Prescriptions

Written By: Kailash Chand
Published: August 2, 2017 Last modified: August 2, 2017

Theresa May’s promise of “parity of esteem” for mental and physical health, the crisis is not being addressed. It’s getting deeper by the day and appears beyond repair.

More than 50% of Clinical Commissioning Groups (CCGs) have cut their mental health budgets last year. Mental health services form a crucial part of the NHS, yet they have always been the poor relation in any health system in general and NHS in particular. The forgotten Cinderella services, struggling, underfunded and parked. One in four adults experience at least one diagnosable mental health problem in any given year. But it is a postcode nightmare. Where you live is what you get.

Evidence from the World Health Organization suggests that nearly half of the world’s population are affected by mental illness, with an impact on their self-esteem, relationships and ability to function in everyday life. An individual’s emotional health can also impact on physical health and poor mental health can lead to problems such as substance abuse. A person struggling with his or her mental health may experience stress, depression, anxiety, relationship problems, grief, addiction, ADHD or learning disabilities, mood disorders, or other mental illnesses of varying degrees.

A leaked report by a government taskforce has painted a devastating picture of England’s mental health services, revealing that the number of people killing themselves is soaring, that three-quarters of those with psychiatric conditions are not being helped, and that sick children are being sent “almost anywhere in the country” for treatment.

A warning about the level of service given to black African and Caribbean men is also made in the report. It says that people in this group are on average detained five times longer in secure care than other groups and more targeted care is required. Somehow aren’t we still in the dark ages of the management of patients with mental health conditions?.

The Independent Mental Health Services Alliance has found that high demand and mounting financial constraints has resulted in the average deficit of NHS mental health trusts increasing by 6.3 per cent over the last two years.

The first quarter of this year has already seen 31 trusts, nearly half of all mental health trusts, experiencing deficit. The independent think-tank the King’s Fund recently concluded in their analysis of services across England, that around 40% of mental health trusts experienced a cut in income in 2013/14 and 2014/15.

The Fund points out that during the same period for acute health, 85% of hospital trusts saw their income increase. Indeed, commenting on this finding, Stephen Dalton the chief executive of the Mental Health Network, said that this was evidence of institutional bias that exists in the NHS and local authorities in how mental health is funded.

A further well-established fact is that in austere times, health commissioners tend to raid mental health budgets to plug the growing deficits in the acute hospital sector.

I have been a GP in Greater Manchester for over 30 years, and I have known for that duration that mental health and learning disability services have struggled for survival. Illness of the mind is inherently more difficult to diagnose than illness of the body. And treatment outcomes are more uncertain.

I have witnessed many reforms in these services, but it seems to me that good intentions have not delivered on the much needed stability to a service that is as vulnerable as its patients.

The scale of the mental health challenge has been underestimated. NHS England has set out its roadmap for achieving recommendations made in its Five Year Forward View for Mental Health to improve mental health care by 2020/21. The NHS vows to transform mental health services with extra £1bn a year. But welcome as more funding is, it will not stem the tide of distress if the basic causes remain in place. And we don’t need more research to work this out.

The prime minister has talked about the burning injustices in society and she’s highlighted the impact of mental health on people – so now is the time to deliver on that, the mere lip service is not enough. We need political will and action.

There should be “No Health Without Mental Health”!