Written by Adam Jones, UKCP Policy and Advocacy Officer
Today is World Mental Health Day – an opportunity for people around the world to reflect on the importance of mental health issues and how they are being tackled.
Here in the UK, the government is marking the occasion by hosting a two-day summit for ministers and delegates from over 50 countries. The stated aim of this is to promote parity of esteem – equality between physical and mental health.
In advance of the event, recently-appointed Health Secretary, Matt Hancock, said: ‘The world must unite and take this opportunity to deliver parity for mental health so it is treated the same as physical health.’
This is, of course, a welcome ambition. So too is the idea of international cooperation helping to bring about positive change.
However, given the extent of the government’s rhetorical commitment to parity of esteem, this seems an appropriate moment to scrutinise the government’s actions on this matter. And the chastening reality is that there is still a huge way to go for genuine parity of esteem to be reached in our publicly administered health services.
At the heart of the issue is the funding gap between physical and mental health. While mental health accounts for 28% of the ‘disease’ burden in the UK, it receives only 14% of funding from Clinical Commissioning Groups (CCGs) in England.
The reality is much of the money earmarked for mental health isn’t reaching the frontline. That’s why it must be protected by ringfencing.
With CCGs still under huge financial pressure, it is likely that unprotected funding will continue to be diverted in order to balance local budgets.
Investment in mental health services carries huge financial benefits, not just for the public purse but for the economy as a whole. However, it is hard to see that this is in the thinking of decision makers in government and local commissioners across the country.
What they don’t seem to recognise is that investment in mental health services would save money across all corners of public provision – elsewhere in the NHS, in social care, a range of local authority services, the Department for Work and Pensions, the police, the Criminal Justice system – not to mention the revenue generated through greater productivity in the economy.
Nevertheless, in the absence of ringfenced funds, it is perhaps understandable that hard pressed CCGs are unwilling to make investment in services for savings that will fall largely outside of their remit.
This hard truth is indicative of the broad need for more joined up thinking about mental health at both the government and local level.
That could include support from the government for Luciana Berger MP’s Health in All Policies Bill, which would not only help to address shortfalls in provision but also help to shift the focus towards prevention.
However, in the immediate future, at least let’s ensure that, at a minimum, money designated for mental health reaches the frontline – and the only way to do that is through ringfencing. With demand for mental health services continuing to rise, this is simply an essential step.
If the government is serious about addressing the escalating mental health crisis in this country, it is essential that people can access a range of high-quality psychotherapies on the NHS. And securing greater funding for mental health services is of fundamental importance to the future of psychotherapy in the public sector.
Yes, we need to persuade the National Institute of Health and Care Excellence (NICE) to include a greater choice of therapies in their recommendations for first-line treatments for common mental health issues. And we are campaigning hard to make this happen.
But high-quality psychotherapy services also require financial commitment from the government. And, in the current climate, the need to widen access to psychotherapy has never been more obvious.
Despite 75% of people saying they would prefer psychotherapy to medication, fewer than 1 million people accessed talking therapies through the Improving Access to Psychological Therapies (IAPT) programme in the past year. Meanwhile, antidepressant prescriptions continue to skyrocket, with over 7.3 million users annually in the UK.
Furthermore, the effectiveness of many IAPT services has been called into serious question.
Between 2007 and 2017, considerably less than half of patients referred chose to take up and complete the IAPT treatment offered to them. Of those who did complete their treatment, less than half achieved ‘recovery’. And the crudeness of IAPTs indicators for recovery is illustrated by the fact that less than half of those who ‘recover’ through low intensity IAPT services remain recovered after 12 months.
This is the result of a continued narrow emphasis on interventions – often cheaper up front – which are simply inadequate for a great number of people experiencing mental health issues.
If the government is serious about addressing the escalating mental health crisis in this country, it is essential that a range of high quality psychotherapies are accessible through the NHS.
This, of course, will require some upfront investment, but increasing the rate of enduring recovery will save hundreds of millions of pounds of public money in the long-term.
And this investment will only be possible if money allocated for mental health is reaching the frontline.
That’s why we are urging the Chancellor to ringfence mental health funding in this month’s Budget.
Rhetoric from the government around parity of esteem is welcome, and helps the battle against stigma. However, those words mean nothing unless they are backed up by concrete action to address the mental health crisis we face in the here and now.