Ben Goldstone, Mental health worker, West London Socialist Party
More and more adults and children in the UK continue to experience difficulties with their mental health. NHS services are in a state of crisis. NHS data shows over a million adults, and rising, use mental health services every month. Among children and young people, numbers are rising alarmingly quickly. In April 2016, 96,789 children and young people came into contact with mental health services. Fast forward to April 2022, this number had risen to 355,807.
Funding
In 2019, with services already under strain, the Tories promised an extra £2.3 billion a year by 2023-24. A report from the British Medical Association (BMA) makes the case that, as a result of inflation, this would now need to rise to £2.6 billion. The money was intended to fund an extra 2 million appointments a year. However, with the growing demand for services, the BMA estimates £5.2 billion is needed to ensure that everyone who needs help can get it, and that this needs to be matched with an increase in funding for primary care, public mental health, mental health research, and mental health facilities.
Socialist Party Says
- Immediately boost funding to that which is required – as determined democratically by workers in the industry, their trade unions and patients
Waiting lists
If you need help with your mental health, there is a good chance you will be waiting a significant amount of time to get it. In 2022, the number of people waiting for community mental health care rose to 1.2 million. The NHS also had a target that 1.6 million patients would be able to access ‘talking therapy’ through the ‘Improving Access to Psychological Therapy’ service, but only 1.2 million did. Targets for providing services to psychosis patients were also not met in 2021-22.
Research by the Royal College of Psychiatrists has highlighted that nearly a quarter of mental health patients wait more than 12 weeks to start treatment, 12% experience waits longer than six months and 6% wait longer than a year. Of the patients involved in the research, more than three quarters of those on a hidden waiting list reported that they were forced to resort to emergency services or a crisis line in the absence of mental health support (both underfunded and stretched services themselves already).
Socialist Party Says
- Expand talking therapy provision to all those who need it
- Free prescriptions for all
- Increase carer’s allowance, and expand eligibility criteria. Living benefits, that rise with the cost of living, for all who need them
Mental health beds
For those who are in need of inpatient treatment, there are increasingly few beds available. Last year, there were found to have been 18,247 mental health beds – a reduction of 23% since 2010-11. The Tories will say this has been part of a policy shift towards care in the community – services which have been increasingly difficult to access.
People in need of inpatient treatment go untreated, those who do get access can be sent miles away from their families, friends, and social networks at a time when they need them most.
The lack of capacity also means that patients ready to move on to different wards are kept in place – often in a restrictive environment. Shortages are such that last year there was an increase of 30% in children being admitted to adult psychiatric wards.
Socialist Party Says
- No patient to be transferred out of area, all children who need care to be admitted to child-specific services
- Restore and extend provision of mental health inpatient beds
Privatisation
Mental health services are increasingly outsourced to private companies. Out of £2.1 billion in mental health contracts between 2013-2018, 58% of these were won by the private sector, with the total award coming to £1.2 billion.
An estimated 30% of NHS mental health hospital capacity is supplied by the private sector. Over half of NHS inpatient beds for children and teenagers with mental health problems, and almost all of the secure beds for adults, are supplied by private companies. 99% of ‘out-of-area’ placements for patients with personality disorders are provided by the private sector.
Socialist Party Says
- Bring all private mental health provision in-house, with no compensation to the fat-cat profiteers
Staff shortages
Like the rest of the NHS, staff shortages blight mental health services. There are thousands of vacancies for nurses, therapists and psychiatrists. Between 2009 and 2020, there was a 12% reduction in the number of mental health nursing positions occupied. In 2021, 10% of psychiatrist positions were not filled.
Alongside this, NHS workforce data showed there to be one consultant per 12,567 people in the UK. It’s unsurprising there is such a long wait for people to be seen for mental health support.
A survey of workers in 2020 showed that 52% were “too busy to provide the care they would like” and 65% said that on their most recent day of work they were short by one or more nursing staff members.
For workers in post this means extra pressure. In 2022, over one in five sick days taken by nurses were due to mental health reasons and this was the most frequent reason for sickness. This is no doubt exacerbated by the stress of working in an underfunded and under resourced system.
Socialist Party Says
- A mass recruitment and training programme for mental health workers
- Immediate inflation-proof pay rises for all NHS workers, and all outsourced workers to be brought in house on NHS pay terms and conditions. £15-an-hour minimum wage now
- Scrap tuition fees, establish living student maintenance grants
Quality of care
Government ministers have established an inquiry into safety in mental health inpatient settings. The quality of care and safety in mental health services has been brought into stark focus following a series of revelations, including a BBC Panorama programme revealing abuses at the Edenfield hospital near Manchester.
