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
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