Mental health: investment and innovation are urgently needed

by Andrew Molodynski

Lockdown has affected vulnerable people the most and the NHS must prepare for a rise in damaged mental health

Location: UK
Published: Wednesday 12 August 2020
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The past few months have been nothing short of devastating. It’s been grim to witness the relentlessly climbing death toll on our television screens, morning radio shows, and in the newspapers. Lockdown has been a necessary but dismal way to spend the better part of half a year (and it’s not over for many).

Tens of thousands have endured all this on top of losing loved ones. There is clear evidence that people are suffering poor mental health for the first time, and that those with existing mental illnesses are finding their symptoms worsen. A survey from Rethink Mental Illness, for example, found that more than three-quarters of people had seen their existing mental health conditions worsen as a result of the pandemic and the measures to contain it.

Lockdown and self-isolation have been undeniably difficult for our mental health. Some of the most vulnerable groups have suffered the most, such as older people or the physically ill in isolation, as well as people on lower incomes and in poorer accommodation.

We know that BAME (black, Asian and minority ethnic) communities have been especially affected and many vulnerable children have been without the safety net of school. Mounting job losses, housing evictions, and the developing economic recession will make things worse still.

Our work in July analysed the available evidence and the message was clear. The Government must be prepared for what, as a psychiatrist working in the NHS, I can only conclude will be an ‘avalanche’ of mental health problems in the coming months.

Mental health services are not ready for such a surge in demand. They haven’t been for years, if ever, and austerity has significantly weakened our resilience. But hope is not lost. The quicker we act now, the better we can prepare mental health services to help those in need.

That’s why the BMA is calling for a Government mental health strategy that is 100 per cent COVID-19 ready. We want to see action from Government to fund and equip services for the anticipated increase in demand, and to make access easier for anyone who needs it. This must include making dedicated funding available to clinical commissioning groups. Preventive measures must also be prioritised through the introduction of a ‘mental health in all policies’ approach to Government policy making to encourage policies that promote good mental health, and which address the challenges ahead.

Last year’s NHS Long-Term Plan made several welcome commitments to improving the quality of and access to services. However, targets still fell well short of the kind of access available to people with physical health problems. Restoring mental health services to a state where the NHS can treat most people who need it is a huge challenge.

Naturally, COVID-19 is going to disrupt some of the means of achieving those plans, but the urgency to be able to respond to those in need has not gone away. Indeed, matters have only become more urgent. Investment, innovation, and a release from mindless bureaucracy will be needed alongside a clearer patient and carer focus. The BMA will hold the Government and NHS England to account on the commitments they made last year and continue to lobby for them to go further.

Everybody who needs help for their mental health deserves it. I am deeply concerned that an already unacceptable situation is becoming steadily worse as the mental health of the nation suffers from a deeply affecting crisis that has left few of us untouched. On behalf of my colleagues and my patients, we want to see the Government take this looming crisis seriously. It cannot afford not to. It is time for real parity across healthcare, not kind words easily spoken.

Andrew Molodynski is BMA mental health policy lead