This morning Community Care published the findings of research that raises question marks over the adequacy of funding for mental health services in England. Our research, based on figures obtained from 43 of 56 NHS mental health trusts, found that services had seen an 8.25% real terms reduction in funding in 2014-15, compared to 2010-11. Here, we collect reaction to the findings from the sector…
‘The government’s policy progress is being undermined’
Professor Graham Thornicroft, professor of psychiatry at King’s College London
These findings are deeply disturbing in terms of the implications for people with mental ill health and their family members. The government has given a commitment to maintaining funding across the whole of the NHS and in real terms this commitment has been met. Yet I’m disturbed to find that there is hard evidence of real cuts in mental health expenditure which have not been applied to physical health care.
This government has made tremendous advances in terms of the parity of esteem policy so that people with mental ill health should be treated on a par with people with physical conditions. Yet there is very worrying information here about the lack of implementation of this policy.
On one hand we are now in England seen as one of the world leaders in terms of mental health policy, for example in terms of the successful impact of the Time to Change programme to reduce stigma across England. On the other hand we see reductions in the quantity and quality of care since the recession began to hit home.
What does this mean in real practice? It means longer delays to get access for assessment and treatment. It means mental health services are able to take on and support fewer people with mental health difficulties. It means diminished possibility for recovery of people needing mental health care.
It is important now in the lead-up to the general election for all parties to recognise that a quarter of us, a quarter of the whole population will experience mental health problems this year. Half of us will have experience of these problems in our lifetime. Three quarters of everybody in our country will know somebody with mental health problems across the course of our lifetimes.
The important point is this – mental health is a vote winner. Parties which will commit not only to redressing recent cuts in mental health care but to progressively improving the quantity and quality of mental health services in the future can expect to gain great political support as well as moral support on this long-term commitment.
‘Staff are left firefighting’
On the frontline it feels like there has been cut after cut. It’s not just about beds, it’s about the other support – the services that should help us intervene early, the relationship-based working.
When services like crisis teams are being cut back at time of more demand, it means many just become medication droppers rather than delivering proper evidence-based home treatment.
We’re getting to a stage where people are just getting triaged out – they are either deemed not sick enough or they are too unwell for home treatment. So the whole prevention agenda has just gone by the wayside because people don’t have the capacity to do it.
Staff are being left out there firefighting, which can be sole destroying. The acuity in the system is rising. Our inpatient wards are chaotic, if you can find a bed at all. As an AMHP you want to find a less restrictive alternative to admission but often there simply aren’t any available.
If you talk to most social workers the reason we do it is to try and make a difference. Too often, the way mental health services are just now, it feels like we’re stopped from making a difference because we don’t have the tools to do the job properly.
‘The impact of these cuts falls squarely on patient care’
Paul Farmer, chief Executive of Mind, the mental health charity.
The impact of these cuts falls squarely on patient care. Bed shortages, cuts to frontline nursing posts and long waiting times for therapy have been well-documented in the last couple of years and, at the same time, demand has been increasing as more and more people come forward and seek help.
The treatment gap for mental health is huge – 75 per cent of people with mental health problems get no help at all. Meanwhile, many more are being turned away from services when they need them the most, left to cope alone with self-harm and suicidal thoughts.
The next government will need to hit the ground running on mental health. Those in power can no longer ignore the fundamental truth that services only work when they are properly resourced. We need to see a permanent increase in the NHS mental health budget of at least £1bn if we are to reverse the damage caused by years of neglect and recent cuts.
‘People with mental illness are facing a triple whammy’
People who experience mental illness in England today face a triple whammy of benefit changes, the overall impact of the recession and reductions in mental health services. People have been asking me recently about why I’m campaigning around the stigma surrounding mental illness. Well this is why.
They [government and NHS England] talk about parity of esteem – well you see these funding decisions and you think ‘are they having a laugh’? Because that’s what it feels like at the moment.
‘Disturbing and unacceptable’
We are continually told that mental health beds have been cut so that people can be looked after by community mental health services.
The cuts revealed by this investigation are disturbing and unacceptable. This now means that there will be thousands of people who will have no cure or treatment and be left at risk.
There will be more neglect, suicide and suffering of patients and families, negating the pledges of better mental health services in recent months. What is the point of raising awareness when many people seeking help are turned away?