The NHS Long Term Plan must recognise the role of non-NHS services in delivering services to people with mental ill-health, argue Chris Hampson, chief executive of Look Ahead and Sean Duggan, chief executive of the Mental Health Network.
The recent publication of the NHS Long Term Plan heralded vital progress towards parity of esteem for mental health.
The sector welcomed the announcement of the £2.3 billion ringfenced local investment fund for mental health, which, provided this funding reaches the front line, will help alleviate the severe pressures on the system as well as improve and increase access to mental health services.
However, there are challenges to achieving the bright vision set out in the plans, particularly for the mental health sector which often delivers care in partnership with multiple non-NHS providers to meet individuals’ care needs. It should be noted that, for mental health provision, investing solely in statutory services is unlikely to yield the government’s expected improvements in outcomes. The key to keeping people well and improving the quality of life for people living with severe and long-term mental health conditions is to invest in a package of services that encompasses health care provision, employment, housing and ongoing social care support.
“Someone to love, somewhere to live and something to do”
Cuts to local authority budgets means that people’s wider care needs often are not being met. The NHS is increasingly working in partnership with the voluntary and third sectors to provide supportive and holistic care which keeps people well and helps support recovery.
At the Mental Health Network, we have been aware for some years now the NHS-funded mental health services are delivered in many forms, by providers from the statutory, independent and third sectors, as reflected in the broad church of our membership.
We have called, via our membership of the Mental Health Policy Group (MHPG), for a cross-government mental health strategy “to effectively tackle the wider social determinants of poor mental health”. The MHPG has stipulated that support should include improved support for people to navigate the health and social care systems and other vital services such as benefits and housing.
The view from the housing sector
As one of London’s largest providers of non-statutory mental health support services, we welcome the plans set out in the NHS’s long-term plan to plough more vital investment into mental health services.
However, Look Ahead is in strong agreement with the Mental Health Network that there needs to be more focus on the role of non-NHS providers who also play a critical role in supporting those with mental health needs. Providers like specialist housing associations such as Look Ahead, voluntary sector agencies and the huge range of organisations that provide non-statutory support.
For too long, the role of these organisations has been side-lined, sometimes even omitted completely in the debates about funding or the future direction of mental health provision in this country. But we know, from our own experience and that of our peers in the sector, that support services are critical in enabling people to stay safe and well and living in their communities. We know, and the evidence shows, that they often provide extremely credible, high-quality and cost-effective alternatives to NHS care.
For Look Ahead though, we believe the future of truly effective mental health provision lies in integrated care – through partnerships between the NHS and organisations such as ourselves. The two are not mutually exclusive, quite the opposite, and when health, social care and housing work together in genuine partnership, we have the greatest chance of delivering the best outcomes for people with mental health needs.
Partnerships like our LIFT service in Lambeth, where our support staff provide medication support to people in their own homes and work alongside local GPs to deliver a combination of specialist and clinical support to people who have previously not engaged with mental health services.
Or our Islington Crisis House, delivered in partnership with Camden and Islington NHS Foundation Trust, to provide short-term support to local people experiencing crisis as an alternative to admission and also valuable aftercare in the local community.
We know it can also work for those with high and sometimes very complex needs; our forensic services in Tower Hamlets delivers intensive support for individuals often returning from costly, out of area secure placements. The outcomes that have achieved in partnership with East London NHS Foundation Trust have been positive, both for individuals and the public purse. Many other non-NHS providers are replicating this work up and down the country to impressive effect.
Going forward, we hope the value of these partnerships is recognised more both in public policy decisions and funding allocations. People struggling with their mental health need as much support as possible. Support to link into community mental health teams, to get out and about, to take medication if required, to set goals, access benefits, build social networks. The support needed is wide-ranging and holistic – and when we work together, more people can benefit and often enjoy a much higher quality of life.
Sean Duggan is chief executive of the Mental Health Network. Chris Hampson is chief executive of Look Ahead, and Mental Health Network board member. Follow Sean on Twitter @SeanDugganMHN and Look Ahead @lookaheadtweets
This blog is part of a series of responses by the NHS Confederation group on the NHS Long Term Plan. Read more in this series.