As a treasury minister I helped to deliver the largest ever cash increase for our NHS in 2018 - an extra £20 billion in real terms each year by 2023-24, including an additional £2.3 billion a year for mental health services. This has since helped more people than ever before to receive treatment and care for mental health conditions and has improved funding for services for children and young people. But increasing funding is not enough. It must be accompanied by meaningful reform so I am pleased that last week the Government set out its proposals for a new mental health bill.
Mental health problems are viewed very differently now than they were in 1983, when the main legislation that covers the assessment, treatment and rights of people with a mental health issue was drafted. Although amendments were made in 2007, the changes fell far short of the major overhaul that is needed to tackle one of the most serious problems in our society. The new proposals will build on the recommendations made by Sir Simon Wessely’s Independent Review of the Mental Health Act in 2018 and have been welcomed by charities such as Mind. The reforms touch on many issues but I will highlight four that I think are particularly important.
- They will improve choice and autonomy for patients, for example ‘advance choice documents’ will enable people to express preferences on their care while they are well, before they need go into hospital.
- They will help to tackle the racial disparities in mental health services (black people are currently four times more likely to be sectioned than white people).
- They will significantly change how we view people with a learning disability or autism by rendering with not a sufficient reason, on its own, for someone to be detained for treatment.
- They will improve access to community-based mental health support, including crisis care, to prevent avoidable detentions.
While statistics on the immediate physical health impact of the Covid-19 pandemic (such as hospitalisations and deaths) and statistics on its impact on the economy (such as GDP growth or contraction) are readily available, its impact on the nation’s mental health is far harder to measure. Will the loneliness caused by separation from our loved ones, our anxiety about friends or family who are especially vulnerable, or the day-to-day stress of juggling work and childcare simply evaporate when lockdown restrictions are eased or will there be a significant rise in lasting mental health problems? Will children who have had their lives impacted so heavily at key points in their development simply adapt as children so often do, or again, will there be lasting damage? The answer to both questions it that we simply don’t know. So while mental health reform was already long overdue, it has become even more important given the events of the past year.