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Words Are Not Enough: The Government Needs to Match Its Promises On Mental Health With Real Investment

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News that NHS spending on mental health has dropped by £150m over the past year, will sadly not come as a surprise to anyone affected by mental illness.

The whole country urgently needs the NHS to get to grips with its responsibilities on mental health. As documented in a recent report by the Centre for Economic Performance, there is already a 'massive unmet need' in mental health and a lack of investment in services.

At a national level, everything is in place. We have a good mental health strategy, a Minister who seems genuinely committed to this issue and mental health is well represented in both the NHS draft mandate and the new NHS outcomes frameworks.

We even have a consultation out on giving people with mental illness choice in healthcare, something people with physical conditions often take for granted.

But the reality on the front line of mental health services tell a very different story. Our members tell us about wards being closed, with little information given about alternatives. People with conditions like schizophrenia, bipolar and personality disorder often still can't get basic services like medication reviews or psychological therapies like CBT.

Money is not the be-all and end all. There are a lot of improvements that could be made to services without extra investment. Many people have told the Schizophrenia Commission how often staff fail to show basic empathy and humanity towards them. Creating a culture of dignity and respect doesn't have to cost a penny and would make a huge difference to people's experience of NHS care.

Some improvements to services can even save money. My charity recently launched new recovery houses in north London which give people a better experience and outcomes than hospital, but cost a fraction of an inpatient stay. Other interventions will save money, but only in the long-term.

Speaking up for short-term investment in mental health within the NHS requires courage and conviction. The current statistics suggest we don't have enough of that in the system. At Rethink Mental Illness, we do all we can to influence things from the outside. But we need more leaders in the NHS who can see the big picture and how mental health is crucial to all patients' lives and the success of all health services.

It's hard to motivate yourself to eat well after a heart attack for example if your depression goes untreated. Equally it's almost impossible to remember to go for a smear test every three years if you're not getting the right treatment for schizophrenia or psychosis.

The new clinical commissioning groups who will soon be in charge of NHS spending on mental health services, need to urgently ask themselves whether they have the skills and understanding of mental health they need to take on this challenge. At least one in four of us has a mental health problem at some point in our lives. It seems reasonable to expect that each of these groups should have at least one person with expert knowledge in mental health.

At national level, there is some thinking to be done. In theory, devolving decision-making to the local level should make services more responsive to people's needs. But are Ministers happy to say and do all the right things but see none of their intentions implemented on the ground? At what point will national government say "that's not good enough" and intervene?

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