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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.