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What do the parties’ election manifestos tell us about the prospects for mental health in the next Parliament?

17 June 2024
By Ed Davie
Ed Davie

Just under 20 years ago, a General Election was under way which would bring New Labour a second term in government. None of the party manifestos had much, if anything, to say about mental health directly.

Two decades on and reviewing 2024’s set of party political manifestos, that much, at least, has changed significantly. All three major parties and the Greens (we’re only reviewing UK-wide parties with MPs elected at the last general election) give significant space to mental health, including many policies that Centre for Mental Health and our partners have called for.

This is important because, in the intervening 20 years, the nation’s mental health has deteriorated significantly following the banking, Covid-19 and cost-of-living crises.

Manifestos and the Mental Health Act

We were deeply disappointed that parliamentary time could not be found to reform the Mental Health Act over the last five years. The current Act, which is used to detain people in crisis who are deemed to be a danger to themselves or others, is outdated and disproportionately used against people from racialised communities, denying too many their dignity and full human rights.

The good news is that all three major parties have used their manifestos to commit to early reform of the Mental Health Act. A ban on LGBT ‘conversion therapy’ was also lost in the last Parliament despite government commitments. We welcome the Labour commitment to a trans-inclusive ban of conversion therapy, and urge the other parties to adopt a similar measure. 

How are political parties promising to improve young people’s mental health?

All three major parties and the Greens have committed to ensuring that every school and college benefits from in-house mental health professionals, and that early support mental health hubs for young people will be created in each local community. With the Children and Young People’s Mental Health Coalition (which we host), we have campaigned hard for these changes and so we’re pleased that they have all-party backing. We know that nearly three-quarters of mental health problems emerge by age 24, so it is vital to have an emphasis on improving support for the youngest. Yet none of the parties is as clear about their commitment to infant mental health. The Conservatives have pledged to expand Family Hubs to all areas of the country, and we hope that the next government will take the necessary steps to support mental health throughout life.

We are very disappointed that neither Labour nor the Conservatives have committed to end the two-child limit for Child Benefit, which causes hardship to so many families.

Election manifesto pledges for adult mental health

All parties also promise to improve mental health services for adults. The Conservatives say they will enhance mental health support through the expansion of NHS Talking Therapies to reach even more people and boost Individual Placement and Support employment services. Labour commits to expanding the mental health workforce with at least 8,500 more staff in the next five years, and the Liberal Democrats promise additional investment in perinatal mental health services and an end to out-of-area mental health hospital placements. None of the parties, however, makes a funded commitment to the expansion of mental health services at the level that is needed, nor to a comprehensive reduction in waiting times. Without these commitments, the next government risks falling further behind rising levels of mental health need.

The Liberal Democrats and the Greens promise to restore the public health grant to local authorities to at least 2015 levels. This would mean over £1 billion additional funds to drug and alcohol, smoking cessation and other public mental health related activities. For every £50 spent on treating illnesses and accidents in the UK, just £1 is spent on prevention. 28% of local authority public health grants have been cut by central government since 2015, while Public Health England was disbanded during the pandemic and its successor bodies cut. We must improve public health as well as treatment, or the latter will be overwhelmed with demand and more people will suffer unnecessarily.

The Liberal Democrats have also pledged to create a new independent Mental Health Commissioner which would help to put mental health at the heart of government: a proposal we advocated in a recent policy briefing, alongside the introduction of a cross-government mental health policy test.

How are parties planning to address the drivers of poor mental health?

Labour’s promise of a child poverty strategy, renters’ reform, and a new Race Equality Act would all address many of the biggest social determinants of our mental health, if they are backed up by practical and sustained action. Similarly, we welcome Labour’s pledge to improve employment support for disabled people, to reform or replace the harmful Work Capability Assessment, and to speed up the Access to Work scheme. The Greens and Liberal Democrats have also made significant commitments that would boost the wider determinants of mental health. It is vital that people with mental health difficulties get the right employment support. It is therefore disappointing that Labour has not committed to ending the harmful use of benefit conditions and sanctions on disabled people. And it is very worrying that the Conservatives are planning to forge ahead with moves to restrict access to essential disability benefits and to increase the use of sanctions for those who are out of work. These measures will cause higher levels of mental ill health and do nothing to help people get or keep work.

Manifesto pledges on social care

None of the parties has provided much detail about how they would proceed with much-needed reform of social care. Social services are as important a part of our mental health system as the NHS, but they have been subject to greater austerity cuts. They need an urgent funding boost, and a long-term settlement that works for everyone.

How could manifesto pledges around immigration, prisons and the environment affect mental health?

The major parties’ asylum pledges are another cause for concern in terms of refugees’ mental health. Labour’s manifesto provides little detail about how it would reform the asylum system to create safe routes for refugees and end current ‘hostile environment’ policies. And the Conservatives’ immigration policies, including plans to go ahead with deportation flights to Rwanda, risk greater traumas for those who have already experienced traumatic events.

Labour and Conservative plans to build more prisons, rather than investing in community sentencing and diversion options, are a missed opportunity to create a justice system that supports better mental health (and therefore reduces reoffending and other poor outcomes). One prisoner in seven is in contact with a prison mental health service, and many more have unmet needs. Many of those on remand or on short sentences could be safely and effectively sanctioned and supported away from custody. The Liberal Democrats have promised to do more to rehabilitate offenders in and out of prison but their proposals are short on detail or promises of funding.

We know that the physical environment plays a major part in determining our mental health. From addressing the climate crisis to tackling air pollution locally, the next Government can take steps towards improving people’s mental health through effective action. Most of the parties set out plans to do this, but we are concerned that Conservative plans to reverse initiatives such as London’s Ultra-Low Emissions Zone could undermine this essential work.

What was missing from the manifestos?

Neither of the two biggest parties has yet committed to a cross-government mental health plan in the next Parliament. We urge then to take this essential extra step, and to review the machinery of government so that all policies are designed to boost the public’s mental health.

What progress has been made on mental health?

While our mental health has been under enormous pressure since 2005, it is worth noting that at least two very significant mental health improvements have been made by Labour, the Conservatives and the Liberal Democrats in government since then. Improving Access to Psychological Therapies (IAPT, now called NHS Talking Therapies), starting in 2008 and expanded many times since, has brought evidence-based treatment for depression and anxiety to millions of people. While it has shortcomings, this programme has shown that large-scale change can be achieved in our mental health system.

Launched at around the same time, the Time to Change anti-stigma campaign (which sadly ended in 2021) was very successful in challenging misconceptions about mental health and illness, and significantly reducing levels of discrimination. There’s still more to do on that topic, as recent debates about disability benefits and sickness certification have made painfully clear. But we are making progress overall.

Both these initiatives shared a strong, evidence-based approach, sufficient investment, good governance and excellent data collection which enabled them to adapt if issues arose.

Whichever party or parties form the next UK Government, we urge them to make a commitment to work with us from the start of the new Parliament to achieve the vision set out in A Mentally Healthier Nation.

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