In Monday’s Budget, the Chancellor included a pledge to make £2billion extra annual investment in NHS mental health services up to 2023/24. This additional funding will come from the previously announced long-term financial settlement for the NHS, meaning that for the first time we know what to expect for mental health services beyond the end of the current five-year plan which ends in April 2021.
Increasing mental health spending as a proportion of NHS funding for the next five years is an important step towards parity. It is therefore vital that this investment is protected for mental health to ensure it brings about the promised improvements in care and support and to put right the decades of under-investment in mental health services throughout the NHS.
The Chancellor’s announcement included some specific pledges to improve emergency mental health care, for children as well as adults, including the provision of dedicated mental health ambulance services (to reduce the use of police vehicles in a mental health crisis) and better help in A&E. This is a welcome step, and it will be important to build the evidence about what works most effectively to make best use of the funds being made available.
It is also crucial, however, to invest in services that prevent emergencies, including support in primary care, community services and help with housing and debt. Mental health crises often arise because opportunities to help people sooner were missed, or because of difficulties with money, accommodation or relationships. While not every crisis can be averted, effective and responsive community services can stop problems from escalating and may prevent someone needing a hospital admission.
The Chancellor also pledged further investment in schools, building on previous announcements about the creation of new ‘mental health support teams’. It is vital that these new teams work alongside existing support (where it is available) and that schools are given the necessary help to promote better mental health: for example through effective classroom-based teaching, anti-bullying programmes and taking early action to prevent exclusions.
The pledge to invest in more tailored employment support for people with mental health difficulties is also very welcome. No one should be denied the right help to get work when they want it, yet this is the reality for too many people with mental health difficulties. International research shows that with effective help and support, many more people with mental health difficulties can get and keep employment.
While Monday’s pledged investment is very welcome, and a recognition of how much more there is to do before the NHS treats mental health equally with physical health, it must also be matched by fairer funding for public health, early years and social care services in local government. Services that prevent poor mental health and that enable people to live well have been cut back in recent years, putting more and more pressure on individuals, families, communities and health services. From evidence-based parenting programmes to housing support, suicide prevention and social prescribing initiatives, local councils hold the keys to improving wellbeing in communities. They have been starved of funds for too long and they need a sustained financial settlement on the same terms as the NHS.
And parity for mental health within the NHS is not the same as equality for people with mental health difficulties. To bring that about we need to see radical changes to the way government prioritises mental health and the ways in which public services of all kinds relate to people with mental health difficulties. We need, for example, to see changes to social security, including Universal Credit, reforming the way people are assessed for benefit entitlements and ending the use of benefit sanctions on people with mental health difficulties. We need to see changes to prisons and probation services to promote safety and wellbeing. And we need to take action against discrimination and social inequality to create a fairer society that will nurture better mental health for all.
Andy Bell is deputy chief executive of the Centre for Mental Health