Social workers welcome government’s mental health ‘call to action’ but warn of resource pressures

Action plan sets out 25 priorities for mental health services but makes no commitments on extra funding

Social workers have backed a new government mental health action plan’s aim of giving mental and physical health services the same importance but questioned whether its ambitions can be realised without more resources.

The action plan, “Closing the gap: priorities for essential change in mental health”, which was launched yesterday, sets out 25 priorities for mental health services. The government will give a progress report on them next year.

Launching the plan, deputy prime minister Nick Clegg described it as “a call to action – across the NHS, the mental health sector and wider society – to champion change, to transform outdated attitudes and practices and to improve the lives of people with mental health problems”. He also talked of the need to give the same weight to mental and physical health.

Other actions in the plan include:

NHS England will set access and waiting time standards for adult mental health services from 2015

From April adults will have a legal right to choose the provider of the mental health service they use and the consultant or professional in charge of their first outpatient appointment except when they are sectioned or need urgent care.

From the end of December the Friends and Family test, already introduced for physical health services, will be “routinely used” in all mental health care settings and the results will be published.

In March the government will hold a national summit on psychosis with Rethink Mental Illness and other groups on the best ways to commission to care for psychosis and severe mental illness.

The priorities in the plan include ensuring young people who use child and adolescent mental health services (CAMHS) do not lose their support when they turn 18 and become the responsibility of adult mental health services.

The paper says the Department of Health will support work by NHS England on a service specification for transition from CAMHS to help councils and local NHS bodies commission good quality services.

The report also states that services like housing, employment service and social work need to join with health to ensure the young person gets the help they need.

Another priority of the plan is that nobody experiencing a mental health crisis should be turned away from services. Under this heading, it says the forthcoming crisis care concordat “emphasises the pivotal role of Approved Mental Health Professionals (AMHPs) not only in arranging Mental Health Act assessments quickly, but also in ensuring that the least restrictive option is put in place and that the person’s rights are safeguarded”.

Mental health social work experts welcomed the recognition of the AMHPs’ role in the paper, but some said it would be difficult for them to realise the aspirations of the action plan without more beds for emergency care. A Community Care and BBC News investigation previously highlighted how professionals were routinely struggling to access crisis care for patients as over 1,700 NHS mental health beds have been closed since April 2011.

Faye Wilson, chair of the mental health reference group for the British Association of Social Workers, said people having a mental health crisis were waiting hours for an emergency bed or being sent to one hundreds of miles away.

She said: “We are in a major, major crisis of access to beds. If they [the government] do not provide support, resources and capacity to do this it [the aims in the paper] will be an ambition rather than a reality. I certainly agree those services are vital but if the already incredibly hard pressed approved mental health practitioners are not supported, resourced and given capacity they won’t be able to deliver to the spirit of this plan.”

Ruth Allen, chair of the mental health faculty at the College of Social Work, said: “It is really, really encouraging that the role of AMHPs is emphasised in this document and hopefully will be in the concordat. It I am sure it will raise questions about implementation and resources but to have this so clearly started is quite pleasing because AMHP work and social work are often not visible as the really important mental health workforce that they are.”

She said the document “is another step on the way” to establishing “parity of esteem” between physical healthcare and showed a “shift ” in the understanding of mental health by the government and department of health.

Although there was no new money attached to the plan, it could encourage a movement of money locally from physical into mental healthcare and influence the decisions of commissioners, Allen said.

Paul Farmer, chief executive of mental health charity Mind, said: “Approved Mental Health Professionals play a crucial part in making sure that when someone is in distress they get the right support, and make difficult, sensitive decisions on a daily basis. We know that there is a huge amount of pressure on people in this role at the moment, particularly because of the current shortage of beds and strain on other parts of the system.

“We are pleased to see AMHPs specifically referenced in the action plan and hope that the concordat, when it is announced, will lead to better support for them to continue to help people with mental health problems when they are in crisis.”

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