The Covid-19 pandemic has put a spotlight on the nation’s mental health like never before. As we deal with loss and bereavement, come in and out of lockdowns, and adjust to a ‘new normal’, it’s not surprising that the pandemic has taken its toll. Although mental health provision has improved significantly over recent years, we need the upcoming comprehensive spending review to invest significantly in the mental health sector. A failure to do so means that not only do we risk stalling on the hard won progress we’ve made so far, but that we actually risk going backwards.
It's worth spending a moment to think about the impact of the Covid-19 pandemic on the nation’s mental health. Over the last 18 months, record numbers of people have contacted the NHS to seek help for mental health issues which have either been triggered by the pandemic or been worsened by it. In particular, the demand for eating disorders has soared – increasing by nearly 50% - and the mental health of children and young people has suffered, with their usual sources of support, structures and routines removed or disrupted.
Frontline staff and trusts are working tirelessly but sadly this is not enough. Services which were seriously overstretched before the pandemic are struggling to cope as Covid-19 creates more need and worsens existing challenges. Put simply, demand for mental health services is significantly outstripping supply despite the fact that services are treating more patients than ever before.
Alongside this the mental health sector has also stepped up to the plate and made huge contributions to support the efforts to manage the pandemic. It has established mental health staff hubs across the country to help the health and wellbeing of the NHS workforce and it has been a major player in the vaccination programme.
It means a staggering 1.6 million people waiting to access mental health services – a figure not often publicised alongside the nearly 5.5 million waiting for routine hospital care. And private estimates from those working in the sector based on the prevalence data for mental ill health across England, indicate there could be up to further 8 million who would benefit from services if they were able to meet the thresholds to access them.
On the frontline, the impact is real: bed occupancy above safe levels; more people, including children, being treated miles away from home because services near them aren’t available; and more people presenting for treatment later, in crisis or with more serious conditions. And the mental health estate – the buildings and facilities where services are provided – is in dire need of serious investment for safety critical repairs, to modernise old and outdated premises and often to redevelop whole sites.
None of this adds up to a good experience for patients or staff. It can often inhibit recovery and it does not support the sustainability or expansion of frontline services.
In the coming weeks, the Chancellor will set out his spending plans for the next three years in the comprehensive spending review. We all know the public purse is under more pressure than ever before and that every part of the public sector has legitimate claims in light of the pandemic. In his decisions on mental health the chancellor has a real opportunity to build on investments to date which, despite the enduring care deficit in mental health, had started to improve services and experiences for mental health patients, and expand access. Mental health providers are not only expanding what they do, they are also making a wider contribution than ever before.
We need critical capital investment if we are to tackle the most immediate challenges facing the mental health estate. We need significantly more funding to recruit enough staff with the right skills. We need community services to be expanded to avoid inpatient admissions and more beds to bring care closer to home. And we need extra investment to tackle the ever-growing backlog of care caused by the pandemic.
So, let’s be honest about the scale of the challenge and recognise that the reality of equity between mental and physical healthcare lies in the level of future investment. Progress so far has been hard won – without the right decisions it may stall, or worse, go backwards.
