Mental health report: how to deliver parity of esteem with physical conditions

You don’t need to follow politics, still less keep up with the Health Service Journal, to realise that attitudes towards mental health are undergoing a revolution. You can just listen to footballer Danny Rose open up about depression, or Princes William or Harry reflect on the toll their mother’s death took on them as they were growing up. Problems that were once taboo are now a part of the general conversation—and the political conversation, too. The Liberal Democrat former minister Norman Lamb was one of those who helped to rewrite the script, and now no big set-piece speech or Whitehall document on the NHS is complete without a nod to improving mental health services.

This is much to the good. All the more so when it’s recalled that it is only two generations since grim old Victorian asylums were phased out—and just one since the scandal of the painfully mistitled “care in the community” reforms, which emptied many of their wards out onto the street with next to no support. The anguish of mental illness contributes as much to human misery as any physical malady, and its debilitating effect on the individual translates into an almighty burden on the public purse. It can strike the young as well as the old, and knock people out of work and paying taxes for decades. It is not merely rhetoric to speak of funding these services properly as “investment.”

Sadly, however, the new willingness to talk about mental health has not been matched by the transformed services that are required. As former NHS Chief Executive Nigel Crisp and Labour’s Barbara Keeley rightly emphasise, the long years of spending restraint are still being felt. Keeley highlights the long delay in getting young people the therapists they need, and Crisp explains how it is not just the “ring-fenced” NHS budget which is an issue, but welfare and housing programmes, where cuts conspire to preclude independent living for many patients, locking them into reliance on (costly) hospital care.

Retrenchment of this sort is self-defeating. As the government at long last loosens its purse strings, mental health must finally receive the resources it has been starved of. It is a problem we have only recently faced up to. Now we need to fix it.