After the recent announcements from the conservatives on mental health I think its essential we explore the reality of mental health funding. It is important to think about, because since 2010 I have heard politician after politician promise there will be a revolution in mental health services, promise things will change for the better and promise to end discrimination, yet the reality for many mental health patients is that mental health services today is that things are going backwards.
We can be under no illusion that people experiencing mental health conditions in 2017 are under great suffering, the list of challenges in the system is extensive and I wont be able to cover them all today. I want to focus on the issue of mental health funding in both local government and in the NHS.
So, lets first look at the NHS and more specifically the funding for mental health trusts, the organisations that deliver front-line mental health services. Many trusts are reporting their budgets being cut, but there is not so much discussion about the reason for these cuts particularly when the government are announcing record spend on mental health services, why the disparity? Well the government have been crafty, because despite announcing the spend, the organisations with the devolved responsibility to spend the money (clinical commissioning groups), are under no obligation to spend the money on mental health, so in the last five years you will find that many clinical commissioning groups spend on mental health has drastically reduced.
Instead of tinkering with pieces of legislation the government could make a tangible difference to people’s lives by ring-fencing mental health spend in the NHS, so the money actually makes it to front-line mental health services. I don’t have the answer to why they won’t do this and people are welcome to draw their own conclusions but the situation gets worse because the real cuts to mental health services have been through local government.
We should ask the question, what keeps people mentally healthy? Well much of the evidence tells us that social and community interventions work well. The problem is in the UK, local government typically provided a plethora of social and community interventions that improved an individual and community mental health; youth clubs, community kitchens, advice services, the list is endless but many of these services no longer exist. Local government is under immense pressure and when the cuts came in 2010, there was no statutory obligation for local government to continue to provide these services and many councils were forced into cutting them by central government to save money.
What the government failed to understand was that by cutting these services, many people lost their mental health lifelines, because as I said earlier it is the social and community intervention that often make the difference in someone’s mental health. Again, why didn’t the government commit to replacing some of those community services that once existed?
In this context, I don’t understand why people are confused at the problem within mental health services today, the early intervention that was delivered in local government no longer exist and the front-line mental health services are being cut. People cannot get the help they need when they need it, they are being told they are not unwell enough or that there are not enough beds.
It is overwhelmingly positive for me to see mental health moving up the political agenda, but since 2010 all we have had is rhetoric. If the conservatives really want to bring about a mental health revolution, they need to revolutionise their mental health policies and stop presiding over savage cuts to our mental health system.