Authored article

NHS must treat mental and physical health equally

The government today published its Mandate to NHS England on how it expects the NHS to improve services for people with mental health problems.

This was published under the 2010 to 2015 Conservative and Liberal Democrat coalition government

The Rt Hon Norman Lamb

For far too long, people with mental health problems have been treated as second-class citizens by the NHS and by society as a whole. Why is it that those with mental health problems were left out of key advances on waiting times and choice over the last decade? It’s impossible to justify and it results in mental health losing out financially as well. I am determined to change this and to challenge this institutional bias which exists in the health and care system against mental health.

Mental illness is the biggest cause of disability in the UK - more than heart disease or cancer. Shockingly, people with a severe mental health illness on average die 15 to 20 years earlier than the general population.

Overall, the economic and social costs of mental health problems - from people missing work, to benefits and other costs - were estimated at £105 billion in 2010, more than the cost of obesity and cardiovascular disease put together.

Yet only about 11% of the NHS budget was spent on NHS services to treat mental health problems during 2010 to 2011.

There are reasons to be optimistic about what’s possible. There are some great and inspirational professionals working in mental health out there. Recently, I visited a brilliant early intervention youth service in Accrington which provided talking therapies for people with severe mental illness. It was incredibly moving to hear the testimony of young people and their parents about the overwhelmingly positive impact that this service had on their lives.

I heard from the father of a young man treated there, who spoke of the temptation to not take mental illness seriously. Once he’d admitted his son had a problem and sought help, he’d allowed real - and once unthinkable - transformation to take effect. The smile now on his son’s face, and the glowing pride on his own, were testament to the life-changing work of these therapists.

But in many parts of the country services still fall short. The previous government introduced a standard that an NHS patient who needs treatment for a physical problem will be seen within a maximum of 18 weeks. But people who use most mental health services have no such access standards. We need to change this. We need to end this discrimination.

Today we published the government’s Mandate which sets out what we expect NHS England - the body which oversees the NHS - to achieve in the next few years. In print, for patients, doctors, and nurses to see, it says that NHS England’s objective is to put mental health on a par with physical health and to close the health gap between people with mental health problems and the population as a whole.

The Mandate also includes our commitment to introduce for the first time new waiting time and access standards for mental health services from 2015. By looking at the availability of mental health services for patients across the country, NHS England will get a fuller picture of where improvement is needed.

But we also need to create a cultural change in the NHS and care systems and remove the stigma which surrounds mental health within, as well as across wider society, where we are already making progress.

One area where there is the starkest gap between mental health and physical health is in crisis care.

Imagine the public outcry there would be if someone who was in terrible physical pain after breaking a leg, for example, was taken to a police station and then discharged the next day without proper pain relief or treatment. Too often this is what can happen to people in acute mental pain and distress. Those who find themselves in a mental health crisis are not treated in the most appropriate place or perceived as a priority by the NHS.

I recently visited one of the Street Triage pilot schemes in Leicestershire. Mental health nurses accompany police officers to incidents where people may need mental health support to make sure they are treated in the right environment. We need more of this type of joint, smart and ultimately logical working between emergency services.

This is why we are also developing a Mental Health Crisis Care Concordat with the police, NHS, Home Office and other key organisations. We are currently drawing up principles on how mental health crisis care should respond everywhere. The Concordat will commit these and other key organisations to ensuring that joined up, good support systems are in place across the country.

For those who are still unconvinced by the urgent need for change and for mental health to be treated as seriously as physical health, let me finish with one sobering thought. One in four of us will experience a mental health problem in our lifetime. The truth is that this affects us all and we cannot afford to ignore it. We as a government will not. And I as a Minister will not.

Published 12 November 2013