The Prime Minister’s speech on mental health today is nothing short of historic. This is not due to the details of the announcement, important though they are, but because it is the first time a Prime Minister in the UK has made a major speech centred on mental health.
This shows just how far we have come as a society in the last few years, as mental health is being brought out of the shadows – helping the one in four people in our community who experience mental health problems to feel able to talk about them openly. The increasing volume of this issue, particularly in the media has highlighted just how many people have been suffering in silence. Cameron has rightly taken note of this change in attitudes and recognised that mental health is an issue that matters to people across the country.
Today’s speech sets out how the £600m first announced by George Osborne in last year’s spending review will be allocated. He announced almost £1bn of funding over five years – a significant, and welcome, ring-fenced investment. It will help 30,000 more pregnant women and new mums get access to treatment for depression. It will ensure every hospital has mental health services in A&E so that people at risk of suicide are not turned away with no support. It will fund a new waiting time target for young people with eating disorders, tracking those seen within a month.
Of course this investment is very welcome. It continues the progress made in the last parliament with the introduction of the first ever access and waiting time standards in mental health and the investment in children’s services. But there is more to do to achieve true equality for mental health. Mental health has faced enormous discrimination within our society and within the NHS for generations. Mental health problems make up about 23% of the total burden of disease in this country, but only accounts for 13% of NHS expenditure. Almost £1bn over five years is a substantial investment but it will not in itself address this underlying problem. The total expenditure on mental health in 2013-14 was £11.36bn, out of a total NHS expenditure of £106.5bn. An additional £1bn alone will not fully address this disparity. Nevertheless, it remains a significant commitment, which will, hopefully, make a real difference to the lives of people with mental health problems in this country.
The Government must now work with NHS England and local commissioners to ensure that the underlying bias against mental health in the system is addressed. The way that mental health trusts are funded needs to be transformed with a move away from simple block contracts. Access and waiting time standards should be rolled out across all mental health conditions and there must be robust data collection so that there are no longer any hidden waits. We need to move towards a system where no one who needs treatment is ever turned away simply because there is not enough capacity for them to be treated. Children’s mental health services need to be open, easy to access (with stronger links to schools) and focused on prevention and early intervention.
Achieving equality for mental health will take time and determination from successive governments to achieve. Nonetheless, today’s speech is a significant step forward on the journey.