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Millions of people are experiencing lengthy waits for mental health treatment, while some cannot access services at all, according to a new report by the National Audit Office (NAO).
This is despite funding for mental health services increasing and the workforce expanding since 2016. The authors of the report say this is because the demand for mental health services has increased significantly since the pandemic.
With demand set to increase further over the next few years, NHS England and the Department of Health and Social Care have put plans in place for service expansion. But even with these plans in place, there will still be a “sizeable gap” between the number of people with mental health conditions and how many people the NHS can treat, the report states.
Gareth Davies, head of the NAO, says NHSE and the DHSC must now get a “firmer grip” on this mental health crisis and ensure that everyone can access the care they need in a timely manner.
Not enough staff to keep up with demand
Expanding the workforce to match demand has been a significant problem in the mental health sector. Demand for mental health services is far higher post-pandemic than the 2019 NHS Long Term Plan anticipated, particularly among young people.
Between 2016/17 and 2021/22, there was a 44% increase in mental health referrals, and while the NHS mental health workforce increased by 22% during the same period, there were still not enough staff to care for patients.
The report states that retaining staff is increasingly challenging, and in 2021/22, 17,000 staff (13%) left the NHS mental health workforce. The NAO’s survey of NHS mental health trusts highlighted specific concerns about shortages of medical and nursing staff, and psychologists.
Concern around rise in demand for eating disorder services
Despite a lack of staff, NHS mental health services achieved new waiting time standards in some areas, including therapy services and early intervention in psychosis services.
However, waiting times for young people’s eating disorder services increased during the pandemic, and during April-June 2022, just 68% of young people who were urgently referred were seen within a week, against a standard of 95%.
In response to demand and service pressures, some NHS trusts allowed waiting times and lists to increase; around half (15 out of 33) raised treatment thresholds and six reduced provision in some service areas.
Some were more likely to struggle to access and use services than others, including children and young people, those from minority ethnic groups, LGBT people, and those with more complex needs or more than one diagnosis.
More support for public health and social care services
Mr Davies says neither the DHSC and NHSE have made clear “what achieving full parity of esteem for mental health services will entail.”
“It is therefore unclear how far the current commitments take the NHS towards its end goal, and what else is needed to achieve it and match the increasing public awareness and need,” he said.
He says it is now “vital that DHSC and NHSE define what is required to meet the growing demand for mental health services”, and NHS Providers deputy chief executive, Saffron Cordery, agrees.
With more people coming the mental health services experiencing stress, debt and poverty, Ms Cordery says levels of support and investment “need to match growing demand.”
“With an estimated 1.5 million people on the mental health waiting list and more people being referred to and in contact with mental health services than before the pandemic – and appointments postponed because of ongoing strikes – pressure will continue to mount in the coming months.
“More capital funding is desperately needed to provide more therapeutic, safe and appropriate environments for people with acute mental health needs.
“We also need more support for public health and social care services given the crucial role they play in supporting people and helping to prevent mental ill health and deterioration,” she concludes.