This week’s Queen’s Speech placed mental health reform on the parliamentary agenda. Changes to the Mental Health Act will focus on giving people greater control over their treatment, redressing racial disparities and tackling rising detentions. While welcoming reform of the “antiquated” Act, the mental health sector has long-called for government action to improve Britain’s “struggling” mental health services.
Britain’s struggling mental health services
Mental health services are under ‘severe strain’. Too many individuals with mental health illnesses face long waits to access care and treatment. Services need greater investment and staff are stretched. The pandemic has exacerbated these challenges. Increased need has seen demand surge and waiting lists grow.
Services for children and young people are under particular strain. Since the pandemic, there has been a 77% rise in children needing treatment for severe mental health crisis. Increased need is outstripping supply leaving children in crisis waiting months for help. ‘Swamped’ services are turning away struggling children who fail to meet high thresholds for accessing treatment.
Post-pandemic, the government has developed a £500m recovery action plan, invested £400m to remove outdated dormitories, and committed to improving UK wellbeing by 2030. All welcome initiatives, but unlikely to address systemic challenges.
So What next?
The need for greater funding
The most transformative development is the forthcoming 10 year cross-government mental health and wellbeing strategy. A strategic review of the societal factors that contribute to our wellbeing, and how services can work together to address them, could deliver tangible change. The sector has warned the new strategy must be underpinned by investment. None of the spending review’s £44 billion of extra NHS investment was earmarked for mental health, while the existing funding envelope doesn’t match levels of need. The 2019 Long Term Plan’s extra £2.3bn a year for mental health was committed before demand for care surged post-pandemic. The sector has called for NHS spending levels to more fairly reflect mental health’s NHS burden. Enshrined in the Health and Care Act are new measures to increase transparency around mental health funding.
Improving access to timely treatment
Timely treatment is crucial. The NHS is consulting on introducing access standards for mental health, for the first time. Guaranteeing timely care would improve outcomes, but providers may struggle to meet standards without support and service investment. Prolonged treatment waits are ‘leading to more acute and complex need’. Earlier preventative support can avoid the need for clinical intervention and resulting demand increases.
No quick fixes to staff shortages
There are no quick fixes to addressing ‘chronic staff shortages’, which present a significant barrier to improving access and outcomes. The mental health workforce hasn’t grown meaningfully in a decade and there is broad consensus that a fully funded workforce strategy is needed. The government rejected sector-backed legislative amendments to reform workforce planning. However, it has recognised its forthcoming mental health strategy must include a comprehensive plan to ‘recruit and retain’ mental health staff.
Time for meaningful action
The Prime Minister is said to be prioritising reforms with an ‘electoral impact’. He’d do well to focus on mental health. Ahead of the last election, mental health was the public’s top spending priority to improve the nation’s health. Labour have sought to capitalise on public concern, committing to extra spending and staff, and guaranteeing treatment within a month. Irrespective of electoral salience, action is needed to combat the acute crisis affecting children, and support the millions who can’t access NHS help. To quote Johnson’s predecessor, Theresa May, this week, “those suffering from mental health issues deserve better from the Government”.
With a long-term mental health strategy under development, the new Parliament presents an opportunity for the government to respond to longstanding warnings from patients, the public and charities. They will be looking for a credible plan, realistic about the resources needed to improve outcomes. In delivering that, maybe we will start to make progress tackling the deficit of unmet need.