On Monday the Prime Minister devoted her first speech of the New Year to mental health. Theresa May rarely does big set piece events – she doesn’t believe in feeding the media beast like her predecessors. Some say it was intended to distract from Brexit. That may be true. But it doesn’t change the fact that the PM’s decision to put mental health front and centre of her domestic policy agenda is a victory for campaigners.
This didn’t come out of the blue. In recent years, we’ve seen a welcome transformation in society’s approach to mental health. Not so long ago the norm was to suffer in silence; crippling anxiety and depression hidden behind a stiff upper lip. But suddenly it seems, one of the last taboos has been dragged out into the open.
An important moment came in 2012 when two MPs spoke openly in Parliament about their own experiences with mental illness. More recently A-list celebrities including model Cara Delevinge, singer Lady Gaga, and British institution Stephen Fry have talked openly about their personal battles. It’s now accepted that mental health problems can affect anyone, no matter how rich, famous or powerful.
We understand mental health much better now than we did a few years ago. And one of things we learned is that lifelong problems usually manifest at a young age. 50% of mental health problems are established by age 14, and 75% by age 24.
We also know that childhood these days is pretty tough. In every classroom there are young people struggling to cope. Research conducted by NCB and the Association of School and College Leaders last year found evidence of increasing anxiety, stress and self-harm.
It’s not hard to see why. Exam pressure; fear for the future in an uncertain economy; anxiety over body image in a hyper-sexualised media environment.
And then there’s the internet. Alongside the tremendous opportunities offered online, come serious threats. Cyber-bullying is a growing concern. No longer can you leave the bully behind at the school gates. They follow you home through your smartphone, tablet and laptop.
The extent of the problem is clear. But what about the solution? It’s well documented that children and adolescent mental health services (CAHMS) are over-stretched and under-resourced. Demand is outstripping supply. Waiting lists are too long. Too many children are waiting too long for not enough help.
The Government is well aware that children’s mental health services are reaching crisis point. That was the reason for the very welcome £1.4bn cash injection by the end of this Parliament. But the reality is that in pursuit of devolved decision making, a key plank of the Health and Social Care Act 2012, the Government has given up a great deal of control over where the money goes. They simply cannot guarantee that funds will be spent as intended.
As Young Minds has found, only half of the GP-led clinical commissioning groups, which are responsible for allocating resources, have increased spend on children’s mental health in line with central government investment. It’s hardly surprising that a cash-strapped NHS would seek to use funds for other competing priorities.
But the fact is that if the funding isn’t used as intended, children will continue to go without the support they need.
The question now is, will the PM’s speech today make any difference?
The tone was right. The emphasis on prevention was important. It’s true that mental health must be addressed not just in our hospitals but in our classrooms and communities. And there were other positives:
- Every secondary school offered mental health first aid training;
- New trials to strengthen links between schools and local NHS mental health staff;
- Thematic review of CAHMS services by the Care Quality Commission;
- A Government consultation paper on children and young people’s mental health to transform services in schools, universities and for families;
- Help for business to support mental health in the workplace.
But here’s the catch: no new funding. And nothing to make sure the £1.4bn is used as it should be.
Speeches like this matter. They set the tone of national debate. They help sway the priorities of decision makers. They help challenge prejudice and discrimination.
But soaring rhetoric does not in itself deliver change on the ground.
If the Government is serious about transforming access to mental health services, it needs to put aside its ideological commitment to devolution and take action to make sure that £1.4bn goes where it was promised.
NCB coordinates the Partnership for Well-being and Mental Health in Schools: a national network of more than 50 organisations from the education, health and children's sectors that supports schools and services to improve the well-being and mental health of all children in education.
This year we have produced a whole school approach to mental health, which available to download here>