The NHS is going to need services operating at two to
three times their current capacity to adequately deal with mental health
problems arising from the pandemic.
This is the conclusion reached in a report written for
the Centre for Mental Health by Nick O’Shea and published at the end of July.
The potential extent of the problem makes investing
strategically in they type of services provided even more important, as O’Shea
writes just providing extra funding isn’t the answer, how and where it is spent
is also important.
Data gathered by the Office for National Statistics
between January and March this year shows that 21% of adults questioned
reported experiencing depression in some form, this is an increase on the 19%
who said the same in a survey carried out in November last year and a
significant rise on the pre-pandemic figure of 10%. Young adults, women and
people living in deprived areas were, the report suggested, suffering most [1].
The report Now or Never: A Systematic Investment
Review of Mental Health Care in England [2] was commissioned by the
NHS Confederation’s Mental Health Network and sets out to place the current
state of mental health care in its historical context, looking at how
treatments and attitudes have evolved over the past two hundred years.
This shows that services have been modified rather
than reinvented with the focus remaining persistently on acute need and public
protection. Development has also been influenced by the traditional
distinctions made between caring for the health of the body and that of the
mind.
The ten chapters of the report each examine a specific
systematic problem in mental health system and sets out a suggested solution.
These include the higher costs incurred by treating
physical and mental health problems separately, the impact of long waiting
times for treatment, and the lack of government investment in promoting good
mental health.
This view is supported by the British Medical
Association, who in a briefing written for members note that more needs to be
done to promote good mental health as part of wider public health initiatives
[3]
The report also highlights the fact that demand for
mental health services is rising faster than the workforce available to deliver
them, and that staff working in the sector are subject to above average levels
of burn-out.
In May the commons Health and Social Care committee
heard evidence that 92% of NHS Trusts had serious concerns about staff
wellbeing, citing the effects of the pandemic as having intensified existing pressures
caused by a near endless cycle of restructuring [4].
It also cautions against seeing digital delivery of
mental health interventions as a panacea for all the ills faced by the
stretched services. Digital delivery has the capacity to widen choice, but it
should not be seen as a replacement for in-person support.
At the end of March, the government announced the launch
of a Mental Health Recovery Plan that will see £500 million invested in services
to meet extra demand created by the pandemic [5].
This is a welcome development, but this level of
funding will need to be maintained over the long-term and that may be a challenge
if paying the bill created by the pandemic sees the return of austerity.
The past eighteen months have been challenging for
staff who deliver mental health services and for the volunteers who often work
alongside them, as they have been for people who depend on those services.
The years to come will be no easier as mental health
services, along with the rest of the NHS, struggle to get back to something
like normality.
There is though, O’Shea suggests the potential if
government is willing to invest in the right way in improving services potential
to create something better than what went before.
As he writes the NHS was created in the hard years
after the war showing that ‘innovation often emerges at the most challenging of
times’ adding that for all the difficulties it has created the pandemic has
also provided ‘the opportunity to resolve long-term problems with fresh
solutions that save money and have the potential to improve all our lives’.
[3]https://www.bma.org.uk/media/2750/bma-the-impact-of-covid-19-on-mental-health-in-england.pdf
[4] https://committees.parliament.uk/publications/6158/documents/68766/default/
[5]https://www.gov.uk/government/news/mental-health-recovery-plan-backed-by-500-million
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