A review of 2,000 deaths at the Essex Partnership University Trust over a 21-year period was triggered by a 100,000-strong petition created by an Essex mum whose son died while an inpatient at the Linden Centre in Chelmsford in 2012.
If services remain chronically understaffed and run for profit, failings will continue.
Socialist Party Says
- Bring all services into public ownership, fully funded and run under workers’ and patients’ democratic control to ensure safety and quality of service
Economic security
Looking at the current political and economic climate, is there any wonder more and more people are experiencing difficulties with their mental health?
The effects of the Covid-19 pandemic, and the government’s mishandling of it, has had an impact on individuals’ mental health.
This is made worse for those isolated in poor-quality housing, forced to work in unsafe workplaces or working from home with the additional pressures of caring for relatives and so on.
But the numbers suffering from poor mental health were increasing prior to the pandemic. Since 2009, government-imposed austerity has made it harder for people to access necessary public services.
People’s ability to meet their basic needs has been hit by benefit cuts, low pay and insecure work. General life prospects have worsened. All the while, profits for big business, and bonuses for bosses, have soared.
Safe, secure, and affordable housing is increasingly hard to come by. Funding for schools and education has been cut in real terms. Young people accessing higher education have been saddled with larger and larger amounts of debt. Poverty continues to climb. It’s a perfect storm!
NHS data showed that, in July 2022, double the number of people in the areas with the highest levels of deprivation came into contact with mental health services compared to those from the areas with the lowest levels. Economic security is clearly a factor when it comes to mental health.
Socialist Party Says
- Inflation-proof pay rises for all workers
- Immediate rise in pensions and benefits, rising in line with the cost of living
- Establish democratic rent controls and a massive council house building programme to provide high-quality affordable housing for all
Socialism
It is clear that the capitalist system, where profit is prioritised above all else, cannot provide for those experiencing mental ill health, or for those who care for them. A socialist society, based on public ownership and democratic control of society’s wealth and resources, would not only be able to provide mental health care for those who need it but would address the economic and societal issues that cause and exacerbate many mental health difficulties in the first place.
Socialist Party Says
- Take the wealth off the super-rich – nationalise the top 150 companies and the banking system that dominate the British economy and run them under democratic working-class control and management
- A democratic socialist plan of production based on the interests of the overwhelming majority
- For a socialist world free from oppression, inequality and want
Students’ mental health suffers in cost-of-living crisis
Noah Eden, Sheffield Socialist Students
A shocking 45% of students said their mental health had declined since the start of the 2022–23 academic year, according to a recent survey by the Office for National Statistics.
The numbers of students suffering from mental health problems has been steadily increasing, but due to the cost-of-living crisis that number has shot up rapidly. The survey found 91% of respondents were concerned about making ends meet.
Students face precarious employment with low pay and a maintenance loan that doesn’t begin to cover the cost of what is needed to get by – the maximum maintenance loan hasn’t gone up in line with inflation for five years, and next year students are set to be £1,500 worse off.
Already, 50% of respondents stated they are experiencing ‘financial struggles’, with a further 15% facing ‘major difficulties’.
Students who face issues with money are more likely to have poorer mental health, greater anxiety, and have higher rates of alcohol dependence. 37% of first-year students suffer from symptoms of depression and anxiety – higher than the general population of the ages 16-29 at 22%. Alongside this, 21% stated that they have used mental health services since September 2020.
Socialist Students fights for an immediate rise in the minimum wage to at least £15 an hour rising with the cost of living, an end to zero-hours contracts, and living grants for students. We fight for better mental health services too – publicly owned and as part of a fully funded NHS.
The Covid-19 pandemic restrictions hit the mental health of many students hard. Many students were forced to sit in their rooms all day and study online. In Manchester, university managers even erected fences around student halls to pin them in; protests eventually tore the fences down. All the while students were paying £9,250 a year and getting deeper into debt.
While students suffer, and university staff are forced to go on strike for fair pay and pensions, university bosses continue to rake in huge salaries and bonuses. The ex-president of Imperial College London, who stood down in July, earned £714,000 a year. How many university-based mental health support workers or counsellors could that money be used to employ? Students unions must do more to demand university bosses fund proper mental health services for students.
Socialist Students fights for the funding our universities need from central government, to provide free, high-quality education and support for students – paid for by the bosses and the wealthy elite.
See Socialist Students conference a key event for the fight back on campus
