Budget cuts have left tens of thousands of adults with mental health problems without key social care support that could help prevent their health from deteriorating to crisis point, a leading charity has warned.
An analysis by Mind found that the number of adults with mental health needs who received social care support has fallen by at least 30,000 since 2005, a drop of 21%. Cuts to local authority social care budgets – the majority of which have hit since 2009 – have left a funding shortfall for care of up to £260 million, the charity said.
Mind extracted the data from research published by the London School of Economics in December last year. When demographic changes are accounted for, the fall in the number of mental health service users in receipt of social care support since 2005 could be as high as 68,000 – a 48% drop. The reduction in the number of people with physical health needs receiving social care support was 33%.
The report also found that almost a third (30%) of councils had halved the number of people with mental health problems receiving social care support.
Paul Farmer, Mind’s chief executive, said the findings suggested the government was failing to “look at the bigger picture” around support for people with mental health needs.
“In reality it is cheaper to provide preventative services like social care, which help people affected by mental health problems at an earlier stage, in comparison to crisis services that are currently understaffed and overstretched,” he said.
Farmer also urged the government to introduce a ‘more reasonable’ national threshold for social care than the current plans to set it at a level equivalent to the ‘substantial’ band used by the vast majority of local authorities. The powers to set a national threshold for care are included in the government’s Care Bill, which is expected to complete its journey through Parliament shortly.
Frontline social workers have also raised concerns over funding for services. More than half (50.5%) of 111 mental health social workers surveyed by The College of Social Work (TCSW) said investment in statutory social work for mental health was ‘poor’ in their area. Over a third (35.3%) rated standards of mental health care as ‘poor’ and almost half (47%) reported problems accessing personal budgets for people with mental health needs.
Steve Chamberlain, chair of TCSW’s network of Approved Mental Health Professionals, said the cuts to social care support highlighted by Mind could be “the tip of the iceberg”.
“It looks like the next two or three years is likely to see even more cuts to funding for local authorities. Thresholds for social care have already gone up in many areas as there is less money to go around. It feels like we are increasingly unable to intervene earlier and work with people to access social elements that can help to maintain their mental health and avoid crises,” he said.
Faye Wilson, chair of the British Association of Social Workers mental health forum, also said that rising thresholds for social care were leading to less preventive work.
“If you really want to support someone’s recovery it’s about things like supporting them to integrate into their community, helping them to access employment or benefits, supporting them to get their life back. The support cannot be restricted to just the healthcare part. You take those other social support components away and you’ve got a real problem,” she said.
Sarah Norman, co-chair of the Association for the Directors of Adult Social Services (Adass) mental health network, said the research had to be viewed in the context of significant reductions to local authority budgets in the past three years and a general drive to reduce dependency on services.
“Throughout, social care services have done their utmost to maintain services for people with mental health issues, and to extend as far as possible the principles of personalisation in working with them,” she said.
Adass believes that the government’s proposed threshold for care, under the Care Bill, is likely to widen rather than reduce eligibility for social care, Norman added.
A Department of Health spokesperson said the government expected NHS and local authorities to ensure “equal priority” is given to mental health and physical health services when making spending decisions.
“We have given councils significant extra funding for social care and are going further by creating our £3.8bn Better Care Fund to invest in joined up services that keep people living well and independently for as long as possible. Our national eligibility threshold will be set at a level that will allow local authorities to maintain the same level of access to support for those who are eligible when they move to the new care and support system in April 2015,” she added.
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As one of those affected by mental illness, I can truthfully attest that cutting back on assistance for those who fight daily to adjust to living in the mailstream will have a dramatic impact on their wellbeing and performance in society. This is not where cuts should be made. The less those of us are assisted, the more people in need will have a negative affect on their contribution to society as a whole. I was lucky enough, after working many years, to be accepted on Social Security Disabiity in May of 2011. I could no longer hold a paying job, even part time. To pay for medications, treatment, and receive basic training to continue in some type of employment, more donations and assistance from the community is essential for our growth and wellbeing. Please fight this battle for funding in your grassroot agencies so that others will not have to suffer because of a diagnosis that they did not incur themselves…
I don’t believe that this is a true reflection. Yes we don’t have the money as local authorities. However, I have never met a social worker who has halved the social support provided to people with mental health problems due to funding. Where there is a need its provided for! The government set these agendas, reduce money and then put money into new agendas to fix the problem they created!
It is good that you publish items of this nature, and seek to challenge the current lack of parity between Mental Health Care services, and care for people with other sorts of health concerns. The truth is that NO service should EVER face cuts in funding that directly affect the quality of support and treatment that it is able to provide. At the end of the day, care is about patients, and about having the best interests of patients in mind. Cuts to services that leave patients without adequate support clearly do not act in the best interests of patients – it might even be argued that they put patients at risk. Furthermore, cuts that affect one service more than they do others might also be viewed as DISCRIMINATORY.
