Mental health is now barely acknowledged by this government
Mental health is barely being acknowledged by the government and must now be put firmly back on at the top of the healthcare policy agenda, writes Sean Duggan.
This article was first published in the HSJ on 21 July 2023.
In the run up to the last election in 2019 a key pillar of the Conservative Party manifesto pledge on health was the commitment to treat mental health with the same urgency as physical health. Yet four years later those warm words have yet to turn into any tangible action.
Amongst those leading on providing mental health services there is a gnawing fear that despite their best efforts in making the case for the prioritising of mental health services over decades, and just when they appeared to have won the argument, they have once again become invisible to the centre.
Bleak picture
The numbers paint a bleak picture – around 1.2 million people are currently waiting for mental health support, and, despite the best efforts of hard-pressed staff, recent data suggests One in five people attending accident and emergency needing mental healthcare, spend more than 12 hours there.
This will be exacerbated by estimates that ten million more people, including 1.5 million children and young people, will need extra support with their mental health as a direct result of the pandemic.
Mental health is barely being acknowledged by the government and is slipping down the priority list
We already know of the clear links between physical and mental health and about the huge economic and social cost of mental health – calculated at £119 billion in 2019/20 and growing.
Yet mental health is barely being acknowledged by the government and is slipping down the priority list.
Exclusion of mental health providers
There was very little reference to it in the three key priorities of the government’s 2023 mandate to NHS England. And the much-anticipated ten-year cross-government plan for mental health and wellbeing was recently scrapped and rolled into the Major Conditions Strategy, with the risk that it will get lost amongst other competing priorities.
There is also the long overdue reform of the current, no longer fit for purpose, Mental Health Act – a Conservative manifesto commitment – which has also stalled. Sadly, the opportunity for an overhaul before the next election is fading fast.
Only one mental health provider is currently included in the government’s flagship 40 new hospitals
We also see mental health being deprioritised when it comes to capital spending. Our members tell us time and again that many parts of the mental health estate are not fit for purpose. While the way we care for people with mental health problems has changed for the better in recent decades, some providers are still having to use unsuitable facilities built two centuries ago. This is despite clear evidence of the negative impact this has on the outcomes and experience of patients.
Only one mental health provider is currently included in the government’s flagship 40 new hospitals, and when the programme was recently extended by a further eight NHS trusts, no mental health providers were included.
Innovation and collaboration
It should go without saying, but instead needs to be said ever more loudly, that all of this has a direct impact on people needing mental health services, on primary, acute and community services dealing with increased demand, and on the wider public sphere and economy.
We in the service will of course continue to work together with social care and housing providers as well as the voluntary, community and social enterprise sector and others and innovation and collaboration is more important than ever before.
Politicians and policymakers must walk the walk when it comes to true parity of esteem
However, setting urgently needed national priorities, increasing investment in mental health services, including maintaining the Mental Health Investment Standard, additional capital funding for estates and other infrastructure projects, and Mental Health Act reform, all need to be prioritised by ministers.
While it is positive news that the recent NHS Long Term Workforce Plan commits to increasing the number of mental health and learning disability nurses at a faster rate than other part of the workforce, given we are starting from a low baseline, there will continue to be a significant shortfall for some time to come.
In partnership with the Centre for Mental Health, the NHS Confederation has identified a realistic vision for mental health, autism and learning disability services for people of all ages in England in ten years’ time. This shows that by 2032 mental health can be in a better place.
Mental health must now be put firmly back on at the top of the healthcare policy agenda. Politicians and policymakers must walk the walk when it comes to true parity of esteem.
Sean Duggan is chief executive of the Mental Health Network. Follow them on Twitter @SeanDugganMHN and @NHSConfed_MHN
