Professor of Health Policy Peter Bradshaw gives his view on the fulfilment by the Health Secretary Jeremy Hunt on his manifesto promise by announcing the creation of 21,000 new posts within mental health services.
“In fulfilment of a manifesto promise, Health Secretary Jeremy Hunt has announced the creation of 21,000 new posts within mental health services at a cost of £1.3bn. This policy aims to secure more trained nurses, therapists, psychiatrists, support workers and other mental health professionals – along with a substantial campaign to re-educate and maintain existing staff (BBC, 2017).
In a spirit of high octane, evangelical fervour, Mr Hunt told both the BBC TVs Breakfast programme and the Radio 4s Today that he will treat an additional 1 million people by 2021 through newly energised 24/7 services. Additionally, he intends to integrate mental and physical health systems and end the ‘historic imbalance’ – thus giving mental health parity of funding and esteem.
Mr Hunt recognises his plans are ‘ambitious’ yet amount to ‘one of the biggest expansions of mental health services in Europe’. When interviewed, he reinforced his convictions admitting this would be ‘challenging to meet’ – but confirming indeed that Cinderella would be coming to the ball at last!
Mr Hunt rightly points out, mental illness is always relegated in importance because acute lifesaving heroics are politically more eye catching, something compounded by the client group being poor self-advocates. It is thus regrettable that mental illness must be validated by analogy with the physical – making our mentally ill feel they have something to prove. The distinction between the mental and the physical is further misleading since we know for instance, that bipolar disorders, about 10% of depressive and anxiety states and almost all the schizophrenias have a biological basis.
Nevertheless, the pledge to improve psychiatric care is admirable but even before this latest recruitment drive, many thousands mental health posts remain vacant and the plan must also be seen in context of the massive recent reductions of inpatient beds – necessitating 500 people a month travelling over 30 miles for in-patient treatment (Mc Nicol, 2016) Furthermore, Mr Hunt neglects to say 5,000 psychiatric nursing posts have been scrapped since 2010 (Campbell, 2016). So beware – because even if these staff can be found – making the numbers look big could be just an illusion that disguises the fundamentals of why our mentally ill are being failed.
The Victorians created asylums to cater for mentally ill people living on the streets, in prisons, in poor law infirmaries and in common lodging houses. While no one would wish for new asylums, we have replicated precisely those features Victorians tried eradicate by not providing some contemporary equivalent places of retreat and safety.
Those with serious mental illness face double jeopardy – they struggle with their symptoms and the disabling impact of their disorder – but they have the additional challenge of stigma that defines their quality of life, employment prospects and interpersonal relationships. If Mr Hunt’s plan tackles any of this in even the smallest way it will certainly be worthwhile.”
BBC (2017) Mental health staff recruitment plan for England – 31 August 2017
Campbell D (2016) Number of NHS mental health nurses has fallen by 15% under Tories – The Guardian 1 November 2016
Mc Nicol A (2016) More mental health patients sent hundreds of miles for care due to local bed shortages. Community Care 20 May 2016