While the government is putting in extra money to help the backlog of NHS elective care, there is the urgent need for funding to support the accelerating numbers of people waiting for mental health services or to be cared for in the appropriate setting. This is particularly pronounced for children and young people. Matthew Taylor makes plain the situation.
Apparently, the ‘red meat’ agenda to revive the government’s popularity includes extra money to help the six million people now waiting for NHS elective care. This is welcome, but what about the 1.6 million people on waiting lists for specialist mental services or the additional eight million with milder mental health problems at risk of becoming more serious without appropriate support?
The number of mental health beds commissioned for children and young people has fallen by a fifth over the last five years
Even before COVID-19 hit, mental health services were under pressure, but the pandemic has made things much worse. Those who work in mental health are now reporting a noticeable increase in the severity of illness in their patients.
This is particularly the case for children and young people, where we have seen eating disorders skyrocketing. Some of these children are extremely ill and need to stay in hospital but there is simply not the space to take them all.
The number of mental health beds commissioned for children and young people has fallen by a fifth over the last five years. This means young, highly vulnerable patients are often placed in general paediatric wards. Staff care as best they can but don’t always have the skills to support their complex needs.
Worse still the numbers of children and young people being placed on adult mental health units has also increased. This is a direct contravention of the 2007 Mental Health Act, which clearly states that children and young people should be placed in age-appropriate settings that meets their needs.
When they are not addressed quickly and effectively, mental health issues very often become more serious, and require expensive specialist services. This isn’t good for the patient, mental health services or the public purse.
The good news is that there is some inspiring transformation work underway to improve access to mental health support.
In the city of York a pioneering service directing people suffering isolation and loneliness to a range of voluntary clubs and activities has not only brought solace and hope it has substantially reduced the number of people with non-clinical needs visiting GPs.
In Herefordshire and Worcestershire the integrated care system has brought primary and secondary mental health care organisations together to make it much easier for adults with mental health needs to access services. This more flexible and accessible service model is being rolled out nationally.
Mental health support teams for children are being developed in over 300 schools. These teams can make a real difference both for individual pupils and for the school as a whole. But consistent and additional funding is needed if the model is to reach every school.
Lack of funding is risking progress
While progress has been made in increasing mental health funding over the last few years, the lack of any additional earmarked money in the government’s spending review puts progress at risk. As was as the plight of those needing treatment today, we are storing up enormous problems.
UK mental health problems account for 28 per cent of the burden of disease but only 13 per cent of NHS spending
The proportion of children and young people with a mental disorder has jumped from 1 in 9 in 2017, to 1 in 6 in 2020. Yet only about a third of them are able to access the specialist services they need.
Today in the UK mental health problems account for 28 per cent of the burden of disease but only 13 per cent of NHS spending. We often fail to recognise or address the mental dimension of physical illnesses, for example the anxiety of cancer sufferers.
As Omicron recedes and our attention can at last turn fully to recovery, it is imperative that widely accepted principle of parity of esteem for mental health is more fully reflected in policy, funding and legislation.
Matthew Taylor is chief executive of the NHS Confederation. You can follow him on Twitter @FRSAMatthew
This article first appeared in The Times Red Box on Wednesday 19 January 2022.