Priority 2: Reverse the mental health crisis

This is the second of five priorities we've included in Preventing mental illness, our manifesto for the next UK General Election.

Fund and resource mental health services to recover and expand capacity to meet growing demand

Almost 1.4 million people with suspected mental illness in England are still waiting to start treatment. During the month of June 2023, 11% of patients in Wales waited over 56 days from referral for a Local Primary Mental Health Support Services assessment and 21% waited more than 56 days for a therapeutic intervention¹. In July 2023, 14% of children waiting for their first specialist Child and Adolescent Mental Health Services (CAMHS) appointment in Wales had been waiting for over four weeks² and 6,667 children and young people were waiting for specialist mental health treatment in Scotland at the end of June 2023.

The situation in urgent and emergency care is also dire, with adult acute bed occupancy not falling below 95% in England since May 2022. In June 2023, there were 39,137 emergency and urgent referrals to crisis care teams, an increase of 53% compared with June 2022; 10.7% of the emergency and urgent referrals during this time period were for children aged under 18³. More than 106,000 inappropriate out of area placement days occurred during the second quarter of the 2023/24 financial year, across all ages and bed types⁴. In the absence of equivalent data across Wales, Scotland and Northern Ireland, we can only assume that the situation is as concerning in these nations as it is in England. We also know that some patients are forced to travel across borders to other nations in the UK to receive treatment.

While patients are waiting, too many will end up in Emergency Departments in crisis, often forced to spend days waiting for an inpatient bed. These delays make recovery from mental illness so much harder and cost the NHS and the economy more in the long run.

Too many people with a mental illness encounter crisis situations. While it is vital that care is improved for people experiencing a severe mental health crisis, too often there is a lack of investment in the continuity of their care which drains the NHS and our economy of its resources. Investing in mental health services in the community could lessen this burden, preventing incidences of mental illness and freeing up resources to be used for other public services, such as the police. Lessening wait times will also reduce the need for inpatient treatment and lower the carbon footprint of mental healthcare.

Recommendations

• Invest in mental health services in the community to lower the number of people having a relapse of their mental illness and presenting to Emergency Departments in crisis.
• Introduce new response time standards for urgent and emergency mental health care.
• Intelligent commissioning of services including of beds that are fully resourced in areas with persistently high bed occupancy rates and inappropriate out-of-area placements, using models like the provider collaboratives.

References

1. StatsWales, Part 1: Local Primary Mental Health Support Services, 23 August 2023
2. StatsWales, First appointment waiting times for Specialist Child and Adolescent Mental Health Services, 13 September 2023
3. NHS England, NHSE, Mental Health Services Monthly Statistics, June 2019 to June 2023
4. NHS Digital, Out of Area Placements in Mental Health Services, 12 October 2023