Patients in the UK with a diagnosis of cancer and certain other physical conditions can expect to be given access to a range of services within specific waiting times, whereas patients with a mental health condition can find themselves in a long queue for limited treatment options. Before throwing money at the problem, UK Government departments would do well to look at how they can work together to implement evidence-based and cost-effective interventions for mental ill-health.
The disparity in the treatment of physical and mental ill-health in the UK was highlighted by a recent report from the British Association of Counselling and Psychotherapy (BACP). The Government recognises the problem. The Health and Social Care Act of 2012 put a commitment in place to provide parity of esteem for physical and mental health. In 2014, new waiting times standards were announced for patients accessing therapy through the Improving Access to Psychological Therapies programme.
Nonetheless, mental health patients often have poor access to services, little choice in the services that they receive, and endure long waiting times in their hour of need. The BACP report highlights that mental illness is the UK's most common “disease,” yet only 24 percent of people with a common mental health condition receive treatment. This leaves millions of people to suffer, with knock-on effects to society more widely.
The lack in provision of services is closely associated with limited funding being made available to mental health services. The BACP report calls for more resources, but given current budgetary pressures it is hard to see how taxpayers' contributions can cover this.
Recent research (PDF) from RAND Europe points to possible new approaches for funding and providing mental health services. We looked at how the employment outcomes of people with mental health problems could be improved. Looking at the relationship between mental health and other outcomes of interest to government is important, because there is an association between poor mental health and lower employment rates, higher rates of incarceration and greater use of care services. Our report looked at how better collaboration between services could improve a range of outcomes, and in particular how health and benefit funding could be used to support people in employment and thereby improve both mental health and employment outcomes. The report proposes a number of interventions that are currently being trialled by the UK Government.
Given the growing pressures on the UK budget it is a matter not only of more funding but also of mobilising different funding streams across government departments to work towards a set of common outcomes. If mental health problems are the most significant barrier preventing people on benefits from taking up employment, then why not transform how the benefit system supports them? Policymakers could redirect some of the significant resources available to the benefit system towards improving mental health outcomes, and put more evidence-based mental health interventions in place. Moreover, the savings to the benefit system should logically pay for this investment.
Getting government to pool resources and work towards joint outcomes is challenging as a degree of public-sector transformation is required to take services out of their traditional silos. The working culture and incentives within the public sector operate against integration. Given the crisis in the provision of mental health services and the lack of funding, scaling up the evidence-based, effective approaches proposed in our report may offer one way to meet the challenge.
Christian van Stolk is director of research in social policy at RAND Europe in Cambridge, UK.
Commentary gives RAND researchers a platform to convey insights based on their professional expertise and often on their peer-reviewed research and analysis.
