Mental health funding: the ‘revolution’ that never took place

Wednesday sees the anniversary of David Cameron’s pledge to bring about a “revolution in mental health”. Since that announcement, however, various reports have highlighted that far from change being on the horizon mental health provision, especially for children, has worsened over the last 12 months.

The Royal College of Psychiatrists found almost three-quarters of consultant psychiatrists who treat children say NHS care for under-18s is either inadequate or very inadequate. The College also found some Clinical Commissioning Groups are spending as little as £2.01 per child on mental health care or young people.

YoungMinds said that children’s mental health services have been in crisis due to the “sad reality” of severe underfunding. Research by the charity shows that half of CCGs are using some, or all, of their share of the £1.4bn ministers under the Coalition government pledged for youth services for other purposes. And Freedom of Information requests have revealed that 57 per cent of CCGs plan to reduce the proportion of their budget they spend on mental health in this financial year.

What’s the solution? Norman Lamb, who was mental health minister for three years in the Coalition, said a tax rise of 1p in the pound to raise £3.9bn would help to achieve the “comprehensive package” of reforms Theresa May called for in her speech at the Charity Commission.

The Prime Minister said it would take years for change to come about but many families cannot wait that long.

For example, in the south east, there are just three hospitals that have mental health units for under 13s – Great Ormond Street, Collingham Gardens, and Acorn Lodge in Bethlem Royal Hospital, all in London. They have around 30 beds in total – split equally between boys and girls yet there was never any spare beds and all of the hospitals have waiting lists.

Social media has been blamed for helping to fuel a nation of “deeply unhappy” children struggling to deal with the pressures of everyday life. Data obtained last month by the National Society for the Prevention of Cruelty to Children found 18,778 children in England and Wales aged 11 to 18 were admitted to hospital for self-harm in 2015/16 – a 14 per cent rise in two years. Teenagers aged 13 to 17 were the most likely to end up in hospital for self-harm, including things such as cutting, overdosing on pills or burning themselves.

Although frontline health services are particularly challenging, there have been reasons to cheer. In September Northumberland, Tyne and Wear NHS Foundation Trust (NTW), along with East London NHS Foundation Trust, became the first mental health trusts in the country to be awarded outstanding under the Care Quality Commission’s new inspection system. Around 80,000 of the 1.4 million people served by NTW are treated for mental health issues every year During the i’s visit following the CQC announcement Northumberland chief executive John Lawlor said: “This is the best job I’ve ever had. Fighting for some of the most vulnerable people in society. There’s a great sense of passion, commitment and dedication among the 6,000 staff here at the trust.”

Mental health is still funded differently to acute care, with a fixed amount of money irrespective of how many people are treated compared to acute hospitals receiving more money the greater the number of patients they treat. Senior health executives do feel that political sincerity towards mental health is genuine, but the money is just not flowing.

The mounting crisis in mental health has seen several high profile campaigns launched in recent months. Last year, the Duchess of Cambridge launched Young Minds Matter, a new global initiative to raise awareness around children’s mental health services, emphasising the need for early intervention In November 2015, a new cross-party, cross-society campaign called for the Government to provide greater support for individuals with mental health concerns and to provide more funding for mental health services. Spearheaded by Lamb, ex-Conservative cabinet minister Andrew Mitchell and political strategist Alastair Campbell, Equality 4 Mental Health focuses on achieving parity for all health treatment.

The growing number of voices in support for mental health improvements seems to have been heard – but concerns remain. Referring to May’s speech, Campbell told i: “I think it is fine as far as it goes, but I genuinely worry that this focus on stigma – hugely important though that is – allied with ‘it is not just about money’ leads to us seeing improvements in attitudes as not complementary to, but a substitute for, the resources needed to make real parity between mental and physical health.” However, the former No 10 director of communications said services were still being “shredded” in some places and that although the Prime Minister is saying a lot of right things about mental health illness “so did David Cameron”, and not enough funding to achieve parity ever came about. The revolution failed to occur.