Mental health faces the toughest three years in living memory

The impact of the COVID-19 pandemic on the nation’s mental health has been substantial and we will see the fall out for many years to come.

It is a stark reality that we are still a long way from achieving parity of esteem

A plethora of stressors from financial insecurity, bereavement, loneliness, substance misuse, domestic violence and school closures have negatively affected many people’s mental health – particularly those from BME communities, people on lower incomes, people with existing mental health conditions and children and young people.

And while there has been impressive progress in mental health over the past few years including increasing access to children and young people’s services and improvements in early intervention in psychosis, psychiatric liaison and crisis services, the level of unmet need was already high before the pandemic hit and has grown ever since. It is a stark reality that we are still a long way from achieving parity of esteem.

Growing mental health backlog

We are all only too aware of the physical health backlog caused by the pandemic. But there is also a growing mental health backlog. The most recent NHS England figures show that 1.6 million people are on waiting lists for mental health services, and an additional 8 million would benefit from treatment but because of pressures on capacity levels within services, do not meet the current thresholds for care.

We are calling on the government to acknowledge the pressures on the NHS mental health sector

We also know that people are more likely to attend A&E and require urgent responses from ambulance services when they are not able to access timely support for their mental health. Given the strong link between mental health and physical health, there is a real risk that people’s physical health will also suffer, increasing demand on primary care and secondary physical health services as well as increasing the need for social care support. We know that over two thirds of local authorities that provide social care are reporting an increase in demand for mental health social care services.

We are calling on the government to acknowledge the pressures on the NHS mental health sector and provide targeted support to protect our children and young people from developing life-long mental health issues. This needs to be coupled with additional resource to build up preventative and early support services which will reduce the demand on the NHS.

While the additional £36bn of funding for the NHS announced last month is to be welcomed, we know that it does not go far enough to address the longer-term impacts of the pandemic including on the nation’s mental health.

As tough decisions are made on how this funding for the health service is portioned out across the system it is vital that we recognise not just the physical health impact of the pandemic, but the mental health one, too.

Underfunding of services

At a minimum, the Mental Health Investment Standard, which requires spending on mental health to grow as a proportion of the NHS budget, must continue to be met. This requires around £1bn in additional revenue for mental health services next year, a further £540m for 2023/2024 and around a further £900m in 2024/2025. Capital and workforce funding must also recognise the long-term, structural challenges for mental health in these areas.

We are already seeing huge rises in demand for children and young people’s services. However, historic underfunding of children and young people’s services means levels of unmet need were high before the pandemic, with only around 40 per cent of those requiring treatment able to access it.

We also need to see a growth in early intervention support, that is why we are supporting the Fund the Hubs campaign

The numbers now are even more concerning. Referrals for children’s and young people’s mental health services rising 57 per cent in the second half of 2020/21 compared to the same time in 2019/20 and demand for eating disorder treatment has skyrocketed, with a 160 per cent increase in the number of young people completing an eating disorder pathway over the same period.

The NHS Long Term Plan committed to increasing the proportion of the mental health budget spent on children and young people’s services, and this must continue to be honoured within the mental health NHS settlement. However, we also need to see a growth in early intervention support, that is why we are supporting the Fund the Hubs campaign, which calls for Early Support Hubs for children and young people in every local authority.

We know that preventive support for all ages is the most cost-effective way to target funding. Ensuring mental health gets its fair share of the social care settlement and public health funding will help, and to that end the Prevention and Promotion fund for local authorities, which is targeted at those most in need, must be continued and expanded.

The next three years are likely to be the most challenging the modern mental health system has ever faced. This is an opportune time for the government and NHS leadership to acknowledge the impact of the pandemic on the nation’s mental health and ensure additional investment to help those in need now and the protect future generations.

Sean Duggan is chief executive of the Mental Health Network. Follow them on Twitter @SeanDugganMHN and @NHSConfed_MHN

This blog was first published in the HSJ.