Key points:
- Covid could lead to new or extra mental health support being needed for 10million people
- Research shows the number of men having suicidal thoughts has double in 10 years
- Charities and unions criticise lack of action and call for more realistic funding to train and recruit extra staff
As the country entered lockdown three it is clear that covid has created a new wave of mental health problems, adding to the burden on services, and resulting in calls for longstanding issues to be finally addressed.
According to an estimate by the Centre for Mental Health 10 million people (almost 20% of the population) will need either new or additional mental health support as a direct consequence of the pandemic, with 1.5 million of those children and young people under 18. This was probably an underestimate at the time.
This is a huge number of people that will need support – some perhaps for weeks others for many years to come.
The pandemic is amplifying a long term trend in rising mental health distress. The latest perspective on that comes from a survey by MIND, in association with the English Football League, released earlier this month, which found that in the last ten years the number of men having suicidal thoughts had doubled and there were worrying increases in the use of negative coping mechanisms, such as drinking alone and taking recreational drugs.
Before the pandemic NHS mental health services were already in crisis.
One in four people with mental health problems were waiting three months to start NHS treatment, and some did not get help after four years, according to research published in October last year.
Services were struggling with demand after years of underfunding, the criteria for treatment referrals were tightening, leaving many patients struggling to get help, some patients are being sent miles from home for inpatient care, and hospitals and community teams are struggling to recruit staff.
In September 2020 vacancies in mental health stood at 19,000 down by 3000 in a year, but there is still a massive shortfall in the staffing, becoming ever more urgent with the covid driven escalation in demand.
Before the pandemic, mental health services had received a funding increase, but by nowhere near enough to improve services and recruit and train the staff needed to cope with demand.
Back in January 2020, the BMA appealed for at least a doubling in funding over the period of the long-term plan (from 2019/20); overall mental health spending in 2020/21 stood at £14 billion, so this would mean a rise to over £25 billion by 2025.
Following on from government initiatives and reports that claim to usher in a new dawn in support and a higher prioritisation of mental health, it would be untrue to say that there has been no progress, but calls from organisations representing staff and patients expose the reality that policy is still being undermined by a fundamental lack of public sector capacity.
Now with a growing wave of mental health illness already upon us, one would expect the government to be investing heavily in both facilities and staff. In mid-2020, the BMA called for several actions by the government to equip and fund mental health services to enable them to cope with demand, including once again asking for a doubling in funding for mental health services and making recruitment and retention of mental health staff a priority for the NHS.
In August 2020 Andrew Molodynski, BMA Mental Health Lead, said that although mental health services are not currently ready for such a surge in demand (and perhaps never have been) “hope is not lost” if actions are taken now to prepare mental health services to help those in need.
In the last spending review in November 2020, however, there was little that could be said to really tackle the challenge of mental health services. Rishi Sunak gave around £500 million to address waiting times for mental health services; £165 million capital funding ring-fenced for 2021-22 to replace outdated mental health dormitories with single en suite rooms; and £4.3 million to be used for green social prescribing. This comes to around £670 million, and as Vicki Nash, Head of Policy and Campaigns at the mental health charity Mind, said:
“ [the funding] is some way short of estimates that due to increased demand mental health services will require more than £1bn a year for the next three years, to deal with the long term fall out of the pandemic.”
Some funding has gone to charities, including a £27m recruitment drive launched by mental health charity Think Ahead, which will recruit and train up to 480 mental health social workers and a £46 million scheme to provide more effective and coordinated support for vulnerable people.
Whilst mental health services now compete for funding far more successfully and government policy is to some extent being influenced by wiser voices from within the sector, the government must grasp the need for a new plan to lift NHS mental health capacity to levels where we can truly guarantee access to mental health care for all.
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