For a long time, Mental Health Services were the “poor sibling” of the rest of the NHS and Social Services – a sort of “Cinderella service”. I suspect that this is a legacy of our society’s long-ingrained negative attitude towards mental illness; the legacy of stigma. Current cuts to funding come on top of this, leaving a huge deficit.
Sadly, it is my personal belief (and has been ever since I qualified as a Social Worker) that society just does not really understand Social Work – what it is, what workers do, what role the service fills. I firmly believe that many people in Government, and in the NHS, also have this lack of clarity. It is as though there are some people out there who think we could do away with Social Care altogether! Others seem to think that Social Care is just an “appendix”, a sort of “bolt-on” – that the NHS does all the “real” work, and Social Workers just “faff” about doing trivial things. This is the result of their lack of comprehension.
When I qualified as a Social Worker, I got the distinct impression of a job that many people did not see the purpose (or value) of, and that had a seriously low profile – adding to the lack of understanding and clarity as to what function Social Care actually performed. I would strongly argue that this is why Social Care in general is always so badly hit in terms of budgetary cuts. AND why the profession lacks good numbers of suitable recruits. Where society does not really understand a job, they will certainly be reluctant to fund it – and, incidentally, to DO it!
Many people certainly have little to no understanding of PREVENTATIVE services. Again, this is a situation born of ignorance. We live in a society that is obsessed with budget cuts, funding cuts, saving money, making things profitable… For one, I firmly DO NOT believe that the health service should EVER seek to copy private industry – the care of human beings is NOT a money-making scheme. CARE, and GOOD CARE at that, should always and only be first and foremost! Whilst we are so firmly obsessed with profits and cash, we overlook care standards. Not only this, but we seek to take “short cuts” in the hope of saving extra pennies. This often leads to a lack of preventative care, because people just do not get the point of it. Many in Government, I would suspect, think that if a person is not at crisis point, then how poorly actually are they, and do they really need care? I firmly believe that people kid themselves that savings can be made by not providing care until a person is desperately in need (they naively assume that up to this point, the person is caring for him/herself and is therefore “no problem”!).
The reality is FAR from this. People who are left until crisis point and up needing far more care, and far more costly care. Quite simply, their illnesses, their problems and their needs have been left to develop to such a state as to be truly staggering. What may have started as a simple illness, or an easily-fixable problem; is now a well-entrenched, chronic illness, or a problem that has gone on so long they can no longer get to the roots of it!
I say this, quite simply, because of PERSONAL experience. I have Endometriosis (a Gynaecological complaint). My symptoms began @ 2002, but I was not offered an effective diagnosis or treatment until 2011. THAT meant 9 years of pain, fatigue, stress, chronic illness, and worsening menstrual problems. It also meant an undiagnosed illness festering away in my body. The outcome has lead to 4 surgeries, and infertility! I am pretty certain that had I been diagnosed and treated sooner – had I not been left to reach crisis-point – I might have salvaged my fertility, and have required fewer, less extensive surgeries.
Interestingly – I had only vaguely heard of Endometriosis before the diagnosis. Perhaps had I been more aware; had society been more aware; I could have taken some preventative measures? Or I may have been diagnosed faster? I can certainly state that lack of awareness of a condition leads to diagnostic delay, complications, and increased treatment need.
And THIS mirrors what I feel about Mental Health care. Lack of early education, lack of awareness, and lack of preventative work leads in the end to diagnostic delays, complications, increased need for inpatient care, and increased need for intensive long-term care.
Personally, I think it’s high time that the Social Care profession took the initiative, and did three main things…
1. Increase awareness of what Social Care is, and what qualified Social Workers do. This should focus on making society fully clear as to what goes on, and dispelling myths. It should also focus on making sure that potential Social Work trainees know EXACTLY what the job involves (as opposed to some of the people I studied with, who wanted to work in Child Protection because they thought they would be working with cute little babies!) It should further focus on making sure recruits are of the best possible standard, academically and in terms of attitude plus understanding of the job.
2. Consider separating Social Care completely away from Local Authorities, and making it utterly independent. This means that budgets could be completely re-addressed, and that “thresholds” need no longer be manipulated (preventing people in need from getting care). The Social Care profession needs to examine carefully such pilot schemes as exist, in which Social Care is no longer bound to a Local Authority.
3. Campaign to reduce stigma for mental illness sufferers. Whilst society continues to have deeply-ingrained prejudices, these WILL affect the quality of care that stigmatized groups receive.