Mental health improvements must go much further, much faster

Paul Farmer, Mind CEO, outlines the charity’s priorities over the next five years, his concerns about funding and his views on where the new Government should be concentrating its efforts to support those with mental health problems.

The lead-up to the General Election brought us more proof than ever before of an appetite for mental health, with positive manifesto promises from all the main parties. This represents considerable progress from the previous General Election campaign where we would consider ourselves lucky to get so much as a line on mental health. If nothing else, this election marks how much mental health has become part of every party’s agenda.

But with the advent of a new Government we need to see this positivity translate into something more than just ambition. The stark reality of the world of mental health is that in recent years life has become significantly more difficult for many people with mental health problems. The lasting effects of the recession, unemployment and changes to the welfare system are all having an impact on the mental health of the nation. The consequent increase in demand for mental health services means that the years of underfunding in the NHS are showing more than ever.


“Local authorities currently do little to nothing about mental wellbeing as part of their remit”

A recent report from the All-Party Parliamentary Health Group found that parity of esteem between physical and mental health services is still a world away from being achieved. That’s no surprise considering that people with severe mental illnesses such as schizophrenia can expect to die 20 years earlier than the rest of the population. Local authorities currently do little to nothing about mental wellbeing as part of their remit to prevent ill health in their local communities.

Even within the NHS we are still failing to treat mental health crises with anything like the sense of urgency that we treat physical health emergencies. Many people are being turned away from services altogether, left to cope alone with psychosis and suicidal thoughts, told by overstretched staff on local crisis phone lines to have a bath or a cup of tea. Our new Government then has to do much more, and far faster, to achieve parity.


“The cost of mental health problems to the economy is estimated to be over £100 billion annually”

Ultimately this will always come back to the same thing, funding. Some might say it’s naïve to ask for more money in the current climate but the moral and economic case is irrefutable; years of chronic under-investment, compounded by cuts over the last few years at a time of rising demand, mean that our new Government has no option but to grasp the nettle and put things right. The cost of mental health problems to the economy is estimated to be over £100 billion annually, equivalent to the cost of running the entire NHS.

Recent investigations by the BBC and Community Care found that mental health services have been cut by eight per cent in the last five years. We have lost 3,300 frontline mental health nursing posts and bed numbers have dropped by 2,100. Meanwhile, demand is increasing and we are starting to see the scale of the unmet need with around 75 per cent of people with depression and anxiety getting no help at all. Although mental health accounts for a quarter of the disease burden on the NHS, spending on it is at only 13 per cent. This is an untenable path to continue on and we need to see an increase in NHS funding for mental health to the tune of at least 10 per cent over the next five years if we are ever to see the mental health services people deserve.

There are green shoots appearing, with exciting pilots happening around the country in A&E, in police forces and in children and adolescent mental health services that have the potential to transform the care that people receive, but only if the resources are put in place to support them. We recently saw the introduction of the first ever waiting times and access standards for mental health services. While these are undoubtedly major landmarks on the road towards parity, we must be clear that these new beginnings can only become truly meaningful if they are invested in rapidly and comprehensively. We also need to see a substantial chunk of public health funding given over to preventative mental health initiatives so that fewer people need more intensive and costly NHS services in the first place.

In some ways we have made significant progress in recent years. The conversation around mental health has grown significantly and everyone agrees that it needs to be a greater priority. But if the last five years have been about talking, the next five have to be about action. This is not just true for the NHS and local authorities, but across all government departments. Our new Government must keep up the positive momentum around mental health and, above all, finally give services their fair share of resources so they can improve the lives of all of us who live with mental health problems.

About the author:

Paul Farmer is chief executive of the mental health charity Mind, a post he has held since May 2006.

Paul is chair of the NHS England Mental Health Patient Safety Board, an advisor to the Catholic Bishops on mental health and was on the Metropolitan Police commission on policing and mental health.

He is a trustee at the Mental Health Providers Forum, an umbrella body for voluntary organisations supporting people with mental distress.

Paul is also trustee at Lloyds Banking Foundation and chair of the ACEVO board.

In November 2012 Paul received an Honorary Doctorate of Science from the University of East London in recognition his of achievements in promoting the understanding and support of mental health.

Paul was selected most admired charity chief executive in the Third Sector Most Admired Charities Awards 2013.

Read more on mental health:

Experiencing schizophrenia: hearing voices