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
Thank you
rebecca.cotton@nhsconfed.org
@beckycotton
@nhsconfed_mhn