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Mental health to get £1bn lift after taskforce paints bleak picture

The government has agreed to invest another £1bn in mental health services by the end of the decade after the much-anticipated mental health taskforce published its final report today – painting a stark picture of health inequalities around the country.

The report, chaired by Paul Farmer, chief executive of Mind, recommended that, in the context of a tough Spending Review, an extra £1bn be invested by 2020-21 to ensure mental health forms part of the government’s view for a seven-day NHS.

People facing crisis should have access to mental health care every day, 24 hours a day, in the same way that they can access urgent physical healthcare, the taskforce said.

This headline recommendation was based on bleak numbers nationwide. For example, three-quarters of people with mental health problems receive no support at all – and within those who do, “too few” have access to the full range of interventions recommended by NICE, such as medication and therapy.

Across psychological therapies specifically, only one-quarter of adults in England have their needs met, despite the fact that its provision has “expanded hugely” in recent years.

There is still considerable variation in the service, with the best-performing areas having a waiting time of just over six days – compared to a near half-year wait in the worst-performing areas.

And despite improvements in inpatient care admissions, the severity of need and the number of people being detained under the controversial Mental Health Act continues to soar, suggesting prevention and early intervention opportunities are lagging behind.

As NHS Mental Health Clinical Commissioners Network chair Dr Phil Moore said, the report “does not duck out of the complexity and challenges of funding, fragmentation, variation, workforce, and data issues and the vital need to get it right”. It also deliberately agreed challenging recommendations and targets, he said.

But Dr Moore, who was a member of the taskforce and is also vice-chair of NHS Kingston CCG, argued its recommendations are “sensible and solid” to move the agenda forward at pace within the context of the Five Year Forward View.

Background and key recommendations

The taskforce, created in March last year, spoke to over 20,000 people to understand what the top mental health service priorities list should be over the next five years.

NHE had previously spoken to former care minister Paul Burstow to find out what we could expect from the final and delayed taskforce report – which already indicated the need for psychosocially-minded organisations, investment in research, and home-based and 24-hour services.

Reiterating all these findings today, the taskforce also vouched for a “data revolution” to sit alongside world-class research facilities. It identified a “black hole” of data available, with even good information not being co-ordinated properly or analysed usefully.

“Financial reporting is an important indicator for scrutinising commissioning and provision. Yet it is not consistently available in mental health,” the report said.

“Provider level data is also linked to care ‘clusters’ and reference costs for the clusters vary hugely across the country, partly due to lack of consistency in their use and partly to variations in the services provided.

“While CCG programme budgets for physical health are broken down by disease, there is only one category for mental health. Local information on investment in care, by condition, is therefore essential.”

In terms of psychosocial organisations, one of the main recommendations in today’s report included supporting all local areas to have multi-agency suicide prevention plans in place by 2017, reviewed annually thereafter.

It also repeated some of the recommendations published in last week’s timely and also stark Crisp Commission report – such as the need to eradicate the national practice of sending patients long distances for treatment, and creating appropriate targets that cap the “unacceptably long” waits between appointments and follow-on support.

Similarly to the Crisp report, the taskforce also claimed councils and housing providers should be working with the NHS locally to increase access to supported housing for vulnerable people with ill mental health.

Paul Farmer, who led the report, said: “This is a landmark moment for mental health care in this country, a once-in-a-generation opportunity to transform services and support for people with mental health problems.

“We are saying to the NHS, to government, to industry, to local leaders and to the public that mental health must be a priority for everyone in England.”

He underlined the need to focus on prevention first, responding to people’s problems at the earliest possible opportunities.

“This report is a feasible and affordable blueprint for how to significantly improve care for people with mental health problems,” added Farmer.

Responding to the report, health secretary Jeremy Hunt MP said the government will work with the NHS to make the recommendations a reality. Part of this included a commitment to pour another £1bn into mental health services to help another one million people.

A share of this cash injection will be specifically focused on 24-hour, weeklong community care for those facing mental health crises, he said.

(Top image c. Dominic Lipinski, PA Wire)