Mental health funding in the 2018 Autumn Budget: the devil will be in the detail

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Years of underfunding mean that people with mental health problems often struggle to get access to the same level and quality of care as people with physical health problems. In this week’s Budget, the government took further steps towards addressing this when Chancellor Philip Hammond announced that funding for mental health services will grow as a share of the overall NHS budget over the next five years.  

The government first committed to achieving ‘parity of esteem’ between mental and physical health services in the Health and Social Care Act of 2012, pledging to ensure that people experiencing mental health problems get the same access to safe and effective care as those with physical health problems. But progress has been slow and, as the Prime Minister herself highlighted four years later, the inequalities faced by people with mental health problems still serve as a ‘burning injustice’ in our society.  

This latest commitment follows Theresa May’s announcement in the summer that funding for the NHS will increase by £20.5 billion a year over the next five years. The NHS long-term plan for how the money will be spent is due out later this year but, according to the Treasury, at least £2 billion of this extra funding will now be allocated for new and vital improvements in mental health services, on top of current levels of mental health spending.  

How the extra money is spent will have a huge impact, but we won’t know about that until we see the full plan.   

Providing a ‘sneak preview’ of how some of the money will be spent, the Chancellor highlighted an additional investment of £250 million in new crisis services including: 24/7 support via NHS 111, children and young people’s crisis teams in every part of the country, comprehensive mental health support in every A&E by 2023/24, more mental health specialist ambulances, and more community services such as crisis cafes. The focus on people in crisis is important, as this is when they are most vulnerable and in need of professional support.  

The Chancellor also committed to prioritising services for children and young people, including mental health support teams based in schools and specialist crisis teams for young people. This is sorely needed. An independent review by the Care Quality Commission in 2018 found that many young people experiencing mental health problems don’t get the kind of care they deserve. Finally, there will be an expansion of specialised employment support for people with severe mental illness, and the announcement of £10 million of further support for veterans with mental health needs.  

Many of these commitments build on existing work, including the NHS five year forward view for mental health developed in 2016, and government proposals published earlier in 2018 to transform children and young people’s mental health support. The devil will be in the detail as to how far the new proposals go beyond these existing plans. Given that only a small proportion of the £2 billion has so far been accounted for by the Chancellor, there will be a clamour to go much further in addressing issues such as quality of inpatient care and support for people with mental illness in the community that have not received the same attention or investment.  

While the announcement of more funding is encouraging, mental health care needs more than just extra money to meet demand. For people working in mental health, and the NHS more widely, the key issue will be whether enough staff can be recruited and retained to deliver planned improvements. The NHS workforce plan identified over 20,000 vacant posts in NHS specialist mental health services. Meeting current need will require investment in significantly more staff, but delivering parity of esteem will require far greater investment in preventative measures to reduce the number of people who require the support of NHS mental health services in the first place.   

Comments

Pearl Baker

Position
Carer/Independent Mental Health Advocate and Adviser,
Comment date
01 November 2018

'Parity of esteem' is important when we speak of Mental Health, but this will never happen if those Agencies fail to implement the Care Act 2014, and use 'Staff Shortages' as an excuse. EXAMPLE: if you suffered a Heart Attack the route is EASY, if you require EMERGENCY/CRISIS Support for those suffering a Mental Illness episode there is no direct route, this should be included in your 'Care Plan' if known to the system. It is important that 24/7 access is available to Mental Health Systems, including two way conversation or even ' SKYPE' if this has been set up for CARER and Patient. Mental Health is on the increase, including the breakdown of those already within the system for many reasons. DWP Disability - PIP has seen the MOST 'vulnerable' being effected by having their Welfare Benefits withdrawn? either because they failed to turn up for an Interview, or the 45page questionnaire was not accepted. The question is where is the TEAM or 'Care Worker/Manager'? probably at an ICS meeting discussing 'irrelevancies' when it comes down to basics, and common sense.

The Equality Act 2010 list Schizophrenia and Bipolar at the TOP of Mental Illness. The Ministerial response states anybody suffering from a 'severe' disability will 'automatically' be excluded from PIP ASSESSMENTS, supported by Government, but why is it still happening, and LA are no where to be seen?

The problems Carers and those suffering from a Mental Illness are this: Patient centred -Personal choice-Holistic leading to a better quality of life has all but been forgotten. Personal Budgets not even on the Horizon.

ICS cannot possible succeed, it has no idea what their finances 'SHOULD BE' based on the fact they are ignoring Patients Legal Right to a Personal Budget. The 'system' failure is down to poor training, education, insufficient staff, and an 'abuse' of their 'powers' in not delivering on their legal responsibilities to this 'vulnerable' group.

Nat

Position
A carer,
Organisation
Nursing home
Comment date
08 November 2018

This makes me so mad weres the Money come from in the first place? And this isnt gunna help anyone wat needs it towards any sort of mental health services if the doctors helped you in the first place with the right diagnosis an not just putting you on any sort of medication which doesn't suit you in the first place an there's a start then it should help, why should we go an sit in a room with a complete stranger talking about our problems about the way of life if it wasn't for the government taking off poor people and giving to the rich then we obviously would possibly start to feel a bit better in life then being dragged to piller to post on support services which don't help anyway,after those meets with professionals you still go back to the same house we're u live with all the same problems how's that gonna change with just talking to someone. Instead of them cut, cut, cutting everywhere all in the wrong places why don't the government look at there own parties an start cutting there own people an their wages etc as to how many people are in parliament, surely in this day an age they don't need that many sitting on them benches as they don't do naff all anyway just look important but all they go back to they're 'perfect families an watch the world go round an think everything's alrite when clearly its not people are suffering they ought to open there eyes from daydreaming themselves before taking liberties of other people they owt to take a long hard look at themselves and start cutting on there end. Soo frustrating if they only had deep depression and adhd they'll soon change there minds!!!!!

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