In 1997, the in-coming Labour Government inherited an NHS and mental health system that was falling apart. They were turned around with record levels of investment, more doctors and nurses and record levels of public satisfaction.
A National Service Framework for mental health was introduced, which improved standards. It created three new specialist service models for people with severe mental health problems: crisis resolution and home treatment teams, assertive outreach teams for community support and early intervention teams for young people with first-time psychosis.
An additional £173 million was invested over three years to enable the development of psychological therapies to those experiencing mild to moderate depression and anxiety. This made a significant improvement in the range of options available to GPs for responding to their patients who were experiencing anxiety, which was often quite debilitating and affecting their working lives.
Far from building on this significant improvement in mental health services, the coalition government went into reverse. It cut mental health services 20% greater than other health services. Unsurprisingly, this has led to a crisis with service cuts, staff shortages and vulnerable people being let down.
A recent report, ‘Mental Health Under Pressure’ by the independent and highly-respected Kings Fund, highlighted widespread evidence of poor-quality care. Only 1 in 7 patients said that they received appropriate care in a crisis. Increasing numbers of patients are reporting a poor experience of community mental health care.
The lack of psychiatric beds has led to significant increases in out-of-area placements. Last year, there was a 23% rise in the number of patients sent out of area for treatment. Some patients were sent more than 300 miles for in-patient treatment. Yet these out-of-area placements are costly, have a detrimental impact on patients and are associated with an increased risk of suicide. Suicide rates are increasing; it is the biggest killer of young men under 45.
In 2014, the government promised a new five-year national strategy for mental health covering care and support for all ages by autumn 2015. However, the report is still not published and George Osborne has pushed it back into 2016.
After considerable pressure, David Cameron promised an extra £250m to community mental health services this year. However, like most of his promises, it hasn’t been kept and he has been forced to admit that the government will only spend £173m, some 30% less.
There is an urgent need for this government to change tack. It’s a matter of sanity.