The government’s aim of improving mental health services and achieving parity of esteem with physical health may not be achievable due to the cost, a critical Parliamentary committee report has said.
In its report, the Commons Public Accounts Committee concludes that while the government has a "laudable ambition" to improve these services, "we are sceptical about whether this is affordable, or achievable without compromising other services.”
The Committee found pressure on the NHS budget will make it very difficult to achieve parity of esteem between mental and physical health and that this is a task "for the whole of government".
While 1 in 4 adults is diagnosed with a mental illness at some point in their lives, only around a quarter of people estimated to need mental health services have access to them.
The report states: “The challenge is to build joined-up, well-configured services within the health system and across other parts of government that provide people in all areas of the country with access to the services they need, near to where they live.”
Systems for working across government are weak, says the Committee, citing no consistent way to access mental health services for people leaving prison, inconsistent availability of counselling in schools, and a disconnect between the NHS and Department for Work and Pensions in helping people with mental health problems get back into work.
The way mental health services are designed and configured is “complex, variable and difficult to navigate”, with significant variation in people's access to services.
The Committee concludes achieving parity of esteem will depend on the health system having the right staff, with the right skills in the right places – but "there is not yet a clear plan to develop the workforce needed.”
It also finds commissioners and providers are not sufficiently incentivised to deliver high-quality mental health services for all who need them.
The Committee has made a number of recommendations to government, including challenging the Department of Health and NHS England to collect and properly understand by the start of 2017–18 the cost and performance data it needs to improve services.
In addition, government should develop an effective strategy to integrate health services and to join up relevant public services to ensure continuity of care for those with mental health problems, “whatever their circumstances and wherever they live,” the Committee added.
The Department of Health, NHS England and Health Education England should also work together to collect the information needed to estimate the workforce required to achieve parity of esteem between mental and physical health, and by the start of 2017–18 put in place a plan for supplying that workforce.
Meg Hillier MP, chair of the Committee, said: “Many people can make a full recovery from mental health problems if they receive appropriate treatment at an early stage.
“This is good for them and has wider benefits for the economy and society in general. It is therefore crucial that mental health is given equal priority to physical health and that service provision reflects this.
“The government has committed to making much-needed improvements to mental health services but we are concerned it does not yet have sound foundations to build on.
“As a priority the Department of Health and NHS England must achieve a better understanding of the current landscape and the likely costs of achieving its goals.
“If these goals prove beyond the scope of the funds provided then it is vital a plan is in place to make best use of the money available.
“It is the responsibility of government to ensure its departments work together more effectively to support people with mental health conditions and in doing so reduce pressure on the public purse elsewhere.
“If it is serious about achieving its aims it must also plan to secure skilled staff in sufficient numbers."