{"id":49068,"date":"2020-11-19T14:03:33","date_gmt":"2020-11-19T13:03:33","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=49068"},"modified":"2020-11-19T14:03:33","modified_gmt":"2020-11-19T13:03:33","slug":"saffron-cordery-we-must-not-lose-our-focus-on-mental-health-at-the-very-moment-its-needed-most","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/11\/19\/saffron-cordery-we-must-not-lose-our-focus-on-mental-health-at-the-very-moment-its-needed-most\/","title":{"rendered":"Saffron Cordery: We must not lose our focus on mental health at the very moment it\u2019s needed most"},"content":{"rendered":"<p><span style=\"font-weight: 400\">As we navigate our way through the second national lockdown for England and beyond, we must not lose sight of the impact of the pandemic on mental health and the need to take into account the increasing pressures facing mental health services now, as well as over the longer term.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Great strides had been made, and <\/span><a href=\"https:\/\/www.longtermplan.nhs.uk\/\"><span style=\"font-weight: 400\">promising further plans put in train<\/span><\/a><span style=\"font-weight: 400\">, to increase investment in mental health services and deliver on aspirations to improve quality and access, following a decade of campaigning by the sector and the dedication of those leading and working in it. However, covid-19 has accelerated mental health trends and intensified the challenges facing mental health services as a consequence.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Many mental health trust leaders were already <\/span><a href=\"https:\/\/nhsproviders.org\/recovery-position-what-next-for-the-nhs\"><span style=\"font-weight: 400\">reporting<\/span><\/a><span style=\"font-weight: 400\"> a significant increase in demand to NHS Providers, and the severity of new referrals back in June, and <\/span><a href=\"https:\/\/nhsproviders.org\/restoring-services-nhs-activity-tracker\/october-2020\"><span style=\"font-weight: 400\">last month\u2019s NHS figures<\/span><\/a>,<span style=\"font-weight: 400\"> showed demand and activity for mental health services across the country at an all-time high. The monthly figures for care contacts in 2020 have <\/span><a href=\"https:\/\/nhsproviders.org\/restoring-services-nhs-activity-tracker\/november-2020\"><span style=\"font-weight: 400\">been above the 2019 equivalent<\/span><\/a><span style=\"font-weight: 400\"> throughout the course of the pandemic. Recent data from the NHS Benchmarking Network also showed bed occupancy in most <\/span><a href=\"https:\/\/twitter.com\/SteveWatkinsNHS\/status\/1313863408576540672\"><span style=\"font-weight: 400\">specialties back close to pre-covid-19 levels<\/span><\/a><span style=\"font-weight: 400\">. Anecdotally, trusts have also reported significant increases in demand for early intervention services, often linked to the wider impacts of covid-19 such as economic hardship.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Given this backdrop, it comes as little surprise that <\/span><a href=\"https:\/\/nhsproviders.org\/the-state-of-the-nhs-provider-sector-2020\"><span style=\"font-weight: 400\">our latest survey<\/span><\/a><span style=\"font-weight: 400\"> of mental health trust leaders found 9 in 10 were concerned about the impact of seasonal pressure over winter on their trust and local area. One trust leader said that \u201cfor the first time the surge in demand is starting to overwhelm [their trust\u2019s] services.\u201d Another told us \u201c[mental health] activity levels are growing exponentially now so any additional surge in winter will be incredibly challenging to deliver, especially as the money that has arrived for the accelerated crisis response goes nowhere near covering the actual costs\u201d.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Mental health trusts are currently working hard to meet a series of important objectives and targets set centrally for the remainder of the financial year. These include fully resuming psychological therapies services, retaining the 24\/7 crisis lines for all ages rapidly set up at the very start of the outbreak, as well as maintaining the growth in the number of children and young people accessing care. However, only one in four mental health trust leaders felt these were achievable. They stressed that meeting these objectives depended largely on the scale of: winter pressures; the second wave; and surges in demand for mental health services. Trust leaders also stressed the need for clarity on funding and investment for the sector. One trust leader stressed the quality of services is very much \u201csubject to funding keeping pace with demand.