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Monday, 19 January 2015

Miliband commits Labour to a radical improvement in mental health provision

The Labour leader Ed Miliband will today commit the next Labour government to a radical improvement in mental health provision with more emphasis on prevention, early intervention and better support - particularly for young people - as part of Labour’s plan to sustain and improve the NHS. Unveiling the report of Stephen O’ Brien’s independent Mental Health Taskforce, which he commissioned more than two years ago, he will say the scandal of failure and false economies in this neglected area is costing billions of pounds a year as well as increasing pressure on the NHS and hospital services.

Ahead of a visit to a mental health group in Enfield, Mr Miliband said: “Taking action to improve mental health is essential if we are to thrive as a nation and ensure the NHS remains sustainable. The approaches proposed in this report – prevention, early intervention and better support – are key to achieving that. It is an excellent roadmap for change as we draw up our programme for action. This government’s failure and false economies on mental health need to be replaced with smart investments that will save money and put our NHS on a sustainable footing so it can meet the challenges of the 21st Century as well as it did the last.”

The report highlights how half of all hospital in-patients have a mental health condition, rising numbers of young people are needing serious mental health support, and unaddressed mental health problems are costing the NHS billions each year in terms of worse physical health. Mr Miliband said that Labour’s 10-year plan for the NHS later this month will contain key measures to integrate mental and physical health provision with social care to ensure problems get identified and addressed as early as possible.

These include ensuring that the training of all NHS staff includes mental health so problems get spotted. At the same time people with complex physical and mental health conditions will be given a single point of contact for all of their care. Mr Miliband pledged more action on child mental health, which is among the priority areas identified by the report, and said that a renewed commitment to early intervention should also guide the work of the next Labour government in this area.

1. Ending the scandal of the neglect of child mental health

The report highlights that just 6 per cent of the mental health budget is spent on children, even though three quarters of adult mental illness begins before the age of 18.

The Government’s false economies in Child and Adolescent Mental Health Services in this Parliament have led to a growing number of young people being placed in adult wards, and many sent hundreds of miles for hospital care as a result of bed shortages.

Mr Miliband said: “It cannot be right that when three quarters of adult mental illness begins in childhood, children’s mental health services get just six per cent of the mental health budget – nor that these vital services have been stripped back in recent years while £3bn has been wasted on an NHS reorganisation.

“Labour will work to reverse the damage suffered by child mental health services under this Government. And we will set an ambition that, over time, the proportion of the mental health budget spent on children will rise as we make smart investments to improve mental health in childhood, in the process lessening some of the demand on mental health services when young people turn into adults.”

He added that in future all teachers should have training in child mental health so they are equipped to identify, support and refer children with mental health problems. Good child mental health is critical for academic attainment and future employment prospects: children with emotional problems are twice as likely to struggle with reading, spelling and maths.

He said: “Around 10 per cent of children at any one time have a diagnosable mental health problem – that’s three in every classroom. Yet of these, almost three quarters get no help. That has to change and under Labour it will. I want to ensure that any child who is struggling gets linked up with the help and support they need.”

2. Early intervention

The report expresses concern that a range of prevention and early intervention services have been stripped back in recent years, including Child and Adolescent Mental Health Services, Early Intervention in Psychosis Services and the Early Intervention Grant which funds Sure Start services.

The report argues that: “For want of getting people the support they need, when they need it, we are having to pay billions dealing with problems when they reach crisis point.”

So as well as firm commitments on child mental health, Labour is supporting two long-term objectives that the Taskforce say could play a part in improving health, making savings and ensuring a more sustainable system of healthcare.
  • An expansion of talking therapies, working towards a 28-day waiting-time standard for access to both adult and young people’s talking therapies.
A 28-day standard, with 80 per cent seen within 28 days, would ensure more people get quicker access to treatment. While the current average wait for adults to access talking therapies is five weeks, in some Clinical Commissioning Groups average waits are up to three months. Investment in evidence-based talking therapies saves money on the costs of failure: according to the government figures, it saves £1.75 to the Exchequer for every £1 invested, through reduced physical healthcare costs and reduced welfare costs.
  • Local authorities, the NHS and schools should work together to ensure all children can access school-based counselling or therapy if they need it.
Counselling services are unavailable in too many schools even though they can provide the kind of lower-level, preventative intervention that can stop problems subsequently becoming more serious. Mental health problems during childhood and adolescence result in increased costs of between £11,030 and £59,130 annually per child.

The next Labour government will begin work on a timetable and strategy for these recommendations and delivering the savings they might bring, in consultation with health professionals.

Mr Miliband said: “We will only ensure the NHS can survive the very real funding pressures it faces if we stop making false economies by stripping back preventative services and start making smart investments in early intervention and support. Without decisive action to tackle problems before they become too serious, the NHS will be overwhelmed as it struggles to pick up the pieces.

“That is why Labour is committed to improving access to services and support. We welcome this report’s ambitions for government to work towards a 28-day waiting-time target for access to talking therapies, and to ensure that all children have access to school-based counselling if they need it. The timing and approach will need to ensure the savings are achieved to cover the costs of making these changes.”

3. Wider recommendations

In addition to early intervention services, the Taskforce report also makes recommendations on public mental health and on further steps to support those living with mental health problems. The report is an independent report and its recommendations will be considered by the Labour Party.

Some of its key other recommendations include:
  • Greater use of social prescribing to link those who are isolated or lonely up with social activities and support
  • Ensuring providers of government employment programmes have specialist knowledge of mental health and can offer access to evidence-based programmes
  • Continuing the Time to Change campaign – which aims to improve attitudes towards mental health – through the next Parliament.

Sir Stephen O’Brien, Chair of the Taskforce, said: “With one-in-six of us affected by a mental health problem at any one time, and with the costs of poor mental health to the economy put at over £100bn, it is vitally important to look at how we can improve the mental health and wellbeing of our nation.

“This report sets out some of the key next steps we need to take to become a mentally healthy society – on public mental health, on early intervention and action, and on ensuring better opportunities and support for those living with mental health problems. And underpinning it all must be a wider shift in attitudes and behaviour towards mental health, so no-one feels ashamed or unable to speak out.

“Getting there will be a challenge, and will require a contribution from everyone – public services, businesses, charities and citizens themselves. But rising to the challenge is essential to building a fairer, more prosperous country where everyone can play their part.”