by Steve Beasant on 14 May, 2014
In my time as Mental Health minister, I have written here several times about the unacceptable disparity between mental health and physical health in our health system. For far too long, physical health has been prioritised over mental health.
Perhaps the most stark difference is in terms of what happens when you suffer a mental health crisis. If you break your arm or suffer a stroke, you know that you will be taken to A&E, where you will get access to the expertise you need.
It’s very different in mental health. You may end up in a police cell or you may get sent a long way away from home to get a bed in a mental health unit. This would never be tolerated in physical health so why should it be acceptable in mental health?
Many of you last week will have seen or heard the story run by the BBC highlighting the shortage mental health beds. There were examples of people being sent tens or hundreds of miles out of their area because of a shortage of mental health beds locally. This is completely unacceptable.
The problem is that, despite protecting NHS funding throughout this Parliament, mental health has not had its fair share – I have said there is an institutional bias.
But why is mental health always disadvantaged by local commissioners when the money is tight? Exactly the same thing happened during the last government. During the financial squeeze in the NHS in 2005/6 the Health Select Committee concluded – with its Labour majority – that mental health had lost out.
As Lib Dem Shadow Health Secretary during the last government, I argued that the 18-week maximum waiting time for physical health conditions, combined with ‘payment by results’, sucked money into acute hospitals to the disadvantage of mental health. Now, in government, the Liberal Democrats have secured a commitment to introduce access and waiting time standards mental health from next year. This will finally force local commissioners to recognise that those with mental health problems have an equal right to access services on a timely basis and it will help to ensure that mental health gets its fair share of resources.
We have also introduced standards for mental health crisis care: every local area has been asked to sign up to the new Crisis Care Concordat before the end of this year. It sets out clear standards of crisis care in mental health – not just for health organisations, but also for other organisations like the Police who so often come into contact with people experiencing a mental health crisis. The Concordat demands a 50% reduction in the number of people with mental health problems who end up in a police cell as a so called ‘place of safety’. It also makes clear that mental health beds must be available locally for those who need them. This has been widely welcomed by those working in mental health. Crucially, the CQC will inspect mental health trusts against standards in the Crisis Care Concordat, and will expose areas where commissioning groups are not commissioning adequate crisis care.
But it is also important that we don’t simply focus on inpatient beds and crisis care in mental health. Often a patient only needs crisis care, or a stay in a hospital bed, because they haven’t received the care and support they need from community services.
I want to make sure that mental health services become much more focused on early intervention, supporting people in the community, and on recovery. We should not be waiting for them to arrive in hospital, or a police cell. So there is still a lot to do in terms of making sure that money within mental health services is spent in the most effective way. The Schizophrenia Commission highlighted the proportion of resources spent on ‘containment’, often with little or no ambition to pursue recovery – getting to a better place where the person is able to enjoy a good quality of life. Instead, they argued, there needs to be a shift of emphasis towards intervening earlier and aiding recovery.
Last week’s publicity from the BBC is a timely reminder of the scale of the task still to be achieved. It reiterates more than ever the need to fight for mental health to get the recognition it needs. And as Liberal Democrat health minister, that is what I will continue to do.Leave a comment