THE STATE OF
M E N T A L H E A L T H
CARE IN THE NHS
The rate of suicide in the UK has fallen, ONS statistics show, but is the quality of care also starting to slip despite recent successes?
The rate of suicide across the UK has undergone a historic drop, new figures from the Office for National Statistics show, with rates in England and Wales falling significantly, but a slight rise seen in Scotland.
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The rates between men and women have remained roughly constant since official records were initially published in the 1980s, with male suicides accounting for roughly three-quarters of all suicides. The rate fell by 3.6% for males and 7.4% for females, with middle-aged men making up the majority as the most at-risk group.
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Citing work from the suicide prevention charity, Samaritan's, the ONS said this risk was likely “due to a complex set of reasons, including increased family breakdown leaving more men living alone; the decline of many traditionally male-dominated industries; and social expectations about masculinity.”
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Despite the rise in Scotland, the overall UK rate has fallen, Emyr John, of the ONS said "The fall in suicide rates from 2015 to 2016 is the largest decrease in 20 years. It fell for both males and females in the UK, although men still account for three-quarters of all suicides.”
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In some age groups,
the rate of suicide has halved since in the 1980’s.
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A press spokeswoman from the ONS was hesitant to pass comment on what has led to the overall decrease in suicides in the UK, because the figures have slightly risen in Scotland, but the smaller population of Scotland means the data is prone to fluctuation.
This apparent progress may be under threat however, from delays in accessing care, cuts to funding and increasing demand for services across the UK.
The true scale of mental illness in the UK is hard to gauge accurately, the most recent figures, taken from the NHS National Study of Health and Wellbeing Survey, last undertaken in 2014 showed that mental illness affected 1 in 3 adults, a 24 percent rise on the previous survey taken in 2007.
That works out as about 17 million adults across the UK.
A Care Quality Commission report on the state of mental health services in the United Kingdom, published this year showed distinct problems in waiting times for access to mental health care.
NHS guidelines introduced in 2015/16 laid down new rules limiting waiting times for referral appointments to a maximum of 18 weeks, and that 75 percent of patients would be seen within 6 weeks.
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The UK’s mental health services are stretched thin, but this could be set to worsen still, with potential cuts to available funding on the horizon.
The UK government has not published data on the allocated spending for the NHS mental health services since 2014/15, but investigations by FullFact.org through freedom of information requests have shown that over half of local authority mental health services could see a reduction in their funding.
The UK currently has 211 Clinical Commissioning Groups, who are responsible for allocating funding to different NHS local services. 128 responded to freedom of Information requests regarding their plans for mental health spending, and 57% of those who did so said they would be reducing their funding allocated for mental health services in the United Kingdom in 2016.
Contrary to this however, a statement issued from the department of health in February of 2016 claimed that one-billion pounds of additional funding was being made available for mental health services.
To give context to this, the latest available figures for spending on mental health services show that in 2014/15, 11.7 billion pounds, or 11.9 percent of the NHS budget was devoted to mental health.
The NHS’s budget is set to increase to just under 120 billion pounds in 2020, thats an increase of about 22 billion pounds since 2014. For mental health spending to remain in-line with the increasing budget at 11.9 percent, would require an additional 1.6 billion pounds on top of the promised one-billion pounds of funding.
However because the government has not released further information, it is unknown whether the rise in mental health spending will be limited to just this one billion pounds that has been promised, and if this is true, mental health services across the UK will have to cope with far smaller increases in funding than other NHS departments.
While the statistics released by the ONS at the end of last year show a significant improvement on the whole in combating suicide in the United Kingdom, the future of the NHS and its Mental Health care services are certainly uncertain, and the recent figures showing performance for the care of children and young people is troubling to say the least. Without more information it is hard to say if this trend of delays and budget cuts will continue or not. What can be said for certain is that more people than ever are suffering with mental health, and unless improvements are made, the system will struggle to cope in its current state.
The CQC reports highlights significant failings in adherence to these guidelines. In some areas, over 75% of patients had to wait up to 10 weeks for a referral appointment. The state of childrens and young persons services are even worse, with routine appointment waiting times of up to 25 weeks.
Particularly worrying figures released by the NHS benchmarking service have shown that demand for children and young adults care rose by 64 percent from 2013 to 2015. Bearing this in mind, a report from the Education Policy Institute found that a “specialist mental health services are, on average, turning away over a quarter (26.3 percent) of the children and young people referred to them for treatment.”
Tom Quinn, the Director of External Affairs for BEAT, the UK's eating disorder charity said “The findings of the CQC report confirming children and young people are still waiting too long to access mental health services are worrying.”
“Eating disorders are serious, complex mental illnesses and early intervention is key to recovery. All evidence tells us the sooner someone with an eating disorder gets the treatment they need, the more likely they are to make a full and sustained recovery.”
“For this reason, more work must be done at a national and local level to ensure children and young people, irrespective of where they live, are able to access fast treatment. Too often we hear from our service users of varying experiences in different parts of the country. This postcode lottery must end.”