Mental health services under significant pressure and ‘not sustainable’, report warns
Services for mental health patients are under “significant pressure” and have faced reductions in both hospital and community care in recent years, a new report has concluded.
The Centre for Mental Health said it is “not sustainable to keep cutting community services at the same time as reducing bed numbers”.
The Royal College of Psychiatrists warned that a reduction in both community mental health services and beds means the people with the most serious problems are being “failed”.
The report, from the Centre for Mental Health and the NHS Benchmarking Network, found the number of acute inpatient beds for adults with mental health problems in England and Wales fell by 15% between 2012/13 and 2015/16. The number of inpatient staff reduced by 20%.
But the number of people admitted and the time they stayed in hospital did not change and the proportion of people admitted under the Mental Health Act has risen year on year.
During the same time, community mental health service provision also fell – the number of people on community team caseloads reduced by 7%, staffing levels fell by 4% and contacts reduced by 6%.
But the authors point out that 900,000 people with common mental health problems received psychological therapy through the NHS in 2015/16.
NHS England and NHS Wales have both published recent strategies for improving mental health services.
Centre for Mental Health chief executive Sarah Hughes said: “Mental health services have been under significant financial pressures in the last five years.
“While reductions in bed numbers continue a long-term shift from hospital to community care, any reductions in community services are a major cause for concern. It is simply not sustainable to keep cutting community services at the same time as reducing bed numbers.
“The Five Year Forward View for Mental Health in England sets out a clear ambition to improve community mental health services and increase investment in mental health care across the spectrum. Today’s report shows that this is a vital mission. We need to see investment in evidence-based community mental health services to provide people with the best available support where and when they need it.”
Commenting on the report, Professor Wendy Burn, president of the Royal College of Psychiatrists, said: “Reducing the amount of psychiatric beds will only work if it is matched with a simultaneous increase in community mental health provision.
“A reduction in both community mental health services and beds means we are failing the seriously mentally ill.”
A Welsh Government spokesman said: “Mental health is one of our top priorities. We continue to spend more on mental health services than on any other part of the Welsh NHS – with funding increasing to over £600m in 2016-17.
“Following the introduction of a Wales-specific Mental Health law in 2010, we’ve ensured more mental health services are available in local communities, with dedicated local primary mental health services established across Wales.
“A small proportion of people with a mental health problem will always require inpatient treatment. We expect that wherever possible care should be provided as close to home as practical.”
An NHS England spokesman said: “This report, based on historic data at least a year-and-a-half old, pre-dates the Mental Health Taskforce investment. It also provides a misleading view based on accounting and service classifications that were abandoned several years ago, as it ignores the fact that community provision and the range of services have all increased and improved since 2015.
“This report does however acknowledge substantial improvements we have already made, including at least an extra 900,000 people each year are getting help in their community through IAPT (Improving Access to Psychological Therapies programme) but overlooks the overall 3% increase in community beds between 2015 and 2016 and the £574 million increase in funding for mental health this year.”
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