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">Looking further ahead, only 3 out of 10 trust leaders told us they were confident that their trust had the capacity to meet demand for mental health services over the next 12 months. Mental health trusts are having to factor in providing services for a new and unknown level of mental health need as a result of the outbreak and meeting this on top of existing demand will be extremely challenging, as we warned <\/span><a href=\"https:\/\/nhsproviders.org\/media\/689590\/spotlight-on-mental-health.pdf\"><span style=\"font-weight: 400\">earlier this year<\/span><\/a><span style=\"font-weight: 400\">. One trust leader told us \u201c[their] forecasting work is giving some big numbers and it\u2019s not just these 12 months but over a 5 year period\u2014this is a sustained increase in demand across all mental health services. So this is not going to go away.\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">And of course, we must remember that the demand mental health trusts were facing for their services prior to the pandemic was already <\/span><a href=\"https:\/\/nhsproviders.org\/mental-health-services-addressing-the-care-deficit\/the-demand-challenge\"><span style=\"font-weight: 400\">far outstripping their capacity\u2014<\/span><\/a><span style=\"font-weight: 400\">despite the substantial progress made in recent years, with new services and higher levels of investment. Without prompt and effective action from government and national policy makers, the direct and indirect effects of the pandemic could make the longstanding care deficit in mental health much worse.\u00a0<\/span><\/p>\n<p><i><span style=\"font-weight: 400\">\u201cWe will not potentially be able to provide services to everyone who needs them in a timely way.\u201d Combined mental health trust, learning disability and community trust chief executive<\/span><\/i><\/p>\n<p><span style=\"font-weight: 400\">The new challenges around delivering services in the current context are compounded by the longstanding neglect and underinvestment in the mental health estate. While the most recent announcement of funding to eradicate mental health dormitories is welcome, and it\u2019s good to see tangible, first steps are being taken to begin addressing the state of mental health facilities, the dialogue around mental health remains unequal and significant challenges still face the sector. These challenges are rooted in the <\/span><a href=\"https:\/\/nhsproviders.org\/mental-health-funding-and-investment\"><span style=\"font-weight: 400\">historical, structural disadvantage<\/span><\/a><span style=\"font-weight: 400\"> the sector has suffered compared to physical health provision, which was exemplified most recently by the prime minister\u2019s announcement on investment in new hospitals that almost entirely overlooked the needs of mental health trusts. Acute hospitals were also given extra money in the spring to send patients that needed physical health care for treatment in independent hospitals, but NHS mental health trusts were not able to do the same for the people needing their services.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The needs of mental health services must be adequately prioritised in future plans. This means fully and promptly funding, on a sustainable basis, the rapid expansion of services needed to meet the extra demand for mental health care and support. Adequate investment to maintain and build on the steps being taken to grow the mental health workforce, and the sector receiving its fair share of capital funding, are both also crucial. National policy must not only focus on increased support for mental health, but public health and social care too.<\/span><\/p>\n<p><span style=\"font-weight: 400\">If we fail to provide the support mental health services need, we are storing up significant problems for the future, at great cost to individuals, their families and wider society. We can and must not let that happen.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-39100\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/05\/saffron_cordery3.jpg\" alt=\"\" width=\"160\" height=\"160\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/05\/saffron_cordery3.jpg 160w, https:\/\/blogs.bmj.com\/bmj\/files\/2017\/05\/saffron_cordery3-150x150.jpg 150w\" sizes=\"auto, (max-width: 160px) 100vw, 160px\" \/><em><span style=\"font-weight: 400\"><strong>Saffron Cordery<\/strong>, director of policy and strategy and deputy chief executive, NHS Providers.<br \/>\n<strong>Competing interests<\/strong>: None declared.<\/span><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>As we navigate our way through the second national lockdown for England and beyond, we must not lose sight of the impact of the pandemic on mental health and the [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/11\/19\/saffron-cordery-we-must-not-lose-our-focus-on-mental-health-at-the-very-moment-its-needed-most\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":66,"featured_media":45151,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[236],"tags":[],"class_list":["post-49068","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nhs"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - 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