By Laurie Rackind, Chief Executive at Jami
Dear Prime Minister,
In the heat of election fever, mental health appeared on the agenda of most political parties. For those of us involved with mental health this was fantastic news, with each bulletin and press release bringing closer the promise of “parity of esteem”.
While the idea that mental health conditions can be treated on a par with physical health conditions seems obvious to most, all acknowledged that this was a great destination – but with a fair distance left to travel.
Mental health services have suffered a loss of funding in real terms over the past decade, with many services now only able to offer interventions reactive to crises. They offer medication and only a tiny proportion have hope of accessing the range of psychological therapies now shown to be effective both in amelioration of current episodes and prevention of future relapse. We have all heard the much referenced one-in-four statistic and now know that mental illness is common.
In fact, among people under 65, nearly half of all ill-health is mental ill-health, and this is generally more debilitating than most chronic physical conditions. However, only a quarter of those with mental illness, such as depression, are in treatment. Despite the political focus on mental health, we remain far from “parity of esteem”. There is no doubt that figures of 75 percent of those with cancer remaining untreated would never be seen as acceptable.
Political talk of the “Big Society” was one of the hot topics of the last government and was intended as a way that we would pull together to support those with needs in our communities.
However, the lack of funding to either statutory or voluntary sectors to achieve this has led to ideas of community support remaining only rhetoric in most cases. The ideas behind the Big Society remain heartwarming but, in order to facilitate them, the promises of increased funding and investment in our mental health need to run alongside.
In your pre-election manifesto, the Conservative Party outlined what you would do, if elected, to improve services for people with mental ill health.
You reaffirmed your existing commitment to put mental health services on a par with physical health, with a promise to go further, including ensuring that there are therapists in every part of the country providing treatment for those who need it. In addition, the manifesto said the Conservatives would increase funding for mental health care.
The Secretary of State for Health, Jeremy Hunt, has said: “My biggest priority now is to transform care outside hospitals – just as we have dramatically improved the quality of care inside hospitals in the last few years.”
I embrace these words, but am mindful that the rhetoric needs cold hard cash. The NHS mental health care is able to provide only a minimal amount of short-term care for a minority of those who need it. Ironically, treating mental health remains cost effective – with the economic and social cost of mental health problems far outweighing the cost of providing services.
While the new government is respectful of the third sector and recognises the impact that it can and should have on the landscape of mental health, at present much of this is delivered without statutory funding.
At Jami, less than two percent of our £2m+ income is provided by statutory funding. There is so much more that we want and need to deliver. The gap between the demand and supply of psychological therapies continues to grow, but with so many calls on voluntary contributions from a host of charity providers, at present it remains a pipe dream than we can begin to redress this gap.
Mental health policy has frequently changed the focus and mode of delivery of services, from institution to community to crisis services and to partnership care.
The reality is, while this has often been useful, a re-badging is not enough. We need investment, we need funding, we need more and not just re-allocation of the existing monies around and around.
Yes, services could be better arranged, better hosted in primary care, better delivered in community settings, but this is not the total answer.
Dear Prime Minister, please can we have investment.