Mental Health: Urgent Letter to the Prime Minister

The Rt Hon Sir Keir Starmer MP

Dear Prime Minister,

Immediate Action Required: Clarification on Mental Health Waiting Lists and Essential Funding

We are reaching out on behalf of seventeen significant organizations dedicated to enhancing mental health services across the UK. Our collective concern revolves around the alarming neglect of mental health waiting lists, which are not adequately prioritized in your Plan for Change. Recent reports suggest that the government may be considering eliminating crucial protections for mental health funding. This is particularly troubling given that mental health services are currently aiding more individuals than ever, yet the waiting list has surged to a staggering 1.6 million individuals.[i]

As mental health services operate under immense pressure, accounting for one-fifth of the UK’s overall disease burden while receiving less than 10%[ii] of the NHS budget, any reversal of progress at this juncture would be catastrophic. Such actions could jeopardize vital commitments from your government, including the implementation of a revised Mental Health Act and the necessary transition from institutional to community-based care. It is imperative that your administration upholds its commitment to the Mental Health Investment Standard (MHIS) and ensures that mental health services receive an increasing allocation of the NHS budget to effectively meet the growing demand.

The MHIS plays a crucial role in ensuring that funding for mental health, distributed by Integrated Care Boards, keeps pace with overall NHS spending. Upholding this standard is essential to rectify the historical underfunding in mental health services. The current scenario reveals that mental health services have been struggling to catch up regarding adequate services, skilled workforce, and necessary data to meet patient needs in comparison to physical health. Just a decade ago, there were significant gaps in mental health provision, a lack of centralized data, and a workforce drastically reduced due to budget cuts. In a challenging financial climate, expenditure on mental health services plummeted from 14% of the budget in 2008 to a mere 8% by 2016[iii]. The MHIS, along with other commitments to ensure increased spending, has been vital in addressing the care deficit and striving towards parity of esteem between mental and physical health.

Nonetheless, substantial challenges remain, and mental health care is confronted with unique issues that have been intensified by the rising demand for services. Those suffering the longest for elective community mental health care, including both adults and children, have faced waiting times of up to two years[iv], which is twice as long as the waits for elective physical health care. Rethink Mental Illness’ Right Treatment Right Time survey[v] revealed that a significant majority of individuals with severe mental illnesses experienced deteriorating mental health while awaiting treatment. Alarmingly, 42% of these individuals required urgent care, and 26% ended up hospitalized, undermining the intended shift from hospital to community-based care. Moreover, mental health patients endure significantly longer waits in Accident and Emergency departments compared to those seeking emergency physical care. Nearly half of children and adolescents with mental health needs still lack adequate support. Overwhelmed professionals face burnout, worsening workforce shortages and diminishing quality of care. The omission of mental health elective waiting lists from the government’s Plan for Change is a critical oversight. Any reduction in funding or failure to prioritize addressing mental health waiting lists will exacerbate these systemic challenges, making it increasingly difficult for vulnerable individuals to access the care they desperately require.

The ramifications of these issues are profoundly concerning. For those grappling with severe mental conditions, such as schizophrenia, delays in receiving treatment can lead to acute crises that endanger the individual’s health and safety. Such delays can hinder their capacity to participate in education and employment and, in severe cases, may even pose risks to the safety of others. The Right Treatment, Right Time report indicated that 25% of individuals whose mental health worsened while waiting for treatment attempted suicide, underscoring how inadequate funding for mental health care can obstruct efforts to reduce suicide rates. Additionally, the tragic events in Nottingham highlight the dangers faced by individuals in need of care who fall through the gaps of an overstretched mental health system.

Beyond the significant personal tragedies, the neglect of mental health services incurs substantial societal and economic repercussions. As outlined in your government’s Get Britain Working white paper, there exists a strong correlation between poor mental health and economic inactivity. Effectively addressing mental health challenges is essential for unlocking economic growth. If left untreated, mental illness can lead to severe consequences, including homelessness and preventable loss of life. Currently, poor mental health is estimated to cost the UK economy around £300 billion annually due to lost productivity, welfare dependency, and escalating healthcare expenditures[vi]. In addition to hindering economic growth, deprioritizing mental health could exacerbate these costs, as manageable conditions deteriorate into crises necessitating far more expensive interventions.

Rather than scaling back investments, the government must prioritize the strengthening of mental health services. Recent investments have already yielded significant benefits, such as the establishment of nationwide perinatal services, consistent early intervention in psychosis meeting waiting time standards, the expansion of eating disorder services for children and adolescents, and the recruitment of approximately 40,000 additional staff.

It is crucial to continue investing in and transforming community-based care, expanding crisis intervention programs, and addressing workforce shortages to foster a robust and responsive mental health system. This commitment is not only a moral obligation but also an economic necessity.

We were encouraged to see in the Labour Manifesto your commitment to “reform the NHS to ensure we give mental health the same attention and focus as physical health.” We implore you to clarify the government’s stance on mental health elective waiting lists, the MHIS, and Share of Spend, while reaffirming its commitment to achieving parity between mental and physical health care. Protecting mental health treatment and care is essential for fostering a healthier, safer, and more resilient society. Anything less would represent a failure of leadership and vision.

We eagerly await your response and hope to see the government’s commitment to mental health reflected in its policies and funding priorities.

Your sincerely,