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06.06.17

Making it happen for mental health

Paul Farmer 2 PREFERRED editFollowing the launch of the Five Year Forward View (FYFV) for Mental Health, Paul Farmer, chief executive of Mind, argues that we need to maintain the current momentum and put mental health firmly at the heart of the next government.

In a few days, the UK goes to the polls to vote for the next government. Two years ago, for the first time, mental health was on the agenda of every main political party. This time parties appear to be building on their previous manifesto promises, giving the issue more attention and offering more detail about what changes they will make to ensure the one in four of us who experience a mental health problem every year will get the services and support we need. Mind produced its own manifesto, ‘Making it Happen’, setting out our key priorities, chief among them how NHS mental health services need to improve. 

When I chaired the NHS taskforce on mental health in 2015, we heard from 20,000 people with mental health problems and those working in mental health services about what needed to change. The message was loud and clear: people need timely access to good-quality mental health services, and for their mental and physical health needs to be treated equally. Recent years have seen real progress in terms of attitudes towards mental health, but additional investment and improvements in our services are still at a fragile early stage. 

Maintaining the momentum 

Whatever happens on 8 June, we need to maintain the current momentum and put mental health firmly at the heart of the next government. We must also acknowledge that while we have made a good start, there is still so much more to do. 

In many parts of the country, services are still poor and people lack the essential support necessary to participate fully in society. Bed shortages, stretched community teams, rising antidepressant prescriptions and a lack of alternative treatments have all been well-documented in the press and point to something of a crisis in some parts of mental health services. When people don’t get the help they need, when they need it, they risk becoming more unwell and need more intrusive, intensive and expensive support further down the line. It’s not surprising, therefore, that Mental Health Act detentions continue to rise, but it shouldn’t come to this. 

The work of the taskforce culminated in the FYFV for Mental Health, a landmark moment in transforming mental health care. The 58 recommendations and associated minimum investment of £1bn by 2020-21 were accepted by the NHS and the current government in full. 

Among the commitments by the NHS are that, by 2020-21, one million extra people will be provided with support for their mental health problem and that everyone facing a crisis should have access to mental health care 24 hours a day, seven days a week. Above all, it is now accepted that our mental and physical health should be treated equally – including people with severe mental health problems, women in the perinatal period, children and young people. 

Equal access to services for all 

Crucially, we need to see equal access to good-quality services for all. Too many people from Black, Asian and minority ethnic communities have problems accessing appropriate mental health care until they reach crisis and have little faith in services. Urgent action must be taken to ensure that everyone gets the help they need with cultural needs taken into account, irrespective of their background or the communities they belong to. 

The FYFV on Mental Health is clear on how mental health care needs to be transformed. It is down to the next government, the NHS and other organisations to get the job done. The workforce, both those working in mental health and those in the wider health service and in local communities, is critical to making this happen. The next government needs to ensure we have a skilled, highly competent workforce to deliver what’s needed, and one which prides itself in looking after its own mental health and wellbeing, alongside those using services. 

cogs of the mind

This is only the start of the journey, though. Mental health has been underfunded and ignored for decades, and it will take years of investment and attention to bring services up to the standard we all deserve. The additional £1bn committed is welcome, but more will be needed in future, not least to cope with the rising demand we are already seeing and can expect to continue to see as more people come forward to seek help. Mind is calling for at least £500m a year of additional investment in NHS mental health services continuing through until 2022-23 to help meet need and expand access to services. 

In addition, it’s vital that whatever the budget for mental health, the money reaches the frontline. There have understandably been questions over whether funding is getting to where it needs to be. That’s why it’s so important that we now have the mental health dashboard and other mechanisms for improving transparency and accountability. We can see who is spending what on mental health and ask questions when the figures don’t add up. 

Each CCG has a vital part to play 

Every CCG in the country has a part to play. Every commissioner needs to make mental health a priority and design and implement services that meet the need of the population they serve. We also needs to see mental health as a key focus in the delivery of all sustainability and transformation plans. The proof will be in the improved experiences of people accessing services, which should be at the heart of every decision made about where to invest. 

Mental health is one of the biggest domestic issues facing the next government and it’s good to see it finally getting some of the attention it deserves. For too long, those of us with mental health problems have had to put up with second-rate, second-class services, with two-thirds of people with common mental health problems still not receiving any treatment or support at all. This has affected lives and it has cost lives. 

Now, as more people than ever are speaking out about mental health and demanding change, our expectations for better mental health for all are higher than ever. The next government, and the NHS, must rise to this challenge.

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