England

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Lost in transit? Funding mental health services in England

Historically, mental health has been chronically underfunded, and has not had the same level of political prioritisation as physical health care.

Over recent years there have been a number of welcome commitments to increase investment in mental health services in England, yet there remain concerns that money being committed to improve these services is not reaching the frontline.

This briefing explores how well mental health services are funded in England and what this means for frontline care, with a focus on:

  • Perinatal mental health services
  • CAMHS (child and adolescent mental health services)
  • Access to psychological therapies in secondary care

Alongside available data, we have conducted a series of FOI (freedom of information) requests, and surveyed professionals working in child and adolescent mental health services, to explore the impact of recent funding commitments on frontline services.

 

Find out more...

  • Key findings

    • Despite some geographical variation, there appears to be no obvious uplift in overall mental health spending in recent years. Many CCGs (clinical commissioning groups) across England are either maintaining or decreasing current spending levels and a significant number are not meeting the Mental Health Investment Standard set out by NHS England.
    • As a result of ring-fenced funding commitments, tangible improvements to the provision of perinatal mental health services in England have been realised, though service provision remains far from optimal.
    • Data from FOI requests show that many CCGs are not increasing their spending on CAMHS. In a 2017 BMA survey of CAMHS professionals, 91% of respondents felt that CAMHS is poorly funded, and 58% felt that changes to CAMHS funding levels had made them less able to do their job.
    • Data from FOI requests indicate that just over a quarter of CCGs and only half of mental health trusts are increasing their real-terms spending on psychological therapies. When comparing spending between IAPT (Increasing Access to Psychological Therapies) services and psychological therapies in secondary care, the majority (83% of CCGs and 64% of trusts) spent more on the former than on the latter.
  • Areas for action

    • The Government should increase funding for mental health services to more closely match the burden of disease of mental health problems in England. Other commitments to mental health, such as expansion of the mental health workforce, also need to be adequately funded.
    • The Mental Health Dashboard should be expanded to include spending on other crucial services, and local authorities should publish their spending on promoting public mental health.
    • CCGs must meet the Mental Health Investment Standard. Those who are failing to do so should be required to produce robust spending plans, and be provided with extra support.
    • Measures should be taken to ensure that funding committed to mental health is only spent on mental health services, particularly where provision is poor. This may be achieved by ring-fencing funding where necessary.
  • Download the briefing

    Read the full research briefing which analyses a range of data on recent changes to the funding of mental health services in England, and assesses whether commitments to increased investment are being met.

    Download the full briefing (PDF)

  • Further resources

    Funding for mental health services fails to reach the frontline

    Read the story

    The iller you are, the longer the wait

    Read the blog

    Policy and research, Public and population health

    Read more about our work on mental health