“The NHS is failing mental health patients,” The Independent informs us today. Meanwhile, BBC News warns that NHS managers have been accused of “shocking discrimination” in providing mental health services.
The news is based on an academic policy report on the state of mental health services in Britain. The report found that mental illness accounts for nearly half of all ill health in people younger than 65, and that only a quarter of people in need of treatment currently get it. The report concludes that money spent on treating physical conditions could be better spent on cost-effective psychological therapies, which are still not widely enough available.
This story is covered appropriately by The Independent and other news sources. However, it is important to note that terms such as "discrimination" and "horrific scale" come from a press release, rather than from the more cautiously-worded report, which describes "inequalities".
While the report makes several significant recommendations, it is worth bearing in mind that these are aimed at a national and local NHS policy level. They are not recommendations for the care of individuals with mental health problems.
The report, from the London School of Economics Centre for Economic Performance Think Tank, was produced by a team of economists, psychologists, doctors and NHS managers. It says that mental illness is widespread and is generally more debilitating than most chronic physical conditions. The researchers report that a third of all families in Britain have a family member with mental illness. Additionally, nearly half of all ill health in those younger than 65 years is due to mental illness and only a quarter of those needing treatment receive it. The report estimates that 6 million adults have depression or anxiety and 700,000 children have a mental health disorder. The report also found that mental health problems account for nearly half of absenteeism at work and a similar proportion of people on incapacity benefits.
According to the report, mental illness accounts for only 13% of NHS spending on health despite the existence of cost-effective treatments. It offers the explanation that those in charge of planning NHS services (commissioners) are failing to fund the necessary mental health services or expansion of services and are, in some cases, cutting mental health provision, especially for children.
The report states that the under-treatment of people with mental illness is the most glaring case of health inequality in the country. The report goes on to say that mental illness can increase the scale of physical illness and that the extra physical healthcare caused by mental illness now costs the NHS £10 billion. It says that much of this money could be better spent on psychological therapies because the average improvement in physical symptoms is so great that the savings on NHS physical care outweigh the cost of the psychological therapy.
In 2008, the government initiated a six-year programme called Improving Access to Psychological Therapy (IAPT). The report says that:
The report recommends that:
The report states that beyond 2014 there should be another major expansion of mental health services, aimed especially at the millions of people who have mental illness as well as chronic physical conditions.
The report lead, Lord Layard, has called for the challenges of mental health to be placed at the heart of government. He said that NHS planners “should be expanding their provision of psychological therapy as it will save them so much on their physical healthcare budgets that the net cost will be little or nothing”. Lord Layard concluded that “mental health is so central to the health of individuals and of society that it needs its own cabinet minister”.