parity of esteem? rebecca cotton, director of policy, mental health network
TRANSCRIPT
Parity of esteem?
Rebecca Cotton, Director of Policy, Mental Health Network
About the Mental Health Network
• Part of the NHS Confederation – the membership body for all organisations that commission and provide NHS services.
• We represent 70 providers of mental health services in England – including around 95% of NHS Trusts and Foundation Trusts, third sector and independent sector providers.
• Governed by a board of members – including Chief Executives, Chairs, Clinicians and service user and carer representatives.
What we do
• We help shape and challenge national policy and legislation affecting our members.
• We provide members with up to date news and analysis, through briefings and events.
• We also work to identify and spread good practice and innovation in the mental health sector.
• Enshrined in law by the Health and Social Care Act 2012.
• Also included in the Secretary of State’s Mandate to NHS England:
“NHS England’s objective is to put mental health on a par with physical health, and close the health gap between people with mental health problems and the population as a whole. By March 2015, we expect measurable progress towards achieving true parity of esteem, where everyone who needs it has timely access to evidence-based services”
Public attitudes
• Nearly nine out of ten people with a mental health problem say they have faced stigma or discrimination.
• On the whole, society’s attitude to mental health problems are changing for the better.
• Time to Change have found the proportion of people saying they know someone close to them who has had some kind of mental illness has increased from 58% in 2009 to 63% in 2012.
• The percentage saying they would be comfortable talking to a friend or family member about their mental health, for example telling them they had a mental health diagnosis and how it affects them, rose from 66% in 2009 to 70% in 2011.
• The percentage saying they would feel uncomfortable talking their employer about their mental health was 43%, compared to 50% in 2010.
Costs of mental health problems
• Poor mental health carries an economic and social cost of £105 billion a year in England. The business cost of mental ill health among the UK workforce is £26 billion.
• By 2030 there will be approximately 2 million more adults in the UK with mental health problems than today – assuming prevalence rates remain the same.
• Between 10% and 16% of working age people with a mental health condition, excluding depression, are in employment. However, of the vast majority of people with mental health problems want to work.
High degree of health inequalities experienced by people with mental health problems
• People with serious mental illness are at risk of dying, on average, up to 20 years prematurely.
• People with a mental illness are almost twice as likely to die from coronary heart disease as the general population, four times more likely to die from respiratory disease, and are at a higher risk of being overweight or obese.
• A third of the 100,000 annual ‘avoidable deaths’ amongst the under 75s involve someone with a mental health problem.
• Smoking costs the NHS over £5 billion a year, yet 42% of all cigarettes smoked in England are by people with a mental health, drug or alcohol problem.
Addressing this makes sense from an equalities perspective, and from a QIPP perspective
• £1 in every £8 spent on long-term conditions is linked to poor mental health and wellbeing.
• This equates to between £8 billion and £13 billion of NHS spending in England.
• A 2012 Mental Health Network report, Investing in emotional and psychological wellbeing for patients with long-term conditions, highlighted a wide range of innovative services that were both generating much needed savings and improving outcomes for patients with diabetes, chronic obstructive pulmonary disease and a range of other conditions.
Age dimension:
• Around one in ten children aged between 5 and 16 years has a mental health problem.
• 75% of children and young people experiencing a mental health problem are thought to not access any treatment.
• Half of those with lifetime mental health problems first experience symptoms by the age of 14.
• Depression amongst older people notoriously under diagnosed and treated.
Poorer outcomes for BME groups:
• People from black and minority ethnic groups are more likely to be admitted to hospital, more likely to be subject to legal restrictions, more likely to experience a poor outcome from treatment.
How does this play out in the NHS?
• Poorer rates of access to mental health services: • Only around 25% of people with anxiety and depression, and 65% of people with
psychosis, seek and receive treatment.
• Fewer rights: • The NHS Constitution provides the right to start treatment for most health problems
within 18 weeks – in certain circumstances, such as suspected cancer, guaranteed
waiting times are even shorter. But these rights do not extend to people accessing
non-consultant-led mental health services. Changes are coming in from April next
year, but not for all mental health services.
• Squeezed services: • Demand is increasing. Monthly referrals to community mental health teams were up
13% in 2013, and up 16% for crisis services.• Resource isn’t keeping pace: local investment in mental health services has fallen in
real terms for four years in a row.
Headlines from our recent member survey
• 96% of Mental Health Network members who took part are concerned about the effect of an ageing
population on services, 90% are concerned about the future impact of long term conditions.
• 96% are worried about potential future budget cuts, and 90% think there’s insufficient investment to
meet current service requirements.
• 89% are concerned about outdated service and workforce models, and the same percentage are
worried about the relationship between health and social care.
• 90% think the public misunderstand the need for change in the NHS, and 80% think there’s a lack of
political support for the change that’s needed.
• 85% of Mental Health Network members say the agreement of a long term (ten year) strategy and
financial settlement for the NHS as a whole is important.
Base: 103 MHN respondents, February 2014
General Election 2015
• Securing fairer funding for mental health services
• A commitment to no major top down reorganisations over the lifetime of the next Parliament.
• The adoption of workable policies which support ‘parity of esteem’ (including access and waiting times, improving the physical health of service users etc).
• Ensuring fair funding for mental health services
• Giving children a good start in life
• Improving physical health care for people with mental health problems
• Improving the lives of people with mental health problems
• Enabling better access to mental health services
