Spending Review: we may survive a tsunami of mental illness but only sustainable funding will tackle this crisis

It’s no secret that there’s a mental health crisis fuelled by the pandemic. 

During the first lockdown we warned that not being able to get help in these extremely hard times could lead to a tsunami of mental illness. Our fear was that without continued investment mental health services would reach breaking point. That’s what we worked tirelessly to secure in the past few months.

The Chancellor’s commitment to invest £500m to tackle waiting times shows that someone is listening. This money can make a real difference to those already waiting too long for treatment.

It could also lead to fewer people ending up in crisis even in the middle of a pandemic and preventing NHS services from being overwhelmed.

The total of £415m towards replacing outdated mental health dormitories with single en-suite rooms allowing for mental health patients to be treated with the same dignity and respect as those with physical health conditions is a welcome step towards offering high-quality treatment.

But welcome as the eradication of dormitories is, we shouldn’t forget that almost one million square metres of the mental health estate is so dated that it was built even before the NHS existed. 

Old and overcrowded mental health wards increase the risk of covid infection and can contribute to the deterioration of patients' mental health.

Improving health infrastructure is not a luxury. Research shows that the therapeutic environment can improve the value of care and treatment that patients receive.

That’s why it’s crucial that mental health providers get a fair share of the capital funding confirmed on Wednesday for further essential infrastructure projects.

More hospital capacity needed to treat mental illness

We also need to see more of the new hospitals built by 2030 treating patients with mental illness. Mental health trusts should be encouraged to bid and be prioritised for the eight extra schemes, which are now being planned. 

We’re disappointed that the Government did not commit to increasing the Public Health Grant budget at least in line with the funding uplift for NHS England’s budget.

This could put the already stretched public mental health and addiction services at even greater risk of not meeting the unprecedented demand they’re facing as a result of the pandemic. Lack of proper funding for addiction services in the next year could have devastating consequences in communities across the country.

A viable solution would be for local authorities to ring-fence at least 4% of this grant for public mental health spending and to commit to reversing the cuts to addiction services, bringing it back to at least the spending levels of 2013/14 over the next few years.

Social care funding is another area we’re concerned about. The £1bn the Chancellor promised is not enough to cover the huge surge in demand for care services that we’re seeing as a result of covid.

This is especially so as the net spending by councils on social care support for older adults is currently set to fall by 4.2% after inflation this year, compared to the previous one.

The increase in HEE’s budget means that as new nurses and doctors are trained, we’ll also see an increase in the mental health workforce needed to deliver these vital treatments. It’s not all good news though. A forecast from earlier this year indicated the NHS will only see around 70 additional consultant psychiatrists and around 260 mental health nurses added to its workforce by 2023/24. That’s against a requirement of 850 and 9,800 respectively to fulfil existing workforce strategies and deliver the NHS long term plan.

Ambitious and bold decisions needed

We need the Government to take ambitious and bold decisions. This requires double the number of medical school places in order to deliver a sustainable supply of doctors, and the new places must be allocated to medical schools with strategies to ensure the best undergraduate experience in psychiatry and other shortage specialties.

There are reasons to be optimistic that with the funding announced this week we can support more people with their mental health in the difficult year that lies ahead.

These include: the £50m to help more people with a mental illness leave hospital when ready and be supported at home; the commitment of £46m for supporting those with multiple complex needs across 15 pilot sites; £4.3m for green social prescribing initiatives to help improve mental health and reduce health inequalities; £5.9m for the use of transport-related schemes to reduce loneliness; and £15.9 million for access to accommodation and support from hospital for people who are homeless.

The government’s investment in mental health might just be enough to survive a tsunami of mental illness this year. But our mental health won’t be magically cured with the covid vaccine and the declaration of the end of the pandemic.

Mental health needs will not suddenly expire by a certain date. A one-year spending review doesn’t provide long term solutions and puts us in the position of having to return to ask for more.

This new mental health crisis can only be tackled by serious, sustainable investment in mental health services for years to come.