Today is World Mental Health Day, and the theme is suicide prevention. Many politicians and commentators will say or write suitably concerned things about the importance of getting help, without acknowledging that they are part of the reason people need help in the first place.

Mental health is political.

The causes are often political. And the shocking lack of support and treatment for people is political too.

I’ve lost two friends  to suicide this year. One of them took his own life while on a too-long waiting list for treatment. His death was the result of political choices. The system might not have been able to save him. But the system never tried.

The grotesque underfunding of the NHS, underfunding that makes vulnerable people wait years for treatment if they live long enough to access it, is not accidental. It’s the result of many years of swingeing cuts, of ideologically driven changes to the way the NHS works, of a deliberate lack of funding for the training of health professionals, of a refusal to fairly tax corporations and the most affluent people in society to adequately fund health and social care.

I’m particularly aware of this because I’ve seen how desperately underfunded mental health services are. It’s even worse if you’re trans: people who are trans have to wait even longer for help, which is why the suicide, self-harm and substance abuse rates in our community are so frightening. In some cases the gap between initial referral and actual treatment can be four or even five years.

That’s political too. Trans healthcare is a grotesquely underfunded and overworked subset of mental health provision. Once again, that’s the result of political choices – choices affecting the wider NHS, and choices such as the UK governments’ persistent refusals over many years to heed warnings of growing demand for trans-related healthcare. The current crisis in the gender clinic system was predicted years ago by credible experts. Politicians chose not to listen, let alone provide any additional funding.

Commentators play their part too. My own mental health has been severely impacted by the daily demonisation of and scaremongering about trans people in mainstream media – Radio 4 was at it again this morning, platforming anti-trans bigots without any dissenting voices – and on social media, where I have to block thousands of people just to be able to use the apps normally.

It’s not just us. It’s the immigrants blamed for putting pressure on the NHS to distract from funding cuts and creeping privatisation. It’s the EU nationals forced to apply for settled status to continue living here, the non-white people demonised in the national press as criminals and terrorists, the so-called “snowflakes” laughed at for daring to talk about their mental health, the people from ethnic, sexual and romantic minorities whose very existence is questioned and whose rights are deemed less important than those of others.

And most of all, it’s poverty.

There’s a reason people in Glasgow’s affluent West End live longer than those in the deprived East, and that reason has existed since the West End came into being: it isn’t race, it isn’t religion and it isn’t sexual orientation or gender identity.

It’s money.

Money enables you to buy better living conditions, better food, a better education for your children, in many respects a better life.

That’s not to say affluent people don’t get mental health problems. Of course they do. But they don’t rot on the same waiting lists that poor people do. They aren’t bullied by the DWP like poor people are. They aren’t on zero-rights, zero-hour contracts like many poor people are. They aren’t reliant on desperately overstretched and underfunded community mental health services like poor people are.

Mental health problems are not a sudden plague caused by who knows what. They are the inevitable result of successive governments removing the safety net for society’s most vulnerable people, the consequences of creating a society where the most privileged are able to deny their responsibility to help the less fortunate and incite hatred of those who need help most. They are the result of inadequate housing, of slashed funding for mental health services, of inadequate protection against hate crimes and discrimination, of a low-wage, low-rights employment market.

They are the inevitable result of a society that works for the few and despises the many.

It’s not enough to say “if you’re sad, get help”. There needs to be help available. All too often there isn’t. And that’s no accident. That’s political.

We don’t need better mental health awareness. We need better mental health provision. We know we need help. For too many of us, the help isn’t there.

Don’t let the politicians away with it. Don’t let them post “it’s OK not to be OK” and consider their job done. Demand answers. Demand action.

Too many people aren’t OK. And that’s not okay.