Mental Health Services: Doing what no Government has done before

Friday 8th February 2013

Norman Lamb

By Norman Lamb MP, Care and Support Minister

Being healthy does not just mean being physically fit. It means being psychologically fit, as well. One is no more important than the other.

This Government has been absolutely clear about the importance of giving mental health the same importance as physical health. We expect the NHS to listen to us and balance their services along those lines, so there is equity of esteem between physical and mental health services.

For the first time, we have legislated to give equal status to mental health services. By referring to mental and physical health throughout the Health and Social Care Act 2012, we have said clearly that in the new system, mental and physical health are of equal importance.

For too long, mental health has been the Cinderella service of the NHS – neglected and mistreated while other services were given more money, more publicity and more importance. The NHS Mandate will allow us to put a stop to that. The Mandate contains our explicit instructions to the NHS, with one instruction being to put mental health on an equal footing with physical health. That means giving everyone who needs it timely access to the best available mental health treatment. The NHS will be accountable for delivering this to Government and to the public.

Make no mistake – this is a first. Never before has a Government put such an emphasis on mental health in the NHS.

Although the draft mandate was praised for mentioning mental health, in my view it really did not go anywhere near far enough. There was only one section specifically on mental health, and that section required nothing new from the NHS. That in itself reinforced the way mental health has been viewed in the past, as a separate issue to physical illness. This is exactly why I wanted to include mental health into every single section of the Mandate. There is now much more of a focus on mental health, even though the document itself is shorter and sharper.

So how will the Mandate actually change things?

Firstly, we will ask the NHS to show that they are making real progress towards equality between mental and physical care by March 2015. Secondly, mental health’s position in the Mandate mean patients will now be more involved in decisions about their care, as well as having better access to mental health services. That should also mean that waiting times go down.

As part of its objective to put mental health on a par with physical health, we expect the NHS Commissioning Board to identify levels of access to, and waiting times for, mental health services. We want the Board to work with clinical commissioning groups to address unacceptable delays and significantly improve access and waiting times for all mental health services, including Improving Access to Psychological Therapies (IAPT).

While there is no specific waiting time target, we want the NHS to start collecting data on how long people wait so we can understand exactly what is going on around the country. When that happens and we understand the scale of the problem, we can reduce delays and move towards establishing proper standards for access and waiting times for all mental health services. Again, this means that people with psychological conditions will get the same kind of treatment as those with physical conditions.

If we want to move towards parity of esteem, we cannot be half-hearted. We have to be bold and confident, involving all services in our push for equality. Therefore we will improve and extend access to psychological therapies. We will hold the NHS Commissioning Board to account for the number of patients accessing IAPT services and whether they report improvements in their mental health from autumn 2013, through an indicator we are currently developing.

This is our clear signal to the NHS that mental health must be equal in all aspects of NHS care and we will no longer accept anything less than that. I have spoken to service users, mental health staff, charities, carers and many other groups and I know how much this all means to them. I am determined that mental health services will be seen as equal to physical health services and I am desperate to achieve that during my time as a minister.