September 29, 2016

May must deliver on mental illness pledge

Professor Simon Wessely says the Prime Minister must match her stirring rhetoric around mental health provision with the investment required to deliver the services patients need.    

Theresa May put the plight of those with mental illness who don’t have proper access to care, at the heart of her vision for government.

But we have yet to see what that means in policy and practice.  Rumour has it that she will use her party conference next week to respond to the recommendations of the Taskforce on Mental Health which called for a range of measures to ensure that people with mental illness do get the high quality services that they need. Much has already been promised including a commitment to spend an extra £1 billion a year on mental health care by 2020.  Work is already underway at the Royal College of Psychiatrists to support NHS England with the implementation of the targets for access and waiting times including the treatment of psychosis, and for those who need talking therapies.

But as I write, there is a danger that these hopes and the progress made so far, could be swept away by the pressures on funding in the NHS which are building like a wall of water on the horizon.

The signs of trouble are everywhere.  In her annual investigation of how much clinical commissioning groups are spending on mental health services in their areas, the former shadow minister for mental health, Luciana Berger found that at least 73 communities will see their GP mental health budgets slashed this year.

The situation was summed up by the Public Accounts Committee in their recent report which says that the “laudable ambition” to bring about parity of esteem between the treatment of mental and physical health is under threat because of pressures elsewhere in the NHS.

We believe passionately that health services should reflect the individual needs of communities and recognise the important role that clinical commissioning groups (CCGs) have to play in that.  The Royal College of Psychiatrists is supporting the development of tools to enable people to see how their commissioners are performing. But more is needed.  One of the Taskforce’s recommendations was to require CCGs to report on investment in mental health and to increase investment in mental health services each year at a level which at least matches their overall allocation increase. There is no doubt, we need to increase the pressure and scrutiny on CCGs.

If you have a heart attack – no matter where you are in the country, you can count on a well-equipped ambulance with highly trained staff to come to your aid. But if you have a mental health crisis you may have to wait up to 72 hours in a police cell for an initial assessment.  The independent commission on acute care, supported by the Royal College of Psychiatrists, found that each month 500 mentally ill people have to travel more than 50 miles from their homes to get a hospital bed.

Good mental health is not an optional extra.  Severe mental illness can be as debilitating and as deadly as cancer or stroke and deserves equal treatment from the health service.  Theresa May is of the generation who witnessed Margaret Thatcher, on her first day in office, quoting St Francis, “where there is discord, may we bring harmony… where there is despair, may we bring hope”.  And how the clip was replayed in the following years, juxtaposed by images of riots and miners on the picket line.  Although the former Prime Minster spoke in earnest, perhaps she had succumbed to the temptation to over-promise.  The current Prime Minister is famed for her pragmatism and ability to deliver.  So I absolutely believe not only that she spoke in good faith on the need for better access to mental health services.  But more importantly, that it cannot have been an implicit pledge made without a matching determination to do whatever is necessary to make the investment and bring about the change to ensure mentally ill people do have access to the care that they need in the coming years.

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Professor Simon Wessely
Simon Wessely was elected President of the Royal College of Psychiatrists in 2014. In addition to his role with the Royal College, he has been a consultant liaison psychiatrist at King’s College Hospital and the Maudsley Hospital since 1991 where he is now Chair of Psychological Medicine at the Institute of Psychiatry, Psychology and Neurosciences (IoPPN).
  • Nockian

    No article ? Maybe it’s spread to comment central ?

    Central banks don’t work any better than any other kind of soviet style producer. They produce too many tractors when we need more ploughs. This is because banking isn’t independent, it isn’t laissez faire capitalism that is being practised, but the soviet style economics of central planning. It is not, per se, the fault of the central banks, anymore than it was the fault of the Russian tractor factories for under/ over producing as a result of state diktat. Unfortunately we have a mixed economy, which is 50% socialistic and has been expanding for several decades-most of us now give over 60% of our earnings to government directly (it’s probably a bit more depending on inflation and inflexible tax bands).

    The answer is to get the state out of commerce, then the central banks will either survive or collapse within a laissez faire banking system, but first we must begin to accept the truth, that we cannot continue to sustain such a gargantuan welfare system and its associated government. If we want to produce more, we need to be taxed less, we must save not spend.

  • ratcatcher11

    If everyone saved and did not spend there would be a massive worldwide slump, so it is obvious there has to be spending. Making things for sale is thus important, services alone cannot sustain an economy. One of the biggest problems is Keynsian economics that are basically tax, print and spend socialist policies. We do not need the government to build a railway we need a private company to build the railway which will compete with air travel fairly, not by taxing air travel to make it it less profitable. Thus the governments air taxes should be scrapped and private companies encouraged to re open rail lines closed by Beeching. This is the development we need not government spending 90 billion of money on an HS2 line built from somewhere to nowhere and never stops to pick up passengers.

  • Debs

    Expansion of economies cannot go on forever no matter what so called monetary policy is. You dont need to be an economics expert to realise it.

    All I know is governments and banks seem to be constantly coming up with schemes to leave we the lowly tax payer with less of our money.Forget about the trumpeted tax cuts ,everything else is going up accordingly except real wages of course. Dont even mention the Green scam or the cheap labour scam.

    Bail ins and cashless society are two more scams I have seen trailed in various media outlets over the past few years. Gradually our hard earned money is being prised away from us to fritter away on who knows what.

    They wonder why Trump got elected.

  • Nockian

    The market will raise rates eventually, regardless of wether the central bank wishes it or not. The problem is that we have all become mesmerised at central bank control, when, in reality, at this stage they have little at all. They cannot raise rates to normal, because, firstly, we don’t know what normal looks like (it could already be normal) and secondly any increases will create an avalanche effect-let’s face it, no one but the wealthiest wants to bring down countries governments through a collapse in public spending leading to actual anarchy on our streets.

    The bogey man of fractional reserve is a myth that has permeated libertarian consciousness, in a free market banks would have to take risk or they would, by any definition, not be free market. Banks are not currently lending to private individuals because capital requirements are already so high-they have become zombified businesses that look like they function, but are like the shops we set up as kids with funny money and plastic fruit. The market is broken as far as banks are concerned, they are no longer part of it.

    Fixing the problem cannot begin by looking at the central bank, nor the main banks. It’s far too late to consider than anything can be done at this stage, we are so far beyond normal that we aren’t looking at a functioning banking system at all. It would be like bleeding the radiators to solve a broken boiler.

    The problem we have is at its heart a simple one. It’s the problem that labour refused to accept when the banks blew up. We have an unsustainable welfare system and an over sized government. We have to tackle our public spending first of all and I see little sign that any current, nor perspective government is prepared to give the public the awful news about the reality.

    Even the great Tory saviours have flunked out of the monetary boiler rooms. The situation is dire, there is no fuel left, we have been ripping up the ships timbers to maintain the illusion of tranquil sailing progress, but eventually the ship will sink for lack of substance. There is no monetary policy that can save us, all we are going to get is an ever growing war on cash, savers and anyone who tries to make a profit. We are going to end up in the late stages of a soviet style melt down whilst spinning mirrors to pretend it isn’t happening.

    We all know what’s going on, we can offer solutions, make sympathetic noises and talk up any temporary progress, but the reality of the situation is now apparent. We have to do what every debtor must eventually conclude; that our spending has unfortunaly exceeded our earning capacity and all those red letters mean some drastic rethinking is required. We are going to reach the end of the road, not by a sudden explosion, but the drift into monetary authoritarianism which will result in ever greater protectionism and falling living standards. We are in great danger of losing the West to the East and ending up as country cousins of a world of declining freedoms and the rise mysticism.

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