Mental health services are “straining at the seams” and require reform if they are to be fit-for-purpose for the next 20-30 years, a report has warned.
The report, ‘Starting Today’, by the Mental Health Foundation (MHF), said that if prevalence rates for mental disorders do not fall, by 2030 there will be 2 million more adults and 100,000 more children with mental ill health in the UK than there are today.
This rise will be fuelled by a growing, and ageing, population; persistently high prevalence rates of mental disorders among adults and children; increasing levels of co-morbid mental and physical health problems; and funding constraints that are likely to last for many years.
All this will heap added pressure on services that are already “straining at the seams”, the report said.
Fit for purpose
To cope with this expected rise, the report identified 6 key themes that mental health services will need to address to become fit for purpose for the next 20-30 years:
• Personalising services: greater personalisation of services and engagement of patients and their carers and families as equal partners in decisions about care and service provision
• Integrated care: increased integration driven by local leaders between different parts of mental health services; between physical and mental health care; and between health and social care. This will need a new approach to training health and social care staff, and a change in culture and attitudes
• Life span issues: services designed to address an individual’s mental health, and mental health needs, across their life span
• Workforce development: shared training across disciplines from the start of people’s careers and in continuing professional development, moving psychiatry into community and primary care settings, and flexibility for staff to develop and move careers across disciplines
• Research and new technologies: better funded research into clinical and social interventions to support people with mental ill health, alongside a commitment to ensure equality of access to the benefits of new technologies
• Public mental health: a need for mental health to be treated as a core public health issue, so that it will be as normal for everyone to look after their mental health as it is to look after their physical health and a public health workforce that sees mental health as one of its core responsibilities.
Dinesh Bhugra, co-chair of the Inquiry Advisory Panel and president-elect of the World Psychiatric Association and professor of mental health and diversity at the Institute of Psychiatry at King’s College London, said: “A range of factors will undoubtedly impact on future mental health services such as a larger population with more people reaching later life and increased expectations of care and support.
“We need to start taking action today to address future challenges. We cannot expect mental health services simply to muddle along with no clear sense of what is required, and sleepwalk into the future. If we do so, we will be failing all those who in the future need mental health care and their families, as well as the staff who work in mental health services.
“Our Inquiry found that the case for more preventative work is undeniable. Lacking a ‘cure’ for mental illness, a reduction in the number of people across the UK developing mental disorders appears to us to be the only way that mental health services will adequately cope with demand in 20-30 years’ time.
“We need fresh ways of working in mental health, ensuring the best use of available resources and working in truly integrated fashion.
New technology will no doubt bring about more changes as well as challenges. But much of what in our view needs to be done is simply implementing known good practice that already exists. Failure to provide good, integrated mental health care is not a failure of understanding what needs to be done, it is a failure of actually implementing good practice in organisational strategies and the day-to-day business of providing people with the care and treatment that they want. We need to start today to rectify that.”
Paul Farmer, chief executive of mental health charity Mind, welcomed the report. “Their [MHF] call for greater investment in the future of mental health services is set against a backdrop of substantial changes to local NHS and social care mental health services, a remodelled benefits system, as well as a difficult job market, all of which has meant that people with mental health problems are being squeezed on all sides. Government figures show investment in mental health services has fallen for the first time in 10 years, yet demand is rising.
“It is clear that the economic and human impact of mental health problems cannot continue to go unaddressed and we join the Mental Health Foundation in calling the Government to prioritise investment in the future of our nation’s mental health services, starting today.”