The year ahead in mental health - is change coming?

In 2015, mental health moved up the political agenda, but will this be maintained in 2016 and will service users and professionals notice any difference? Editor Dan Parton gets his crystal ball out.

At one point in the campaigning for last year’s general election, it seemed like the three main political parties were queueing up to make announcements about what they would do to improve mental health services.

Since winning the election the Conservatives have outlined funding and set new goals for improving mental health services, but, on the ground, things look much the same as they have done for the past several years, for service users and professionals alike – and I believe they will continue to do so.

For instance, people with mental health issues will remain concerned about benefit cuts. Reassessment for the move from Disability Living Allowance to Personal Independent Payments continues, and with the eligibility criteria having been ramped up, this is causing anxiety and stress for many with mental ill health who fear losing their benefit.

Likewise, the Work Capability Assessment for Employment and Support Allowance continues to cause stress and anxiety. The test has been shown to discriminate against people with mental health issues – it doesn’t take enough account of the way mental health can fluctuate, for instance – and revisions to the test haven’t gone far enough.

Many will also remain concerned about mental health services, or rather the lack of them. A ‘Crisis in mental health services’ has been spoken of and written so often in recent years that it has become a cliché. But that doesn’t mean it isn’t true, and the situation could well worsen, given that further local authority budget cuts are coming in 2016 – and up until 2020 – on top of those seen from 2010-15.

Cuts have come on cuts, and there are only so many ‘efficiency savings’ that can be made before frontline services are affected – in many cases they already have been. The services most likely to be in the firing line are those for people with mild to moderate mental health issues – services that may be relied on and, without them, people could see their difficulties escalating, resulting in their having to use more acute (and therefore more expensive) services down the line.

Local authority mental health workers have also been working with an increasing number of people being referred to services, while at the same time, their budgets have shrunk. Logically, this is a situation that cannot continue in perpetuity.

And that’s just adult services. Child and adolescent mental health services (CAMHS) have been limping along for years, with many having suffered dramatic cuts to their funding – or at the very least a freeze – since 2010, while the numbers of children and young people being referred to services has continued to rise, with no signs that the trend will be reversed in 2016.

While the government made large commitments to funding mental health in 2015, such as the decision to boost the funding of children’s mental health services by £1.25 billion over the next five years to help develop services, including those for perinatal and eating disorders, much more is needed. Local authority services will continue to suffer without investment. 

And, if mental health is to achieve parity of esteem with physical health services – something the government reaffirmed its commitment to in its manifesto – then it requires parity of funding too. And we are nowhere close to that.

Will we see such parity in 2016? No. Simply put, the investment needed in services to bring them up to the desired level is too high for the exchequer to contemplate. There are MPs on all sides of the House who are lobbying hard for mental health provision, but without the will of those who hold the purse strings then the current situation will prevail.

So, as with 2015 – and for as many years as you care to go back – mental health services will continue to muddle along, with professionals making the best of what they have. And there are some genuinely innovative services out there providing great outcomes for service users, which must not be forgotten. 

While there are other positives, such as the new waiting time standard for people with a first episode of psychosis which is being introduced in April, even that doesn’t go as far as many would like – again, money is a deciding factor. 

It seems the investment to make the necessary improvements in all services is too much. For everyone connected with mental health – service user or professional – it is money, or the lack of it, that will be a major concern this year. No change there either.