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Prime Minister and Chancellor must deliver Equality for Mental Health


The cross-party ‘Equality 4 Mental Health’ campaign, co-founded by North Norfolk MP Norman Lamb, has won the backing of nine former Health Secretaries in calling on the Prime Minister and the Chancellor to address the continuing injustice suffered by people with mental ill health in next week’s Autumn Statement.

The health secretaries, who served under both Labour and the Conservatives, have been joined by seven former health ministers, the former Chief Executive of NHS England, a former Permanent Secretary at the Department of Health, the current chair of the Health Select Committee, and leading mental health charities Mind and Rethink Mental Illness.

The 'Equality 4 Mental Health' campaign was launched ahead of last year's spending review by Lib Dem MP Norman Lamb, Tory MP Andrew Mitchell and Time to Change Ambassador Alastair Campbell. 250 leaders from across society joined the demand for an end to the historic injustice of discrimination against the mentally ill within the NHS, and the then Chancellor George Osborne recognised the work of the campaign in announcing an extra £600m for mental health services.

However, many of the examples of injustice and discrimination that were identified a year ago are still all-too-evident evident today.

Many mental health trusts continue to experience cuts to their budgets despite the rhetoric of ‘parity of esteem’ from Government and NHS England. Suicide remains the biggest killer of men under the age of 45 in the UK. Mental health research receives a disproportionately small amount of public funding, and flagship new treatment standards for people suffering from a first episode of psychosis have not been backed by the necessary resources.

In her first speech as Prime Minister, Theresa May promised to fight “burning injustice” in British society, highlighting that there is too often “not enough help to hand” for those who suffer from mental health conditions. She is right, and now has the opportunity to address this.

Norman Lamb, the Liberal Democrat spokesperson and former Minister of State for Care and Support, said:

“It is a stain on our country that people with mental ill health are so often treated as second class citizens. Last year’s joint statement sent a powerful message that this cannot be tolerated, but still we are reminded on a weekly basis how people with mental illness are left without the treatment and support they desperately need. 

“Promised investment hasn’t made the difference many expected – especially in services for children and young people, where the majority of mental health problems begin. At a time when the prevalence of mental illness seems to be rising, it would be negligent for the Government not to act.

Alastair Campbell, former Director of Communications to Tony Blair and co-founder of Equality 4 Mental Health, said:

“We welcome the fact that stigma around mental illness is decreasing but are concerned that the services are not there to match the need. The Prime Minister’s expressed commitment to tackling the growing mental health crisis is welcome, and the Autumn Statement is a golden opportunity for her to deliver on this rhetoric.”

Andrew Mitchell, Conservative MP for Sutton Coldfield and former International Development Secretary and Government Chief Whip, said:

“We are concerned at the new evidence emerging of inequalities in the mental health system based on age, gender, ethnicity and social class.  Promised funding for children and young people’s mental health is not getting through to where it is needed in many parts of the country. NHS Digital has also exposed a dramatic increase in mental illness and self-harm among young women in recent years, while people from Black British communities and lower-income households are less likely to receive treatment for common mental disorders.

“People of all political stripes, who share a belief in the fundamental principle of equality for mental health, must work together to make this ambition a reality.”

 

The full statement is as follows:

EQUALITY4MENTALHEALTH

A year ago, 250 leaders from across society came together to make a plea to Government – to deliver EQUALITY4MENTALHEALTH. The campaign highlighted the current gross disadvantage suffered by those with mental ill health within our publicly funded NHS and urged action from the Government to end this historic injustice.

We called on ministers to deliver on their public commitment to parity between physical and mental health, to ensure for those who suffer from mental ill health equal, timely access to treatment as others enjoy, the same right to the best evidence-based treatment and an equitable share of health research funding.

We were encouraged by the supportive response of the then Prime Minister David Cameron and above all by the announcement of extra funds for mental health by then Chancellor George Osborne. We also welcome the ambitious plans set out in NHS England's Five Year Forward View for Mental Health, and the continued investment in the Improving Access to Psychological Therapies programme. We particularly welcome, on the day she took office, the new Prime Minister's stated intention to focus on mental health.

However, despite the warm words, one year on, we see the same enduring injustice, the massive economic cost of neglect of mental ill health - estimated to be £105bn a year - and the distress suffered by countless families across the country because of failures of the system adequately to support people in need.

In particular we highlight:

1. Despite the promised increases in funding, mental health trusts in England are still suffering cuts to their budgets. Two in every five trusts saw their budgets cut in 2015-16, according to analysis by the King’s Fund. [1]

2. Suicide remains the biggest killer of men under the age of 45 in the UK and the rate has been increasing in recent years. The male suicide rate was three times higher than the female rate in 2014. [2] [3]

3. People experiencing a mental health crisis are still routinely shunted across the country in search of a hospital bed.  Last year, nearly 5,500 mental health patients in England had to travel out of area to receive treatment – an increase of 13% from the previous year. [4]

4. Services for children and young people are going backwards in many areas, with up to 75% getting no support or treatment at all for mental health conditions. Children and young people's mental health services receive just 0.7% of the total NHS budget. In the first year of promised additional investment, only £143m was allocated instead of the £250m expected.

5. Children and young people with eating disorders and mental illness are still too often turned away unless they reach high thresholds for treatment, such as a low BMI and repeated suicidal thoughts. [5]

6. There is evidence of a growing mental health crisis among young women.  More than a quarter (28%) of women aged 16-24 have a mental health disorder, according to a major report by NHS Digital, while reports of self-harm trebled in this group to 19.7% between 2007 and 2014. There needs to be greater understanding of the reasons for this trend, though childhood trauma, sexual abuse, low self-esteem and social media pressures have been cited as possible contributing factors. [6]

7. People experiencing a first episode of psychosis are being denied the timely package of specialist treatment they should be entitled to under flagship new treatment standards in the NHS.  Early Intervention in Psychosis (EIP) is being restricted to patients under the age of 35 across a quarter of the country, while most CCGs are unable to say how much they had spent on the service or whether their care package is delivered in line with official requirements. [7]

8. There are inequalities in access to treatment for mental health disorders related to socio-economic class and ethnic background.  White British adults are more than twice as likely to receive treatment as black adults for common mental disorders, while people living in lower income households are more likely to have requested but not received a particular mental health treatment. [8]

9. Significant concerns that the potential value of Sustainability and Transformation Plans to bring all parts of the health and care system together will be undermined if mental health is peripheral to plans under development across the country.

10. Research into mental ill health continues to lose out with just 5.5% of research funding going to mental health compared to a share of the total disease burden of about 23%. [9]

We are alarmed and dismayed that so many of these points echo those made a year ago when promises of real change were made by the previous Prime Minister and Chancellor. We call on their successors, Mrs May and Mr Hammond, to address this disadvantage in the Autumn Statement and to make good the promise to achieve genuine equality or parity of esteem for those suffering mental ill health.

Norman Lamb, Alastair Campbell, Andrew Mitchell (Co-founders, Equality4Mental Health)

Andy Burnham, Ken Clarke, Frank Dobson, Stephen Dorrell, Patricia Hewitt, Alan Johnson, Andrew Lansley, Alan Milburn, John Reid (Former Secretaries of State for Health)

Paul Burstow, Caroline Flint, Tessa Jowell, Norman Lamb, Ivan Lewis, Dan Poulter (Former Ministers of State and Parliamentary Under-Secretaries of State for Health)

Sarah Wollaston (Chair, Health Select Committee)

David Nicholson (Former Chief Executive, NHS England)

Lord Crisp (Former Permanent Secretary, Department of Health)

 


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