Core mental health services are underfunded and all but overwhelmed by rising demand
The Government’s promises on mental health are welcome, now it’s time for action, says Jeff Smith MP.
In December 2015, I spoke about my family history of depression and the effect it has had on my life.
As one of the growing number of MPs who have now spoken out about our mental health issues, I'm pleased that since then, even in a short space of time, the narrative around the issue has changed.
The stigma associated with mental health is falling away as celebrities such as Stephen Fry and Professor Green have put it on the public agenda. Lloyds, Ford, Lynx deodorant and even the Royal Family have run effective campaigns to get people talking.
This turnaround brings its own challenges. We’ve been busy telling people to open up, talk to their loved ones and, most importantly, seek treatment when they need it. The question now is – what happens when someone in crisis listens? Do we have the services they need, when they need them?
That was our starting point for The All Party Parliamentary Group on Mental Health inquiry into progress made at the half-way point of the Five-Year Forward View for Mental Health, the Government’s plan published in 2015. Over several months we spoke to service users, medical professionals, academics and others with experience and expertise in mental health to see whether this plan was making a difference.
The answer was clear – progress has been made in some areas, but too many people in crisis are still left without the care they need.
While investment has made a difference in some types of specialist care, we heard that core services are underfunded and all but overwhelmed by rising demand. We know that 1 in 4 adults are waiting over 3 months to receive any help and around half of young people are waiting more than 18 weeks. Shortening these times could make the difference between a successful recovery and a prolonged crisis.
The number of mental health beds has fallen by 8000 since 2010 so people are being sent further to get the help they need. Earlier this year I raised the case of a constituent who was told that the nearest available psychiatric bed for her son was in West Sussex, a 450-mile round trip from her home in Manchester.
Is it surprising, then, that more and more people with mental health issues are turning up at A&E as a last resort, or that the number of detentions under the Mental Health Act is rising?
We were told that a key driver of these challenges was workforce recruitment. There is a staffing crisis across much of the NHS but in mental health, it’s particularly acute. Last year nearly 25,000 mental health nurses, therapists and psychiatrists quit the NHS. That’s an eighth of the mental health workforce.
Jeremy Hunt, then Health Secretary, pledged in July last year to recruit 19,000 NHS staff by 2020/21, but over the last year the workforce has increased by just 915. Understaffing drives up waiting times and NHS providers have told us that under current workforce plans, mental health trusts will struggle to meet the rising demand for care.
Finally, we heard that mental health must be joined up with other services. Mental health is a classic cross-cutting issue, touching almost every aspect of an individual's life.
We know that the introduction of fitness-to-work assessments has caused a 50% rise in mental health issues among unemployed disabled people. And we know that the number of homeless people diagnosed with mental health problems is almost double the rate of the general population, with half of homeless people living with a mental illness.
Achieving parity of esteem will not come through NHS spending alone. Like poverty, mental health demands cross-governmental working, backed by investment, to explore the links between mental illness and work, housing, welfare, military service and so much more.
At the root of all of these issues is investment. The Royal College of Psychiatrists found that almost two-thirds of mental health trusts reported a lower income in 2017 than they had in 2011. Ultimately, it’s funding that will improve the care people receive because no amount of awareness-raising can provide more beds, more nurses or more psychiatrists.
The Government must back up their promises on mental health with sustained action so that when people gather the courage to seek help, we don’t let them down.
Jeff Smith is Labour MP for Manchester Withington.