Government and NHS England announce range of initiatives on mental health

Recent announcements from the Government and NHS England promise a better future for mental health services, beginning with the Final report of the Independent Review of the Mental Health Act 1983 (https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/763547/Modernising_the_Mental_Health_Act___increasing_choice__reducing_compulsion___summary_version.pdf).

The Review sought to find a balance between ‘respecting a person’s autonomy and the duty of a civilised State to protect the vulnerable’ in the context of compulsory detention, acknowledging that the process threatens the dignity and self respect of the individual affected. The philosophy underpinning the Review’s findings is the importance of ‘improving patients’ and service users’ ability to make decisions about their own care and treatment’. Its report makes 154 recommendations covering choice and autonomy, minimising restrictions on the individual, ensuring the person derives a therapeutic benefit and is respected as an individual, and changes to the system of regulation and management, including staffing.

NHS England has promised mental health checks and treatment for the partners of pregnant women and new mothers who are themselves suffering from anxiety, depression or psychosis (https://www.england.nhs.uk/2018/12/partners-of-new-mums-with-mental-illness-set-to-get-targeted-support-on-the-nhs). It is estimated that 10% of new fathers experience anxiety or depression during the first six months after the birth of a baby. As part of the NHS Long Term Plan, new and expectant fathers (the announcement did not refer to same sex parents) ‘will be automatically offered a comprehensive mental health assessment and sign-posted to professional support if needed’. Individuals who are ‘seriously unwell’ will be offered a range of interventions such as ‘peer-support, behavioural couples therapy sessions and other family and parenting interventions in specialist community perinatal mental health settings or referred to a leading psychological talking therapy programme’.

The Government has also confirmed plans to improve mental health support in schools and colleges (www.gov.uk/government/news/nhs-and-schools-in-england-will-provide-expert-mental-health-support). This will be available from the new mental health support teams in 25 areas, beginning with training for teams at seven universities nationwide and trailblazer sites serving 20% – 25% of England by 2023/24. Each trailblazer area will have one team providing support to up to 8,000 children and young people in 20 or so schools and colleges. This will build on existing services, including what is available in the voluntary and education sectors, to support children and young people who have mild to moderate mental health issues and help those with more severe needs to access the right support and care. Funding for senior mental health leads will come from the Department for Education.

The new NHS Long Term Plan includes a strategy for supporting children and adults with autism from the autumn of 2019 (www.gov.uk/government/news/government-review-to-improve-the-lives-of-autistic-children). It will collect evidence from autistic children and adults, families, carers and professionals on how to improve services and support, covering how to coordinate services for health, social care and education; providing earlier diagnosis; improving the transition to adult services; and increasing understanding of the different forms of autism.

The NHS Long Term Plan pledges substantial investment for mental health services, raising spending by at least £2.3 billion per year a year on mental health care, aiming to provide therapy for an additional 380,000 people with depression and anxiety by 2023/24 and delivering community-based physical and mental care for 370,000 people with severe mental illness a year by 2023/24 (https://www.longtermplan.nhs.uk/wp-content/uploads/2019/01/the-nhs-long-term-plan-summary.pdf). Less specific plans to improve care for older people included ‘further progress’ on care for people with dementia, more help to live independently at home and an extra £5.4 billion for primary and community care services. These targets and aspirations will be achieved by redesigning service pathways, continuing efficiencies, better use of data, digital technology and increased investment in staff recruitment and training.

The promises were welcomed by mental health charities and the professions. For example, the Mental Health Policy Group, which includes the charity MIND and the Royal College of Psychiatrists, said ‘We welcome the commitment for mental health services to grow at a faster rate than the overall NHS budget… We’re also pleased to see a focus on improving services for people living with severe mental illnesses such as schizophrenia or bipolar disorder by increasing access to mental health services in the community, as well as a continuing commitment to improve crisis care so that more people can access care and support where and when they need it’. However, the Group cautioned, it will be challenging to translate words into action at a local level and the plan will need cross-government commitment to coordinate changes to the health and social services and the benefits system.

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