Patient choice in mental health care a “fantasy” without more funding, warns charity

Interim guidance for commissioners, GPs and providers to help them support patients to choose their mental health care has been published, but more funding is needed if patient choice is to become a reality, a charity has warned.

From April 1 patients with mental health conditions have had the same rights as those with physical problems to choose where they have their first outpatient appointment. They can choose any clinically appropriate provider in England as long as a clinical commissioning group or NHS England has a contract with them.

Commissioners, GPs and providers are encouraged to adopt the interim guidance while NHS England consults further with them on areas that need to be improved. NHS England will also hold engagement events with patients.

Dr Martin McShane, NHS England’s director for long term conditions, said: “Patients’ right to choose who provides their mental health care and treatment is a major step towards establishing ‘parity of esteem’, or equal status, between mental and physical health services in the NHS.

“Helping patients make choices about their care is at the heart of NHS policy. Choice will drive improved services and patient outcomes. We will be working closely with health professionals and patients to ensure they have the support they need for choice to work well, in the interest of patients.”

Fantasy choice

Despite this, patient choice remains a “fantasy” in many areas of England, according to Rethink Mental Illness’ chief executive, Mark Winstanley.

“It’s really important that people with mental illness are offered choice in the same way that people with a physical health problem are,” he said. “We know that when people have a say in the care they receive, and are genuinely informed about their options, they have a better chance of recovering. 

“But if the government wants choice to be more than just a pipe dream, it must first address the chronic lack of funding for mental health services in this country. In many areas mental health services are completely over-stretched, or simply don’t exist at all. It’s often a struggle for people with mental illness to get any kind of treatment, never mind choosing between different services.

“It’s also crucial that commissioners introduce minimum waiting times for care, just as there are for physical conditions like cancer. As things stand, people often wait years for treatment after their initial assessment. Not only does this harm their chances of recovery, it also makes it impossible for them to have a meaningful say about the treatment they receive. 

“Until these basic inequalities are resolved, the idea of choice in mental health care is just a fantasy.”