Dan Parton believes it remains a question of 'if' rather than 'when' for mental health reforms in 2013:
Much is promised for the future of mental health, such as parity with physical health, better integration of mental and physical health services, and the provision of more talking therapies. These will all make a positive difference if they happen. However, the keyword is ‘if’.
Sadly, it looks like it is going to be another tough year for people with mental health problems, and for those who work with them. But then that statement hardly makes me Mystic Meg; the past few years have all been tough, and the reasons remain the same.
While there is still a sense that mental health is not a Government priority – there has been no voice in Government for mental health since the National Mental Health Development Unit’s demise in 2011 – there were announcements last year that, on the face of it, sounded like real steps forward.
For instance, the Government launched the implementation framework for its mental health strategy ‘no health without mental health’ – albeit some 18 months after the strategy was published – to make the commitments within it, which were welcomed at the time, a reality. In addition, the Government published its draft mandate to the NHS Commissioning Board, which sets out the goals and outcomes the NHS must deliver on, including putting mental health on a par with physical health.
As ever with these things, it all sounds great. But now it needs to become a reality, and that’s the tricky bit. There is much cynicism within mental health, both from service users and the professionals working with them, with a sense of ‘we’ll believe it when we see it’. This is understandable: such rhetoric has been heard before on many occasions, yet resulted in little change on the ground.
Otherwise, for many mental health service users, in 2013, the same concerns as the previous few years will remain: how changes – and, often, cuts – to health and social care services, and benefit reform, will impact on their lives.
With health and especially social care budgets being cut back increasingly services are being reduced and this is inevitably having a detrimental impact on some people. With more cuts coming in the next financial year, this is only going to get worse. The salami can only be sliced so thinly.
In terms of benefits, despite further revisions in 2011 and 2012, the work capability assessment for employment and support allowance (ESA) is still seen as taking inadequate account of mental health issues. And many people on incapacity benefit will be reassessed for ESA this year and could lose their payment under the revised eligibility criteria. Similar concerns remain for people receiving disability living allowance, which will morph into the personal independence payment later in the year.
However, while times are tough, it is important not to become disheartened. As I have said before – and it’s worth repeating – there are many individuals and organisations doing great and often innovative work with people with mental health problems; and making a real difference to their lives, regardless of funding cuts.
But in addition to this, Government – central and local – need to ensure that the stated goals for improvement in mental health services are delivered on. If they do, the lives of hundreds of thousands of people could be improved. If. Only Time will tell – and that’s the one prediction I can make with confidence.