Government urged to invest in preventing mental illness, improving NHS staff wellbeing and reducing waiting lists in this autumn’s Comprehensive Spending Review

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29 July 2021

Mental health services in England need to change radically to be fit for the future and respond to the aftermath of the pandemic, according to a report published today by Centre for Mental Health.

Now or never, commissioned by the NHS Confederation's Mental Health Network and written by Nick O’Shea, examines the priorities for mental health services in the run up to this year’s Comprehensive Spending Review. It argues that mental health services need fresh solutions to long-running structural problems that have become more acute during the pandemic. While more money is needed, it must be invested where it can make the biggest difference, and come with big changes in how services are planned and delivered.

The report highlights the cost of NHS staff sickness absence, and calls for 1% of this cost to be invested in supporting the wellbeing of its workforce. This is vital to respond to the stress, burnout and trauma faced by health and care workers during Covid-19.

It states that Government and the NHS need to re-think long-held assumptions and ways of working in mental health to respond to the challenges of today and the coming years. It argues for a greater share of investment in enhancing mental health and preventing mental illness and for long waiting lists to be tackled urgently. And it calls for more integrated care and clearer outcome measures and accountability within the NHS.

The Now or never report concludes that more money alone will not enable mental health services to meet rising demand. While the NHS mental health workforce is growing, staff shortages are still significant and remain the biggest barrier to expanding services, although it suggests that allowing more staff to work flexibly as well as making better use of digital technology may help to close this gap.

It also finds that the new Mental Health Act is an opportunity to modernise legislation which has barely changed in centuries, while the Health and Care Bill could help to integrate services if it fosters genuine partnership across local systems.

Centre for Mental Health chief economist and report author Nick O’Shea said: “Mental health care needs to change if it is to meet the challenges of the twenty-first century. Our Mental Health Act remains a direct descendant of nineteenth-century predecessors. We still see people being placed in long-stay hospitals and nursing homes far from home for mental health treatment. And the segregation of body and mind in health care still reduces the life expectancy of people with a mental illness by more than 15 years.

“Challenging times foster fresh thinking and new solutions. This is the time to act. We need to create a new system that’s designed to promote good mental health as well as treat mental and physical illness together and on an equal footing. We need to act now to improve life expectancy for people living with mental illness and to support the mental health of NHS staff. We cannot afford to leave the nation’s mental health to chance by carrying on exactly as we are for the next decade.”

Sean Duggan, chief executive of the Mental Health Network which is part of the NHS Confederation, said: “The mental health consequences of the pandemic will be with us for years to come. Demand for services is increasing and with the comprehensive spending review on the horizon, there is no better time to look at how we can ensure mental health services are sustainable and fit for the future.

“While the mental health system has improved and expanded over the past few decades, there is still a lot to do to ensure that people are able to access the right care at the right time.

“Additional funding is necessary, but we need to look at how we can most effectively target the funding we have. Preventing mental illness, supporting the wellbeing of our staff and better links between physical and mental healthcare are not the only the right things to do, they also make the most economic sense.

“This challenging report forces us to look differently at the current system and provides a framework for how we can continue to drive improvements in the mental health sector.”


Download the report

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