A new report by NHS Providers reveals deep disquiet among NHS mental health trust leaders about a substantial care deficit resulting from the impact of growing social and economic hardship in their communities.

Mental health services: Addressing the care deficit looks at the levels of demand reported by frontline leaders across the range of services they provide, and examines what lies behind the growing pressures.

In particular the report identifies widespread concerns about benefits cuts and the impact of universal credit. It also suggests that loneliness, homelessness and financial hardship are adding to pressures on NHS mental health services.

In particular the report identifies widespread concerns about benefits cuts and the impact of universal credit. It also suggests that loneliness, homelessness and financial hardship are adding to pressures on NHS mental health services.

   

The report welcomes the ambitions for mental health in the NHS long term plan and the Five year forward view for mental health before it, together with increased investment to improve the quality, volume and accessibility of mental healthcare in England.

However, it also shows how demand for services is outstripping supply, and it concludes that the planned funding increase falls far short of the amount needed to close the gap between physical and mental health care.

Leaders from well over half over half (59%) of NHS mental health trusts took part in the survey featured in the report. Key findings include:

• more than nine out of ten (92%) said changes to benefits including universal credit are increasing demand for mental health services in their area
• a similar proportion (97%) pointed to increased loneliness and isolation
• 95% indicated that homelessness was a factor
• 98% cited financial hardship, and
• 91% pointed to cuts in local services.
  
  

The survey also presents a worrying picture of the impact workforce shortages are having on mental health trusts' ability to meet demand and provide high quality care. Fewer than one in ten (9%) were confident they currently have the staff they need. When asked about the numbers and skills of staff in two years time, nearly two thirds (62%) said they were very worried.

The survey also presents a worrying picture of the impact workforce shortages are having on mental health trusts' ability to meet demand and provide high quality care.

   

Furthermore, more than two thirds (69%) of mental health leaders were worried about maintaining the quality of the services they provide over the next two years.

The report calls for:

• greater realism about the demand for mental health services and better planning with input from trusts, commissioners and national bodies
• a national workforce plan, with appropriate focus on the mental health workforce, to be published as soon as possible
• a mechanism to guarantee funding reaches the frontline
• action on key priorities including reducing out of area placements and meeting the capital investment needs for mental health providers.

Commenting on the report findings, the deputy chief executive of NHS Providers, Saffron Cordery said:

"It is welcome that more people are seeking support for mental health problems. We have seen great strides in promoting equality between mental and physical health, but there is more to do.

It is welcome that more people are seeking support for mental health problems. We have seen great strides in promoting equality between mental and physical health, but there is more to do.

Saffron Cordery    Interim Chief Executive

"We need to be realistic about what services we are providing and when people are able to access the care they need and whether these are adequate to meet demand.

"Mental health leaders are clear that social and economic pressures are translating into higher demand for services. This demand is outstripping supply.

Mental health leaders are clear that social and economic pressures are translating into higher demand for services. This demand is outstripping supply.

Saffron Cordery    Interim Chief Executive

"Coupled with staff shortages and concerns that funding earmarked for mental health is not reaching the frontline, providers are worried about their ability to maintain the quality of services they can provide.

"The NHS long term plan sets out a welcome vision for mental health services, but we need to see greater realism about the demand challenge mental health services face. We need to see urgent action to address the care deficit identified by the sector.

"This must come through measures to lock in funding for the sector, recruit and retain the specialist staff we need and ensure mental health and well-being services play a central role in the development of integrated care systems."


About the survey:

In late November 2018, we surveyed the chairs and chief executives of all mental health trusts to gain a deeper understanding of the current operating environment and its impact on the sector. We received responses from 36 mental health leaders from 32 trusts across all regions, representing 59% of the NHS mental health trust sector. The survey was hosted online and remained open for three weeks. Questions covered the following areas: demand for services, access to services, service provision, commissioning, funding, workforce and system working.