New research commissioned by the NHS Confederation’s Mental Health Network shows the cost of mental ill health for England was a staggering £300 billion in 2022.
The study, conducted by the Centre for Mental Health, shows that the £300bn figure breaks down into:
- £110bn – economic costs such as sickness absence, ‘presenteeism’, staff turnover and unemployment
- £130bn – human costs such as reduced quality of life and premature mortality
- £60bn – health and care costs such as support from public services and informal care delivered by family and friends
This is almost double the health service’s £155bn budget for England in the same year.
However, the failure of the government to heed this massive problem can be seen from the breakdown of where the heaviest burdens fall. The report The economic and social costs of mental ill health explains that the largest share of the costs stemming from mental ill health is borne by people living with mental health difficulties and their families: a total of £175bn.
Businesses carry a total cost of £101bn, while the government share is a comparatively small £25bn annually.
The report suggests that the majority of costs deriving from mental ill health do not fall on health care systems, and are instead reflected in decreases in wellbeing and productivity losses.
The Centre for Mental Health and the NHS Confederation’s Mental Health Network are stepping up their call for a comprehensive 10-year mental health plan, which was set out last autumn as part of A mentally healthier nation.
Sadly there is little indication that ministers are paying any attention. Almost every week brings fresh revelations of ways in which mental health services are lacking, under-resourced, or failing disastrously.
On April 11 for example ITV news, in collaboration with the Royal College of Emergency Medicine, exposed the fact that mental health patients who seek help from A&E are more than twice as likely as other patients to wind up waiting over 12 hours for admission, with many waiting for several days.
Almost one in four mental health patients (23%, more than three times the proportion in 2019) wait over 12 hours for admission, compared with one in ten of all other patients.
One area that has shown a much better service is possible is Lincolnshire. The ITV report noted that Lincoln County Hospital’s new Mental Health Urgent Assessment Centre receives around 50 patients every week, all of whom would have previously attended A&E.
This model needs to be rolled out across the country.
Last month ITV News highlighted the woeful gaps and shortfalls in mental health services for children, quoting Children’s Commissioner Dame Rachel de Souza’s warning of a “tsunami of need” within the child mental health system.
Her figures showed a total of 949,200 young people were referred to Child and Adolescent Mental Health Services (CAMHS) in England in 2022-23 – that’s 8% – one in twelve – of children in England.
ITV reports: “In Stockport, a purpose-built centre for child and adolescent mental health provides therapy for children with anxiety and depression. They also send mental health staff into schools across Greater Manchester. But referrals to their service have almost doubled in four years from 14,000 a year to 26,000.”
Staffing and services are nowhere near enough to cope with this level of demand: the Children’s Commissioner’s figures show:
- 270,300 children and young people are still waiting for mental health support after being referred in 2022-23.
- 372,800 had their referral closed before accessing support.
- Almost 40,000 children waited more than two years for mental health treatment.
- 31,000 children reached a point of mental health crisis last year.
Last month Matthew Boazman, chief executive of Birmingham Women’s and Children’s Foundation Trust, which runs mental health services for under-25s in the city, warned that children and young people are already facing “horrendously poor” experiences due to dependency on out of area beds and the situation will be worsened by deep cuts planned by Birmingham City Council.
The contempt with which ministers also view adult mental health services was summed up recently by Work and Pensions Secretary Mel Stride arguing that concern for mental health has “gone too far”, insisting that “we seem to have forgotten that work is good for mental health”, and arguing that people were being signed off work too easily.
Meanwhile all the symptoms of the government’s continuing neglect and underfunding of adult mental health services also keep surfacing in news headlines.
In Nottinghamshire Hospital Foundation Trust, the Care Quality Commission has found that patients at the hospital that treated killer Valdo Calocane were discharged too soon – and released in a worse state into the community,.
The CQC also found that more than 1,200 patients are waiting to be seen by community services, and several hundred who are receiving treatment did not have a clinician overseeing their care.
Calocane was under the care of the trust’s community service team at the time he killed 19-year-old students Barnaby Webber and Grace O’Malley-Kumar before killing school caretaker Ian Coates, 65, last June. He had been discharged from Highbury Hospital.
In February, The Independent revealed more than 30 staff at Highbury Hospital had been suspended by Nottinghamshire Healthcare over allegations of poor care and the falsification of patient records. According to the CQC’s report, 22 of the staff at the trust were suspended following inquests into the deaths of two patients.
In its review, which also covered inpatient services, the CQC noted high demand for services was leading to long waiting times for care and a lack of oversight of those waiting, and that the trust does not have enough staff to keep patients safe in the community and within some hospital services.
It also warned of reports from staff that its services have a “toxic” and “bullying” culture.
Sadly Nottinghamshire is by no means unique in its poor services.
Norfolk and Suffolk
Chronic failures of care have also led to an astonishing level of unexpected deaths among patients at Norfolk and Suffolk Foundation Trust, with recent publicised examples including the deaths of Christopher Sidle a 51-year old former government climate change advisor two days after being refused a crisis admission, and a Ellie Woolnough, a 27-year old Ipswich woman who had been contacted by the trust’s crisis team the day before, but was downgraded from ‘emergency’ to urgent after a 4-minute triage call with a mental health nurse.
The Campaign to Save Mental Health Services in Norfolk and Suffolk says the trust continues to be in a crisis sparked by austerity driven cuts in 2013. Its calls for a public inquiry into the trust’s service failures were stepped up last year after a review found 8,440 “unexpected” deaths among its patients or those it recently cared for.
Essex inquiry extended
Meanwhile despite being given increased powers, enabling it to compel witnesses to attend, the public inquiry into the deaths of mental health patients in the care of Essex Partnership University Trust (EPUT), first set up in 2021 has not been able start because of government delays.
Its chair, Baroness Lampard, has complained that its terms of reference have still not yet been agreed by the health secretary. The inquiry was initially set up to investigate the deaths of 2,000 people who died either while they were patients on an Essex mental health ward or within three months of being discharged, between 2000 and 2020.
The HSJ now reports that this timespan has been extended to cover all deaths up to December 2023, and the terms of reference include both EPUT and some Essex patients treated by the North East London Foundation Trust.
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