Mental health patients being failed as services face 'potent mix' of workforce cuts and rising demand, shows report

Rise in demand, coupled with steep decline in number of inpatient beds and staff, as well as reduced community mental health provision, prompts professionals to warn system is 'unsustainable'

May Bulman
Social Affairs Correspondent
Thursday 28 September 2017 12:36
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Research from the Centre for Mental Health and the NHS Benchmarking Network found the number of acute inpatient beds for adults with mental health problems in England and Wales fell by 15 per cent in the four years to 2016
Research from the Centre for Mental Health and the NHS Benchmarking Network found the number of acute inpatient beds for adults with mental health problems in England and Wales fell by 15 per cent in the four years to 2016

People with serious mental health problems are being failed as services in England and Wales face a “potent mix” of rising demand and cuts to the workforce, a report has concluded.

A steep decline in the number of inpatient beds and staff, as well as reduced community mental health provision, have prompted professionals to warn the system is “unsustainable”.

Labour's Shadow Minister for Mental Health and Social Care, Barbara Keeley MP, said the findings were "deeply worrying", describing the Government's pledge to make mental health an equal priority with physical health as nothing more than "hollow rhetoric".

Research from the Centre for Mental Health and the NHS Benchmarking Network found the number of acute inpatient beds for adults with mental health problems in England and Wales fell by 15 per cent in the four years to 2016. The number of inpatient staff reduced by 20 per cent in the same period.

But the number of people admitted and the time they stayed in hospital did not change, while the proportion of people admitted under the Mental Health Act has risen year on year.

During the same time, community mental health service provision also fell, with the number of people on community team caseloads having reduced by seven per cent, staffing levels falling by four per cent and contacts reduced by six per cent.

But the authors point out that 900,000 people with common mental health problems received psychological therapy through the NHS in 2015/16.

NHS England has urged that the report is "based on historic data" that pre-dates the Mental Health Taskforce investment and "ignores the fact that" community provision and the range of services have increased and improved since 2015.

The findings have prompted the Centre for Mental Health to urge that it is “not sustainable to keep cutting community services at the same time as reducing bed numbers”, while the Royal College of Psychiatrists warned that a reduction in both community mental health services and beds means the people with the most serious problems are being “failed”.

Sarah Hughes Centre for Mental Health chief executive, said: “Mental health services have been under significant financial pressures in the last five years.

“While reductions in bed numbers continue a long-term shift from hospital to community care, any reductions in community services are a major cause for concern.

“It is simply not sustainable to keep cutting community services at the same time as reducing bed numbers.

“The Five Year Forward View for Mental Health in England sets out a clear ambition to improve community mental health services and increase investment in mental health care across the spectrum.

“Today’s report shows that this is a vital mission. We need to see investment in evidence-based community mental health services to provide people with the best available support where and when they need it.“

Commenting on the report, Professor Wendy Burn, president of the Royal College of Psychiatrists, said: ”Reducing the amount of psychiatric beds will only work if it is matched with a simultaneous increase in community mental health provision.

“A reduction in both community mental health services and beds means we are failing the seriously mentally ill.”

Ms Keeley MP meanwhile said: “It is deeply worrying that community mental health provision has fallen and the number of psychiatric acute inpatient beds reduced, while the number of detentions under the Mental Health Act has risen. This puts even greater pressure on over-stretched acute mental health services.

“The findings of this report show that the Tory pledge to make mental health an equal priority with physical health is nothing more than hollow rhetoric.

“Under the Tories, mental health services have come under increasing pressure due to under-funding and staffing shortages. The Government should match Labour's pledge to invest more in mental health services and ring-fence mental health spending to ensure funding reaches the front line."

Director of policy and strategy at NHS Providers, Saffron Cordery, said the report revealed a “potent mix” of rising demand and gaps in the workforce, saying “urgent action” was needed to overcome the challenges.

“We welcome this report which uses robust evidence to highlight the challenges faced on the frontline,” she said.

“It reveals a potent mix of rising demand, with increased numbers of inpatients and bed occupancy running at more than 100 per cent, at a time of worrying gaps in the workforce and reduced community support.

”We recognise the progress that has been made in highlighting the stigma of mental ill health and the priority it has been given within the NHS. But we need urgent action to deliver on the ambitions set out in the Five Year Forward View for Mental Health.

“Although we know that many mental health trusts are delivering against the odds, there is a long way to go until this has the desired impact up and down the country. We must not under-estimate the scale of the challenges we face.”

An NHS England spokesperson said: “This report, based on historic data at least a year and a half old, pre-dates the Mental Health Taskforce investment. It also provides a misleading view based on accounting and service classifications that were abandoned several years ago, as it ignores the fact that community provision and the range of services have all increased and improved since 2015.”

“This report does however acknowledge substantial improvements we have already made, including at least an extra 900,000 people each year are getting help in their community through IAPT, but overlooks the overall 3% increase in community beds between 2015 and 2016 and the £574 million increase in funding for mental health this year.”

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