the Government's welfare reforms will entail. Mental health is in crisis, and prejudice is only part of the problem.