Mental health reform: a step in the right direction but far from the perfect solution

Last week, universities across the country took part in the annual University Mental Health Day, providing additional support to students and raising awareness of pre-existing on-campus mental health programmes. This event comes in light of recent governmental pledges to increase mental health funding and tackle the stigma surrounding mental illnesses: in January, Prime Minister Theresa May outlined new measures for transforming mental health in schools, workplaces, and communities at the Charity Commission’s annual lecture. Amongst these measures were pledges to provide mental health first aid training to every secondary school in the country; the decision to identify exactly which measures are working and which are not; and leading new trials to strengthen links between schools and NHS mental health staff. In addition, the Government will look to create partnerships with employers in order to improve mental health support in the workplace, choosing to work alongside long-time mental health campaigner Lord Stevenson as well as Paul Farmer, CEO of Mind, a mental health charity. The biggest chunk of funding is set to be fed into the creation of a GDP 67.7 million digital mental health package that promises to significantly reduce the time taken to gain an appointment with mental health services by bypassing local support units.

With these promises in mind – and the fact that the Prime Minister has been raising awareness of mental health ever since her very first speech as PM – it’s no surprise that many are feeling hopeful that the Conservative Party will reinvent itself as the party of mental health. Indeed, we should be thankful for a Prime Minister that is finally acknowledging the inadequate provision of mental health services, an aspect that we have been left unable to ignore since the publication of an open letter in November last year that criticised current mental health funding levels and was signed by nine ex-Health Secretaries (including Conservatives Lord Lansley, Stephen Dorrell and Kenneth Clarke).

To state that previous governments have provided sufficient funding for mental health services would be entirely incorrect: referring to former pledges, The King’s Fund, a health think-tank, found that “promised increases in funding had not materialised in many areas” and that “last year, funding had been cut for four out of ten mental health trusts”. Despite constant promises of further funding, statistics show that between 2010 and 2015 funding for trusts was cut by 8.25% – the equivalent of GDP 598 million from budgets each year. In the last four years alone, GDP 8 billion has been pumped into the NHS, with not a penny having reached NHS mental health trusts. In fact, the failure to cope with mental health issues is currently costing the UK 4.5% of GDP. Of course, some of the blame for these issues could lie with the lack of connection between national and local funding (local government, after all, makes the decisions of how to spend the money, and many local authorities can’t afford to make the costly provision for mental health services), though it is definitely reassuring to see the Prime Minister leading the way for the Conservative Party to finally live up to previous parties’ promises.

Young Minds, a mental health charity that looks to support children and adolescents, recently released data highlighting that 75% of mental illnesses begin before the age of 18, with over 50% of children developing symptoms before they even reach 14 years old. It’s therefore clear that our Government is taking the correct steps to improve prevention by increasing mental health funding for schools, enabling us to tackle mental health problems as soon as they appear and potentially preventing any problems from arising in the child’s later life – or, at the very least, teaching those most at risk to identify and tackle problems should they return.

Furthermore, the Education Policy Institute Independent Commission on Children and Young People’s Mental Health found that one in four patients referred to mental health services by their GP are actually turned away, and many of these patients are only finally admitted after attempting suicide. By creating an online digital platform where citizens can get mental health appointments and support without having to wait months for appointments, these measures could drastically increase the availability of mental health services, potentially saving the lives of thousands each year. Take, for example, the Norfolk and Suffolk Trust, where each case worker is currently assigned to over 95 patients, where the number of unexpected deaths (i.e. suicide or overdose) has doubled, and where specialist outreach teams have been cut. The implementation of online support systems could alleviate this strain on hospitals and physical mental health services, reducing the number of cases per psychiatric professional, and allowing for a more thorough treatment of each patient.

Finally, the Prime Minister has outlined measures to understand exactly what aspects of mental health treatment are working and which are not. This news is likely to come as a breath of fresh air to many mental health trusts: as a result of cuts under previous governments, trusts have had to restructure quickly and inefficiently, with radical transformations leading to negative impacts on patients. In a study of 33 trusts, it was found that, over the last three years, unexpected deaths have risen by almost 50%, with 1000 additional deaths last year alone. These deaths are most likely due to the cutting of specialist outreach teams that act as the support for patients on their road to recovery – teams that many mental health professionals have praised as the most important support network for recovering out-patients. By leading an in-depth inquiry into exactly what we can afford to cut and what must be retained, one would hope that trusts will be able to restructure correctly and efficiently, saving the Government money but still providing for patients’ needs.


However, before we hail the latest pledges as a panacea for mental health treatment, there are several aspects of the measures that need to be analysed further. Firstly, it would be irresponsible for the Government to entirely neglect the funding of mental health facilities and hospitals by favouring online services. Unfortunately, those who suffer from mental health illnesses occasionally cannot recover as out-patients, and must instead be treated on a mental health ward. Whilst we have experienced a 68% rise in the number of young people being admitted to hospital as a result of self-harm over the past 10 years, in the same period the number of psychiatric beds available to these individuals has almost halved (a total loss of 25,000 beds). By primarily funding online support networks and schools, the new government measures are failing to acknowledge the mental health crisis faced by hospitals and the lack of funding for in-patient treatments, instead focusing on the prevention of mental health illnesses in children as opposed to the treatment of those that have already developed mental health problems. With a 14% increase in the number of in-patients per year, the Government cannot afford to continue cutting beds and instead must act quickly to alleviate an already unmanageable problem.

Secondly, as university students ourselves, it is somewhat worrying to read that the new measures barely acknowledge the under-funding of university mental health services. Research by the National Union of Students recently found that over 78% of students have suffered from mental health problems at university, making us one of the most at-risk groups. By omitting provisions for universities from the pledges, the Government is failing to acknowledge that mental health continues on into higher education, putting the safety of 78% of students at risk. Perhaps we could argue that the universities themselves should be devoting further funds for welfare support, though it seems somewhat irresponsible that the Government is choosing to ignore one of the most at-risk age ranges rather than appealing to universities to increase the funding.

With these pledges comes the opportunity for the Conservative Party to become the party of those in need of mental health support, and many of the pledges do appear to be a step in the right direction. However, we can only pave the way for subsequent governments to follow if the correct action is taken. The Prime Minister’s willingness to draw attention to the insufficient provision of mental health services is not a big enough step, and nor is simply focusing on preventing mental health issues from developing in young children whilst forgetting to support other age groups. We cannot simply raise awareness and prevent mental health illness using online services and first aid; we must also be able to provide adequate treatment for those hospitalised or relying on the support of out-patient teams. We must also acknowledge the under-funding of university welfare teams. Rather than continue down the path of cutting funding for psychiatric wards and NHS trusts, this government has the opportunity to make the change that previous governments have not – an opportunity that it should grasp with both hands. Whether it be by restructuring NHS funding, or inviting private funding, we cannot afford to forget those that are already in the system or deny the fact that university students continue to be at constant risk.

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