Achieving Better Access to Mental Health Services

On Wednesday 8 October 2014, the Government published its vision for mental health services in England with a five year plan: Achieving Better Access to Mental Health services by 2020.

There are a number of areas that are critical for primary care within this document. Mental health problems are the largest single cause of disability, representing a quarter of the national burden of ill-health, and are the leading cause of sickness absence in the United Kingdom. Most people with mental health problems currently receive no treatment at all and mental health services face inequitable and severe funding restrictions compared with physical health services. Mental illness represents 23% of the nation's health burden, yet receives only 11% of the secondary care spending budget. As a consequence there is a terrible range of statistics that can be quoted:

  • People with mental illness die on average 15 - 20 years earlier than other people.
  • Mental illness costs the UK economy as much as £100 billion per year.
  • It results in 70 million sick days per year - the leading cause of sickness absence in the UK.
  • 44% of Employment and Support Allowance benefit claimants report a mental health and /or behavioural problem as their primary diagnosis.
  • 75% of adults who access mental health services have a diagnosable condition by 18 years of age.
  • Mental health problems in children and young people are common and account for a significant proportion of the burden of ill health in this age range.

The five year plan identifies that one key way of improving this is to ensure parity between mental health and physical health. This is demonstrated by introducing access and waiting time standards - the first of their kind in mental health services - accompanied by £40 million investment in the first year, which will increase to £80 million in 2015/16.

An £80 million investment will deliver:

  • Treatment within six weeks for 75% of people referred to the Improving Access to Psychological Therapies programme, with 95% of people being treated within 18 weeks.
  • Treatment within two weeks for more than 50% of people experiencing a first episode of psychosis.
  • A £30 million targeted investment will help people in crisis to access effective support in more acute hospitals.

Some of the things we in primary care can do to support this include:

  • Beware of signs and symptoms of early mental health problems in children, adolescents and young people and adults of all ages and ensure they have prompt access to appropriate treatment or interventions. The RCGP Youth Mental Health resource page has useful toolkits on this.
  • Be aware of the role of primary care and the national discussion around mental health Crisis Care Concordat, which is supported by the RCGP.
  • Use the range of primary care resources in primary care teams to support better mental health care and delivery in primary care using the Lester Cardiometabolic tool - screen and intervene!
  • Work in partnership with the named accountable clinician in secondary care to enable more coordinated, recovery focused, effective and personalised care.
  • Be aware of Personal Health Budgets for people who use mental health services.
  • Be aware of the relationship between long term conditions and increased prevalence of anxiety and depression.
  • Engage with mental health leads in your CCGs.
  • Use the resources available here.

References

Department of Health, Achieving Better Access to Mental Health Services by 2020

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