As of October 2022, provisional statistics estimate that 1.9 million people are waiting for mental health care, so it’s crucial that the resource and funding required to deliver necessary support and treatment is available. To understand the state of funding for mental health services, we’ve looked at the last five years of budgets and the various commitments that have been unable to meet demand.
In 2017, the government pledged £6.3 billion to the NHS. Whilst no specific funding for mental health was announced, the government committed to a “parity of esteem” between mental and physical health and published a green paper setting out transformation plans for children and young people’s mental health, including creating new community-based mental health support teams and appointing a mental health lead in all schools.
2018’s autumn budget saw big commitments to improve mental health care. Mental health spending was to increase by at least £2bn per year by 2023/24, in line with the overall NHSE budget. Specific commitments focused mainly on bolstering crisis support, including:
mental health support in every major A&E department and more mental health specialist ambulances
a 24/7 mental health crisis service over NHS 111
a greater number of community crisis services
A year away from the 2023/24 target to deliver on these commitments, it is currently unclear what progress has been made.
In 2019, the budget was cancelled due to the delayed Brexit vote and general election. The government did announce the expansion of personal health budgets to 200,000 people by 2024 which will provide extra funding for treatments, equipment and personal care to support people with mental health needs, autism or learning disabilities.
In 2020, £500m was dedicated to supporting mental health services. The main focus this year was to improve the mental health estate, with pledges made to get rid of outdated dormitories in mental health hospitals and provide single en-suite rooms. This year the government also provided funding to support research into the effect of the COVID-19 pandemic on mental health.
In 2021, further commitments were made around mental health, some of which reiterate commitments made in previous years, including:
- £100m for mental health support for expectant parents
- £95m for researching methods for treating cancer, obesity and mental health
- £150 million to invest in NHS mental health facilities linked to A&E and to enhance patient safety in mental health units
- £300 million to complete the programme to replace mental health dormitories with single ensuite rooms
The BMA commented that this announcement “falls significantly short of the BMA’s call for investment of at least £4.6 billion a year by 2023/24”.
2021 also saw more of a focus on boosting support for autism and learning disabilities. The government allocated £75m for a new 5 year strategy to speed up autism diagnosis, and announced that £2.6bn will be spent to provide 30,0000 new school places for children with special educational needs and disabilities (SEND). Although the National Association for Special Educational Needs said that it is unclear when these schools will be created and how they will be staffed.
Last month, mental health was missing from the 2022 autumn budget. The NHS was given an overall cash boost of £3.3bn, that will mainly be spent on improving ambulance and A&E waiting times and improving GP appointment access.
Mental health charity, Mind, raised alarms around the absence of mental health in the budget, with Sophie Corlett, Interim CEO, commenting “Now is not the time to be compromising on care. The mental health sector didn’t receive pandemic recovery money this year to tackle this backlog, and inflation means that while demand is going up, funding is going down. Despite the country facing a mental health crisis amidst the largest spike in living costs for generations, mental health services have been deprioritised – just as the nation needs them the most.”
This also comes as HSJ report that NHSE is cutting funds earmarked for cancer, maternity care, primary care, community health, mental health, learning disabilities and health inequalities to account for deficits elsewhere.
Our analysis has led us to the conclusion that these funding announcements don’t seem to have made a dent in waiting lists and standards of care. Additionally, little evaluation is done that holds the government and NHS to account against their commitments. For example, just last week the government re-announced its 2018 plans to expand mental health crisis support, suggesting that these initial commitments haven’t been met within the set timeframe. Without accountability, we risk a culture of empty promises. We also need to know who controls mental health spending and what autonomy ICSs will have. Without this knowledge, third sector and private providers are left in the dark about how they can help.
Despite large allocations of funding over the years, mental health services are in disrepair and doing more of the same doesn’t seem to be working. NHS Confederation’s recent report on their vision for mental health services in 2032 echoes this – with one of their three key calls to action being ‘a deep commitment to large scale reform, innovation and change’. We need to do things differently.
The NHS should look to new ways of working and consider private sector partnerships to truly transform care for the better. We welcome the government’s recent alliance with independent providers to tackle the elective backlog and the same approach should be considered to support mental health services.
CHS Healthcare are offering remotely delivered autistic spectrum condition assessments and ADHD assessments to help NHS partners reduce waiting lists and add essential capacity to struggling services. Contact Ellie Norman (firstname.lastname@example.org) or Sam Jordan (email@example.com) to find out more.