The effect of covid-19 on mental health has been significant and well reported. The NHS, which was already struggling to meet targets prior to the pandemic, has faced reduced staff capacity and increased demand. The most pressing question remains—how do we recover lost ground and build back better? In addition to the usual answers around leadership, accountability, and funding, a real focus will need to be on looking at and understanding the data. That is why the Royal College of Psychiatrists is re-launching its flagship data tool, Mental Health Watch.
The dramatic effect of covid-19 on mental health services is evidenced clearly by the experience of perinatal mental health, which had seen substantial improvements since the launch of the Five Year Forward View on Mental Health (FYFVMH) in 2016. In 2019/20, over 30,000 women accessed perinatal mental health services, compared to just 12,000 in 2014/15. Although other areas of the mental health system were struggling to meet targets, the Long Term Plan introduced an uplift on the perinatal target, with a total 47,000 women due to access perinatal mental health services by 2020/21—5,000 more than had initially been envisioned by the FYFVMH for that year. Prior to the pandemic, colleagues were buoyed by the focus on, and funding for, perinatal mental health and the progress being made as a result.
While covid-19 put a halt to much of our day-to-day lives over the course of the last year, women were still giving birth. Despite increased anxiety around having a baby during a pandemic and the lack of access to usual support networks, access to perinatal mental health stalled. 7.1% of women who gave birth should have had access to perinatal mental health services across 2020/21, but data show that for the 12 months to December 2020, this was only at 4.7%, with no region attaining the level expected by March 2021. This means that by the end of the financial year around 16,000 women that should have had access to perinatal mental health services will have missed out on that vital support.
Importantly, variation across regions was considerable, with 22 CCGs reporting performance below 3.5% and North Central London reaching just 0.7% of women. At the other end of the spectrum, 12 CCGs were still able to meet the target, with a further 9 CCGs on track. Despite the chaos caused by covid-19, West London exceeded the target by reaching 10.2% of women. Our ability to understand these differences and apply lessons nationally will shape future access to these essential services and the broader delivery of the NHS Long Term Plan.
Of course, that does not just apply to perinatal mental health. Having a solid understanding of the data will determine whether or not we are able to deliver the parity between mental and physical health that successive governments have committed to but failed to deliver. The Royal College of Psychiatrists’ Mental Health Watch tool compiles critical indicators to understand how well the mental health system in England is performing. New local area reports and data broken down to ICS/STP and CCG level will help local decision makers to determine which services are being left behind and where additional investment is needed. As ICSs are formally established and we begin to rebuild, data can become a key tool in the recovery of the health system.
Trudi Seneviratne, registrar of the Royal College of Psychiatrists.
Competing interests: none declared.