There has been great progress made to improve mental health awareness, develop national policy and enhance the delivery of services in recent years. The ambitions set out in the NHS long term plan around mental health and wellbeing are testament to the continued commitment to tackle this longstanding inequity between mental and physical health.
However, challenges for mental health trusts and their partners in tackling the care deficit remain and they are significant. Demand for services is continuing to rise at a time the sector is facing significant financial and capacity pressures that risk standing in the way of further progress being made. The scale of unmet need for mental health services is still not fully understood and current commissioning, financial and workforce constraints mean that achieving true equity for mental health still seems a long way off.
Our survey has revealed the impact of socio-economic factors on demand for mental health services is a particular concern among mental health trust leaders – in addition to longstanding issues around workforce and funding. Leaders are seeing increased social isolation, deprivation and homelessness increasingly driving demand for mental health services, and changing the nature of the support trusts need to provide. This trend has only been compounded by continued cuts to local authority budgets and the subsequent decommissioning of important local early intervention specialist mental health services which are needed to prevent people becoming more unwell.
Our survey has revealed the impact of socio-economic factors on demand for mental health services is a particular concern among mental health trust leaders – in addition to longstanding issues around workforce and funding.
Despite these challenges, system working provides an opportunity to further pursue equity of treatment for people with mental illness. Mental health trusts now have the opportunity to plan with health and care partners across their systems to work out how, together, they respond to the needs of their local populations in the decades to come. It is clear that mental health leaders are receptive to the challenge of working in a more integrated way, and are thinking positively about how changes to commissioning and increased system working will help them be more efficient and strategic.
As we move from high level plan to implementation, our survey suggests there are a number of priorities and challenges that both mental health trusts and the national bodies will need to consider. They include:
- mental health trusts, with the support of the national bodies, will continue to focus on reducing the number of OAPs and address inpatient capacity problems, although national bodies need to recognise the sustained demand here
- many providers are in need of capital investment so that urgent improvements can be made to estates
- mental health trusts need the national bodies to continue to promote careers in mental health and retain the current financial incentives to recruit mental health professionals.
- mental health trusts will be working hard to continue the progress already made on data collection and data quality to give a better understanding of mental health activity, access and outcomes that can then enable better commissioning.