How can NHS mental health services recover, when demand is higher than ever?

On the 10th of March NHS digital [1] released its monthly statistics for December 2021 and the provisional statistics for January 2022. The data suggests that the mounting effects from the pandemic have led to a huge rise in people referring themselves to specialist services for mental health conditions, while The Royal College of Psychiatrists (RcPsych) cast doubt on whether the NHS will keep up with new demand, while dealing with an unprecedented backlog.

Written by Bryony Porteous-Sebouhian

By the end of 2021, there were 4.3 million referrals to NHS mental health services

This is an increase from about 3.8 million referrals in the years 2019 and 2020. RcPsych carried out an analysis [2] of the NHS Digital data, finding that 3.3 of the 4.3 million were referrals to adult services, while 1.025 million were referrals to specialist children and adolescent services such as CAMHS.

“Staff are working flat-out to give their patients the support they need but the lack of resources and lack of staff mean it’s becoming an impossible situation to manage.” Dr Adrian James, President of RcPsych.

The RcPsych analysis found an NHS working hard to respond to the new and already existing demand for mental health care, but with a staggering 1.4 million people waiting for treatment (a figure that is likely under representative of how many people are struggling with mental health and accessing services), and without a proper, tailored NHS mental health recovery plan, the College fears the NHS will not be able to keep up with demand.

Some other key findings were:

• “424,963 children and young people (0 to 18 years) were in contact with mental health services in December 2021 compared with 367,403 in December 2019 (15.7% increase)
• “642,303 adults (19 to 64 years) were in contact with mental health services in December 2021 compared with 612,222 in December 2019 (4.9% increase)”
• “1,834,137 appointments attended across mental health, learning disability and autism services compared with 1,599,584 in December 2019 (14.7% increase).”

Dr Adrian James, President of RcPsych has said:

“As the pressure on services continues to ratchet up, the silence from government continues to be of grave concern for the College, the wider mental health workforce and, most importantly, our patients.”

Speaking to the mental health impact of the pandemic, and how something that was predicted since near the start, was not heeded, Dr James said: “The warning of the long tail of mental ill health caused by the pandemic has not been heeded. Many thousands of people will be left waiting far too long for the treatment they need unless the government wakes-up to the crisis that is engulfing the country.”

“We don’t need warm words or empty commitments. We need a fully funded plan for mental health services, backed by a long-term workforce plan, as the country comes to terms with the biggest hit to its mental health in generations.”

A government spokesperson also spoke to the BBC [3] on this issue, saying:

“We are committed to ensuring everyone is able to access the help and advice they need, which is why we are investing an additional £2.3 billion a year into mental health services by 2023/24, on top of the £500 million we have made available to address the impact of the pandemic.”

However, the Royal College of Psychiatrists have remained sceptical, over previous and recent statements from the government, criticising it’s lack of specificity on funding to services, whether or not more psychiatrists will be trained and the imminent need to “replace crumbling mental health facilities across the country.”

Finally, RcPsych remarked that this latest NHS dataset is another in a long line, showing the record number of young people waiting for eating disorder treatment, with only 59% accessing urgent care within a week. Their analysis also found that adults are being sent far from their homes to access inpatient care, because of a lack of beds in their area, on this RcPsych said:

“A practice that would be completely unacceptable in physical health services and must urgently be addressed in mental health.”

In light of this data, as well as NHS mental health services being completely missing from the Health and Social Care Secretary’s recent speech on healthcare reform, there is a clear and desperate need for our government to address a crisis that is only going to get worse. A specific and tailored government recovery plan for NHS mental health services, is absolutely necessary.

Reference list:

1. 'Mental Health Services Monthly Statistics, Performance December 2021, Provisional January 2022'
2. 'Record 4.3 million referrals to specialist mental health services in 2021'
3. 'NHS struggling with 'long tail' of pandemic mental ill health'