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Mental healthcare needs a fair deal

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Pressures on mental health are failing patients Pressures on mental health are failing patients

Mental health has often been a poor relation of other health services when it comes to funding. However, in recent years, a government commitment to achieving parity of esteem between physical and mental health and funding announcements for a number of service development programmes have given renewed hope.

Funding for mental health isn’t about levelling up the system for the sake of it; it’s about ensuring that people with mental health problems have access to effective treatment and high-quality care. This is why it is key that we track the money and how it is used on the frontline and then use that data to improve patient outcomes.

Although national bodies are responsible for some commissioning, local clinical commissioning groups (CCGs) hold the greatest proportion of the budget allocated for commissioning mental health services.

In 2015, NHS England instructed CCGs to increase funding for mental health services. But we’ve found that at the end of the financial year 40% of them had received a cut to their income. This raises questions about whether promised increases in funding have indeed materialised and if they are reaching the frontline where they are most needed.

A range of organisations provide mental health support, but 80% of care is provided by NHS mental health Trusts. Less income means less money to spend.

As our mental health briefing paper outlined, many mental health Trusts have dealt with this by reconfiguring services. This has led to some innovation and an increased focus on recovery, but has also contributed to changes limiting access to safe and effective crisis care and provision of evidence-based treatments.

A further impact has been a marked reduction in the number of experienced nursing staff. Our latest survey of NHS finance directors found that 40% of respondents from mental health and community Trusts plan to reduce the number of permanent clinical staff over the coming year. This suggests that many mental health providers are continuing to reduce their headcount, despite the risks this brings to quality of care.

Many of the resulting pressures are reflected in the Mental Health Taskforce report, whose recommendations focus on early intervention in psychosis and crisis resolution home treatment teams. Rebuilding these services requires investment and staff, but while the government has set aside funding to do this, ensuring it gets to the frontline looks like another challenge altogether.

Helen Gilburt is a policy fellow at The King’s Fund

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