As the budget looms large many in the mental health community will be hoping that the Chancellor considers additional investment in mental health services – especially for children and young people. He has said that he is open to the idea of helping where there are particular pressures in the NHS – and nowhere are pressures more apparent than in these mental health services.
Progress has undoubtedly been made in recent years. Mental health spending by CCG’s is up by £1.6bn on three years ago; we have the biggest programme of evidence based talking therapies anywhere in the world and the government has committed an additional £280m every year in improving care for children and young people. This is significant; but there is still a long way to go to fulfil the government’s ambition of achieving parity of esteem between mental and physical health.
The mental health system is under ever greater pressure as a result of rising expectations and increasing demand. Mental health services are still substantially underfunded in comparison to physical health. Evidence shows that the new money is struggling to get through to the front line and there is too much variation across the country in terms of spending and levels of service and care. With the NHS overall under pressure that new money designed for the five year forward view must not get ‘creamed off’ by commissioners to support other priorities.
Which is why I would urge the Chancellor to be bold. Rather than trying to do a lot of small things, it would be better to try and make one or two big changes that have the potential to really transform the system. Let’s not tinker at the edges with loads of small initiatives. Let’s take a big bazooka to the problems.
If for example he were able to find an additional £1bn for mental health services what would be the one big thing that would really make a difference? All of the evidence points to investing it in services to improve the mental health of children and young people, looking at early intervention programmes, as being the most effective use of money. A sustained investment into a reformed CAHMS system based on evidence and sustained over time would make a massive difference. The compassionate arguments for doing so are self-evident. But as the Chancellor ponders on budget spending, it is clear that the economic argument for further investment is also compelling. A huge body of evidence suggests that early intervene in a child’s life will have positive economic consequences, preventing that child from developing a more serious, acute illness; improving that child’s educational attainment and improving the prospects of that child growing into an adult that can lead a productive and fulfilling life.
The other immediately effective improvement would be to make sure that the existing and new investment in mental health gets to the front line by keeping the pressure up on CCG’s to spend it on mental health services. We now have greater transparency than ever before on what CCG’s are spending the money on and where they are falling short in terms of commissioning services. We should use that transparency to call them out. We should bring public pressure to bear to ensure mental health money is spent on mental health services.
This government has made real progress. Many people have battled to get mental health up the list of domestic priorities and we must not lose focus on this vital part of our domestic agenda. So many people – especially young people – are suffering because they still can’t get timely access to care. They are relying on us to make the right decisions. So I hope the Chancellor does exactly that and uses his Budget to signal the government’s absolute intent to continue towards a genuine transformation of mental health care.