What the government’s five-year pledge on mental health could mean for Norfolk and Suffolk services
- Credit: Newscast Online
One million more people a year with mental health problems will receive treatment in England by 2021, the NHS has pledged.
The move comes after a new report found only 15% of people who need psychological therapy in England get access to care, despite mental health problems representing the largest single cause of disability in the UK and suicide rates in England rising after years of decline.
The report also shines a light on problems for children - one in ten of whom have a diagnosable mental health condition.
Children and adolescents can be sent 'anywhere in the country' for inpatient treatment, forcing families to travel long distances, and in some areas one in ten of children's appointments are cancelled because of staff shortages, the report found.
As well as a rising suicide rate that peaked in 2014 at 4,882 deaths, the number of people being detained under the Mental Health Act is rising year on year.
The leading cause of death for men aged 15-49 is suicide and a quarter of people who took their own life had been in contact with a health professional, usually their GP, in the last week before they died.
Suicide is also the second leading cause of maternal death, after cardiovascular disease, but only 15% of areas have the right perinatal mental health services and 40% have none at all.
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A focus on care for new mothers also aims to see at least 30,000 more women a year receive access to specialist perinatal mental health services which are currently only available in 15% of areas.
The plans, set out on Monday in the Mental Health Five Year Forward View, will be funded by an extra £1 billion a year from the NHS by 2020-21.
The report authors - an independent task force led by Paul Farmer, the chief executive of Mind - have suggested integrating physical and mental health care and taking steps to ensure that people facing a crisis should have access to mental health care seven days a week and 24 hours a day.
Mr Farmer said: 'Mental health services have been underfunded for decades and too many people have received no help at all, leading to hundreds of thousands of lives put on hold or ruined, and thousands of tragic and unnecessary deaths.'
The report - which put the cost of mental ill health to the economy, NHS and society at £105 billion a year - recommends actions to help one million more people a year, 280,000 of whom are those with severe mental health problems who will have their physical health needs met.
At the moment, 24/7 community-based mental health crisis care is only available in half the country, but by 2020-21 home treatment for patients in crisis should be available all over England and every acute hospital will have mental health liaison services in emergency departments.
The recommendations come as a survey of GPs by Pulse magazine showed 58% of GPs say they have to diagnose child and adolescent mental health 'above their level of competence' due to a marked deterioration in access to specialist services.
Health Secretary Jeremy Hunt said: 'We have made monumental strides in the way we think about and treat mental illness in this country in the last few decades - from a society that locks people away in asylums to one giving mental health equal priority in law.
'But we must accelerate progress even further. Our shared vision of a seven-day mental health service means people will get the care they need, when they need it, and will help us do much more to prevent mental illness in the first place.'
•The EDP has been running a mental health campaign to improve services
By David Powles, Investigations Editor who runs our Mental Health Watch campaign.
Is a new five-year plan for mental health a turning point for the millions in the country affected by the condition or yet another false dawn? Investigations editor David Powles takes a look at what it could mean for this region.
Given Norfolk and Suffolk's main provider of mental health treatment was the first in the country to be placed in special measures, where it currently remains, it would be fair to assume many of the problems faced by sufferers nationally are also experienced in this region.
And a scan of the new 82-page NHS England taskforce on mental health report proves that to be true, with many of the recommendations proposed likely to chime with those who have received care from the Norfolk and Suffolk Foundation Trust (NSFT).
The lack of a 24/7 service, too many out-of-area placements, high suicide rates, unacceptable waiting times for treatment and a fall in funding for mental health, are some of the issues highlighted in the latest report - and which formed the basis for our own ten-point manifesto to improve care in the region.
But diagnosing the problem is the easy part, it's the cure that has always been harder to find.
Type 'mental health report' into an internet search engine and you will soon realise the subject of the failings of mental health provision in this country have been well covered.
So what makes this latest attempt different?
According to Paul Farmer, chief executive of the national Mind charity and independent chair of the taskforce, this is the first time a government has truly put its money where its mouth is.
He said: 'Public attitudes towards mental health are improving and there is a growing commitment among communities, workplaces, schools and within government to change the way we think about it. There is now a cross-party, cross-society consensus on what needs to change and a real desire to shift towards prevention and transform NHS care.'
Debate is already raging as to just how 'new' the money is, or if it is just a handing back of cash that was stripped from services previously.
The government says that it is pumping billions more into the NHS over the next few years, from which this money should come, and therefore it will represent a real increase, and mean that not only will standards improve, but also one million extra people will be provided with support for their mental health proble.
Some of the key areas highlighted by the taskforce, which are relevant in Norfolk and Suffolk:
PARITY OF ESTEEM
The NSFT's own chief executive Michael Scott has long described mental health as a 'Cinderella service of a Cinderella service' and highlighted the unfairness of a sitation where acute hospital trusts are paid by results (if treatment goes up, so too does the cash), whereas mental health services are given a lump sum to share with an increasing number of sufferers. The government says one of its main aims is for people's mental and physical health to be treated equally.
It has long been the question of campaigners as to why standards of treatment available differ at different times in different parts of the country? Even in Norfolk and Suffolk, which comes under the same trust, there are times when one county provides a service, but the other does not. The expectation of the taskforce is that when someone suffers a mental health crisis, expert care is available around the clock, seven days a week. Currently, when it is not, people end up being sent to A&E where staff often do not have the expertise needed to treat that person.
If you break a bone in your body, you can pretty much expect an ambulance to turn up at a certain time - and then to be seen at hospital within a set number of hours. There is even an expectation as to how soon you might be operated on. If your mind is broken, however, there are no guarantees and the taskforce wants this to change. The first ever mental health targets should come in by April 2016, though in Norfolk and Suffolk concerns have already been raised the cash has not been provided by the Clinical Commissioning Groups to make them achievable. Long waiting times has been a problem for NSFT, though they have cut them in recent months.
OUT OF AREA CARE
This is regarded by many as one of the worst scandals of modern day NHS. Imagine being at your lowest ebb and being sent miles away from home because there are no available beds nearby. This has been a particular problem in Norfolk, fortunately less so in Suffolk, and the taskforce says it must end.
Millions is spent annually by NSFT on agency staff and that is money which could go elsewhere. The taskforce aims to make the sector more appealing for people to work in.
CHILDREN AND YOUNG PEOPLE
Mental health care and provision can be split into two parts; those with an existing problem that needs to be treated straight away and those who might develop one in the future. Both Norman Lamb, North Norfolk MP, and Dr Jon Wilson, NSFT's head of youth service, have talked about the importance of increasing awareness of mental health amongst young people to help stop them worsening when they get holder. Referrals of Norfolk and Suffolk children for mental health problems is already rising and the taskforce wants this to be a key priority, with schools playing a bigger part.
The way it currently works is that central government hands cash to local Clinical Commissioning Groups (CCGs) to be distributed. However, concerns were raised by the report many CCGs are not always transparent about where that cash ends up. Last year, our investigation revealed that funding for mental health had not increased in line with the overall budget rise at five of the region's CCGs – despite an increase in demand. The latest announcements are pointless if the money does not end up going into the right hands.
Have you got a story relating to mental health care? Email David Powles at firstname.lastname@example.org