There is a sea of change regarding mental health at the moment. Public attitudes towards poor mental health have improved, and the public is increasingly aware of the need to improve mental health care. There is also a strong political commitment to improve mental health services with the three main political parties’ manifestos addressing the issue.

The Labour party manifesto says they would ringfence the mental health budget and focus on early intervention for young people. The Liberal Democrat manifesto commits to increase investment in mental health. The Conservative manifesto confirmed their intention to reform the Mental Health Act – and they have pledged previously to increase the number of mental health staff by 2020 and tackle discrimination at work against people with mental health problems.

But although political commitment to tackling mental health is strong, funding is weak. 

In 2013/14, NHS England developed a programme to promote ‘parity of esteem’ between mental and physical health. The idea behind parity of esteem is that mental health and physical health should be equally valued. One commitment of the NHS England programme is that Clinical Commissioning Groups (CCGs) should invest in mental health services each year in line with the growth in their overall funding allocation. At the national level, CCGs have met the commitment. However, there are still variations regionally – with 46 CCGs not meeting the funding requirement on adult mental health care. Our recent analysis Year of Plenty shows that if this commitment was achieved by all CCGs, an extra £21m should have been allocated for adult mental health services. This is enough to fund the salary of around 675 mental health nurses to care for patients.

In addition, the funding increases within the NHS don’t seem to be reaching mental health providers. Between 2011/12 and 2015/16, the health budget rose by nearly £9bn, but the income of mental health providers fell by £150m (-0.3% per year).  During that same period, the income of acute providers rose by about 2% per year. It’s becoming increasingly difficult for mental health providers to maintain a balanced budget. (Their net surplus fell from £264m in 2012/13 to £54m in 2015/16.)

In January 2017, the government announced that of the extra £8bn being given to the NHS, £1bn a year will be spend on mental health care by 2020/21. However, it has since been reported that, in order to offset this year’s provider sector deficit (which is mainly concentrated in the acute sector), the Department of Health will need to hold back £800m of the funds set aside for improvements in services, such as mental health.

Mental health problems affect 1 in 4 people each year – yet only £1 out of £8 in commissioner budgets is spent on mental health. So if true parity of esteem is to be achieved, the next government will have to match its commitment with strong and stable funding.

Sarah LaFond (@SarahLafond13) is Senior Economics Analyst for the Health Foundation

Further reading


What the manifestos might mean for health care funding

22 May 2017

How much would be spent on the NHS in England under the different parties’ proposals?

Research report

A year of plenty?

March 2017

The NHS is facing unprecedented financial pressures 2.5 years after the publication of the Five year...

You might also like...


Emerging evidence of COVID-19’s unequal mental health impacts on health and social care staff

As we begin to take stock of the unprecedented impact of the pandemic so far, we explore the mental...


COVID-19 policy tracker

A timeline to 20 July 2020 of national policy and health system responses to COVID-19 in England.

Newsletter feature

Five key insights on COVID-19 and adult social care

Here we highlight five key insights from two new briefings on COVID-19 and social care.

Kjell-bubble-diagramArtboard 101 copy

Get social

Over 700,000 patients served by GPs at high risk of COVID-19 could be left without access to face to face GP appoin…

Follow us on Twitter
Kjell-bubble-diagramArtboard 101

Work with us

We look for talented and passionate individuals as everyone at the Health Foundation has an important role to play.

View current vacancies
Artboard 101 copy 2

The Q community

Q is an initiative connecting people with improvement expertise across the UK.

Find out more