As the 2017 Budget approaches, there has been a growing call on the Chancellor to ensure that health, and particularly mental health, funding is given a boost in order to meet the Prime Minister’s ambition is tackling the ‘burning injustices’ of poor access to help when people need it.
The need for fairer funding for mental health services within the NHS is now widely known and clear. Mental health care accounts for about 12% of NHS spending yet mental ill health represents about 23% of need. Children’s mental health in particular has long been under-funded, resulting in serious shortages and long delays for parents and young people trying to get help.
The Government has already made some welcome and important commitments to boost mental health service spending and support. First, in order to deliver the NHS’s Five Year Forward View for Mental Health, published last year, the Government pledged that an extra £1 billion would be spent on mental health services by 2020/21: a significant and welcome boost to fund much needed talking therapy services, crisis care and early help for young adults (among others). And second, it has pledged to spend £1.4 billion spread over five years (2015-2020) to improve children and young people’s mental health services.
It is now crucial that the funds earmarked for mental health support, for children and adults alike, are protected and spent as intended. In every local area, we need to see real increases in spending on mental health care coupled with the changes that need to take place to meet people’s needs effectively. In a context where the chief executive of NHS England, Simon Stevens, has warned that the NHS’s finances are under extreme pressure, it is more important than ever that we do not repeat past patterns of ‘raiding’ mental health budgets to offset deficits in other parts of the system.
A Budget for better mental health would, however, look beyond the confines of the NHS. First, it needs to consider the essential role of social care in working with NHS mental health services. Often it is social care that enables people living with a mental illness to live well and to stay out of hospital. Housing support also plays a critical part in mental health services yet is often overlooked and undervalued. Both face severe financial constraints and need a more secure future.
Local authorities also now have responsibility for public health, and more and more local councils are taking action to prevent mental health difficulties and build stronger communities. Most now have strategies to prevent deaths through suicide and many offer a range of interventions to support families to boost children’s wellbeing. Public health departments also commission alcohol and drug services, and the vast majority of people they support have mental health needs that are often poorly met. Yet public health budgets have been cut repeatedly and preventive services have faced big cuts.
A Budget for better mental health would also seek to ensure that schools had the right help and support to build children’s emotional health and wellbeing – from training teachers to be more confident talking about mental health to providing counselling and other support services when students (or staff) need them. It would take concerted action on race equality in mental health. It would take steps to boost employment support for people with mental health difficulties, moving closer to evidence-based help and away from the use of conditions and sanctions. It would ensure people with mental health difficulties who rely on social security benefits had enough money coming in to live on. And it would invest urgently in mental health support throughout the criminal justice system, including prisons and probation, and for people held in immigration detention.
Tackling the injustices around mental health requires commitment across government, linking national and local with a shared goal of bringing about equality for mental health. The Budget could provide a clear signal that the Government is serious about working across the system to build on what the NHS is beginning to achieve through the Five Year Forward View for Mental Health and bring about lasting change in the lives of individuals, families and communities nationwide.