Mental health services have less money to spend on patient care than they did five years ago, according to a damning new analysis from the Royal College of Psychiatrists. This directly contradicts the Government’s repeated proclamations that mental health funding is at record levels but will come as no surprise to patients, carers and mental health professionals.
The Royal College of Psychiatrists’ analysis compared mental health trusts’ income in 2011/12 to 2016/17, controlling for inflation. In England, 62 per cent of mental health trusts (34 out of 55) reported a lower income than five years ago. A similar picture was found in Wales, Scotland and Northern Ireland. Whilst – after the 2012 Health and Social Care Act – these figures do not reflect the totality of mental health funding, the picture is bleak.
Mental health has always been the poor relative to physical health, seriously underfunded in the NHS. At a time when this discrepancy was supposed to be redressed, not only are mental health trusts receiving less funding, but psychiatric services are also facing massive increases in demand. This increase stems partly from the level of suffering caused by austerity measures and a society in free-fall, and partly from an increased tendency to view one’s problems through a mental health lens, meaning epidemic numbers are seeking help from mental health services.
BMA film highlights mental health patient describing voices telling her to kill herself
This rush of interest in mental health has allowed the Government to make various smoke and mirror manoeuvres to appear to be at the forefront of change, while decimating funding for those most in need. Throwing £200,000 at schools to introduce mental health first aid makes for great headlines, but distracts from the more pressing need to adequately fund child and adolescent mental health services. Doubling the number of employment advisors in Improving Access to Psychological Therapies services may appear a useful way to encourage people back to work, but it masks the fact that it is increasingly difficult to access life-saving therapy for other goals such as reducing symptoms or improving quality of life, especially for those with moderate to complex needs.
The pressure to appear to be doing better, with less funding in real terms, is having a devastating effect on patients, carers and staff. I am told, time and time again, of patients with complex needs discharged suddenly from community mental health teams without an adequate package of care after ten, twenty or fifty years of support. Under huge pressure to appear to be progressive, ideas such as that of are put forward, while principles such as continuity of care from the same mental health professional and rehabilitation are dismissed, despite being the bedrock of mental health care for decades.
UK news in pictures
UK news in pictures
20 February 2018
Sarah Clarke is introduced as the new Black Rod to the House of Lords. She is the first female Black Rod in the 650-year history of the role and will be known as the Lady Usher of the Black Rod.
19 February 2018
Britain’s Foreign Secretary Boris Johnson holds a rhinoceros horn as he visits a Metropolitan Police wildlife crime unit facility in London. The Foreign Secretary’s visit was to help him learn more about the work they do internationally to tackle the illegal wildlife trade (IWT).
18 February 2018
Allison Janney, Daniel Kaluuya and Gary Oldman clutching their BAFTA awards
17 February 2018
Lizzy Yarnold of Great Britain celebrates after winning the gold medal during the Women’s Skeleton on day eight of the PyeongChang 2018 Winter Olympic Games
16 February 2018
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15 February 2018
Dame Vivienne Westwood walks the runway to model in the #INEOSVTHEPEOPLE catwalk presentation outside fracking giant INEOS’s headquarters in London
14 February 2018
Foreign Secretary Boris Johnson delivers his speech: Road to Brexit, a United Kingdom, as part of the Government’s road map on Brexit, at the Policy Exchange, London
13 February 2018
England and Durham cricketer Ben Stokes, 26, leaving Bristol Magistrates’ Court, where he was told he will face a crown court trial over an altercation outside a nightclub
12 February 2018
Labour leader Jeremy Corbyn meets with local party supporters and residents in Penicuik, Midlothian, before speaking at a campaign rally at the town’s Miners Welfare Hall
9 February 2018
Volunteers create a heart shaped collection of plastic bottles littering the foreshore of the River Thames at Queenhithe Dock in central London, in an event organised by the #OneLess campaign and Thames21 to draw attention to the impact that single-use plastic water bottles are having on the environment.
8 February 2018
Florist Hank Roling poses with a Vanda orchid during a press preview of the Thai Orchid Festival at Kew Gardens, London
7 February 2018
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6 February 2018
Prime Minister Theresa May joins female Members of both Houses at the Palace of Westminster, to mark the 100th anniversary of the passing of the Representation of the People Act, which gave certain women over the age of 30 a vote and the right to stand for Parliament.
UK Parliament/Jessica Taylor/PA
5 February 2018
Lauri Love outside the Royal Courts of Justice after a judge ruled against extraditing him to America in a case where he was accused of hacking thousands of US government computers.
4 February 2018
A statue of suffragette Alice Hawkins being unveiled in Market Square, Leicester. Ms Hawkins, a shoe machinist, was jailed five times while leading the Suffragette campaign in the city in the early 20th Century.
