The Commons: NHS Mental Health Care is in crisis
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“Anybody who has ever been in hospital will know it’s a bleak place to be. But being there when you can’t have somebody wait with you or even come and visit you – especially during a mental health crisis – is overwhelming and isolating to a completely new degree.” - Faith Clarke
Faith Clarke is a freelance journalist who lived in Wales during the Covid-19 pandemic. She was admitted to Hospital in August 2020 after attempting to end her own life via an overdose. Faith was told a Psychiatrist would see her at 9.00 the next morning. She would not see a Psychiatrist for another 3 – 4 months. While she waited for the care she was promised, she faced constant mental health stigma, believing she was selfish for taking up a hospital bed and wasting the NHS staff’s time. (Her full story can be found here.) Sadly, she is not the only one being let down.
The crisis within the NHS mental health services is real and the need for mental health care is growing. According to the British Medical Association, the number of adults in contact with NHS mental health services rose to an all time of 1.37 million in May 2024. On top of this, nearly 500,000 children were receiving mental health care in March 2024. Understanding the causes of Britain’s mental health decline is crucial to finding solutions to this crisis. Covid has of course been a major factor in this; lockdown prevented Brits from socializing, seeing loved ones, and doing hobbies, all of which took their toll on millions of people. Additionally, the ongoing cost-of-living crisis is significantly impacting mental health across the country, particularly people in poverty or on low-incomes. Poverty rates are increasing, and as such, many more have suffered from the cost-of-living crisis, and this is starkly reflected in their mental health. Data published by the NHS shows those in higher deprivation are substantively more likely to be in contact with mental health services.
Number of People in contact with mental health services by index of multiple deprivation
The other side of this crisis is the supply side. Years of austerity measures and NHS spending cuts carried out by consecutive UK governments left the NHS unprepared for the rapid growth in mental health needs post-covid. A report done by the National Audit Office shows mental health spend as a proportion of total NHS England spend in real terms dropped from 9.05% in 2018/19 to 8.06% in 2022/23. Simultaneously, there are simply not enough doctors and psychiatrists in the NHS to deal with the demand for mental health care. The vacancy rate in June 2024 stood at 15.1%, higher than when the Covid-19 pandemic began (12.6%). One of the most concerning statistics comes from the child and adolescent mental health services (CAMHS). In the period from April 2016 – June 2024, the number of Psychiatrists working in CAMHS increased by around 18%. In the same time frame, the number of children and teenagers in the CAMHS system increased by 473%. This shocking fact highlights the pressure this vital service is under and how understaffed it truly is.
The relative number of children in CAMHS compared to the relative number of psychiatrists available
Tackling widespread poor mental health will require more than just additional funding, fundamental reform is necessary to change the way mental health is treated. Switching from a responsive approach to a preventive approach could save millions of people from mental health deterioration and could save billions of pounds for the NHS. Local government and community support groups could play a huge part in achieving this goal. A report done by the Local Government Association clearly emphasized how much more local government could do. The mental health of our communities and individuals is a priority for local government. “Councils have a range of statutory duties directly related to mental health, statutory duties that support mental wellness, non-statutory duties they undertake on mental health, and non-statutory duties that have an impact on mental wellness. … With mental health such a fundamentally important issue for the country, and with councils playing such a key role, it is surprising that local government has featured so little in national dialogue about how to improve mental health.”
The report goes on to express the importance of the voluntary and community sector in keeping communities mentally well and supporting those who become mentally ill. This is especially prevalent when discussing certain community groups such as veterans, LGBTQIA+ groups and victims of domestic abuse. Each different group has separate experiences, and so by talking through issues and creating a community with those who have been through similar hardships, it can considerably improve someone’s mental wellbeing. However, local government funding has been slashed by almost 40% since 2010 so this shift in focus to community prevention and local government needs significant national government investment in order to succeed.
Fortunately, the UK government have recently announced major reforms to the mental health act, aimed at modernizing mental health treatment to improve quality of care, particularly for prisoners and for autistic people. As well as this, in the October budget, they announced £26 million for mental health crisis centers, with extra funding for 380,000 patients to receive talking therapy. While this is a good step towards improving NHS mental health care more generally, the underlying issues have yet to be addressed. More staff are urgently needed if we are to provide quality care to those in need, and the national dialogue on using local government to support the NHS needs to begin. Ultimately, mental health deterioration is a spiraling problem and, if the government do not get a grip on it soon, it could lead to hundreds of thousands of preventable illnesses over the coming decade.