3 February 2018
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2 February 2018
Millicent Fawcett by Annie Swynnerton, newly on display at Tate Britain. Fawcett was a leading figure in the suffragist movement and campaigned relentlessly to get the vote for women in this country. The portrait of her is on display at Tate Britain to mark the centenary of the Representation of the People Act, which gave women over 30 the right to vote.
1 February 2018
British Prime Minister Theresa May and husband Philip May visit the Forbidden City in Beijing during her three-day visit to China.
31 January 2018
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30 January 2018
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29 January 2018
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28 January 2018
Members of the English Civil War Society take part in the King’s Army Annual March and Parade, in London, as they commemorate the execution of Charles I. The route follows the route taken by Charles I from St James Palace on the Mall to the place of his death at the Banqueting House in Whitehall.
27 January 2018
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26 January 2018
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25 January 2018
President Donald Trump meets with British Prime Minister Theresa May at the World Economic Forum in Davos.
24 January 2018
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23 January 2018
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22 January 2018
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29/47 21 January 2018
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30/47 20 January 2018
Britain’s Penny Coomes and Nicholas Buckland perform in the pairs ice dance free dance event at the European figure skating championships in Moscow.
31/47 19 January 2018
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32/47 18 January 2018
French President Emmanuel Macron and British Prime Minister Theresa May look up at a military fly past at Sandhurst Military Academy in Camberley. Theresa May is expected to make an announcement as part of the Anglo-France Summit at The Royal Military Academy Sandhurst, where she will discuss Britain’s strong and wide-ranging bilateral relationship with President Macron.
33/47 17 January 2018
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34/47 16 January 2018
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35/47 15 January 2018
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36/47 14 January 2018
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37/47 13 January 2018
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38/47 12 January 2018
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39/47 11 January 2018
British Prime Minister Theresa May watches birds from inside a bird hide with school children at the Wildfowl and Wetland Trust’s (WWT) ahead of a speech to launch the government’s environment plan in London. Campaigners on January 11 criticised Theresa May’s plan to eliminate all avoidable plastic waste within 25 years, calling it a “missed opportunity” that lacked the necessary urgency. The government will extend a charge on plastic bags to all businesses and encourage supermarkets to introduce plastic-free aisles, May said in speech.
40/47 10 January 2018
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41/47 9 January 2018
Prime Minister Theresa May leads her first cabinet meeting of the new year at 10 Downing street.
42/47 8 January 2018
Journalist Carrie Gracie speaks to the media outside the BBC in London after she turned down a £45,000 rise, describing the offer as a “botched solution” to the problem of unequal pay at the BBC. Gracie said she told the corporation she wanted equality, rather than more money, and was determined not to help the organisation “perpetuate a failing pay structure by discriminating against women”.
43/47 7 January 2018
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44/47 6 January 2018
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45/47 5 January 2018
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46/47 4 January 2018
Stuart (no surname given) with his possessions in a bus stop near Windsor Castle, Berkshire. Prime Minister Theresa May has said she disagrees with Tory council leader Simon Dudley, who called on police to clear rough sleepers from Windsor before the royal wedding.
47/47 3 January 2018
Storm Eleanor lashed the UK with violent storm-force winds of up to 100mph.
Funding is now skewed to services for those with common mental health conditions, where large numbers of people can be seen, treated and discharged quickly, as opposed to prioritising those most in need (whose treatment costs more). Even in services like Improving Access to Psychological Therapies that serve those with milder mental health problems, therapists are intimidated into seeing patients for less than the number of sessions the evidence-base requires to mask unrealistic service contracts. These issues are producing record levels of burnout across NHS mental health services in staff members. Indeed the task for staff has now become performing, rather than providing care, a reversal which staff fight against each and every day.
The real casualties of the funding cuts, though, are not staff but those in deep pain – a pain often caused by a society that has let them down and looked away. The same responses come up repeatedly whenever a new government initiative is announced. Where exactly is it safe to talk when one’s community mental health team is discharging patients at the rate of knots? When people wait years and years for evidence-based therapy? When psychiatric beds are now often at 100 per cent occupancy, with patients treated hundreds of miles from home? When rates of self-harm and suicide are at a record high? When patients have to phone the Samaritans on acute wards because staff are too overstretched or undertrained to actually listen?
The Royal College of Psychiatrists’ report slices through the rhetoric-reality gap around mental health funding like a hot knife through butter, demanding ring-fenced money after five years of real-world cuts. It is time for the Government to actualise its own rhetoric, and adequately invest in mental health care.
Dr Jay Watts is a consultant clinical psychologist and psychotherapist, and honorary senior research fellow at Queen Mary, University of London
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