Create a cross-government mental health strategy
Clinical care is only one part of a bigger package of support needed to give people severely affected by mental illness a meaningful life in the community. Housing, welfare and employment all are a crucial part of giving people the best quality of life possible. Every government department must take action to make a difference.
The next government must lead the development of a cross-government strategy for mental health that adopts a mental health in all policies approach.
Social care for working age adults
Social care for working age adults is critical to support the many people severely affected by mental illness who might struggle to leave the house, volunteer, take part in social activities or prepare meals alone. Yet social care for working age adults is means tested and there is a significant funding shortfall. The Local Government Association has estimated that this amounts to £1.2bn. The NHS Long Term Plan cannot be
effective without adult social care being funded as an equal partner. That’s why we are calling for a funding settlement for working age adults that covers the next 10 years.
Most people do not receive social care that lives up to the compelling vision of support set out in the Care Act 2014. All too often people wait long periods of time to be assessed before finding out they have to make significant contributions towards their care – which often does not meet their needs. Carers can go without any support and advocates are not available as early as they should be. That’s why we are calling for a review of how the Care Act provides adult social care for people living with severe mental illness and their carers.
Supported housing is an essential prevention and recovery service for people severely affected by mental illness. It is a stable environment where people can re-learn the skills and confidence to live independently, but if current trends continue it is estimated that there will be a shortfall of nearly 47,000 supported housing places by 2024/25.3 A lack of supported housing means people are kept on hospital wards, despite being medically well enough to be discharged, because there is nowhere for them to go. There must be a commitment from the Ministry of Housing, Communities and Local Government to increase the supply of supported housing, accompanied by a stable funding mechanism, that meets the needs of people with mental illness.
The central aim of the disability benefits systems is to provide vital financial assistance to those who are unable to work. It is a lifeline for
people severely affected by mental illness, but we routinely hear stories from people severely affected by mental illness that show that the
current assessment processes for both Employment Support Allowance and Personal Independence Payment are inappropriate. The number of decisions eventually overturned at tribunal shows that incorrect decisions are being made far too frequently. That’s why we believe the PIP assessment and the Work Capability Assessment must be reformed to better fit the needs of people severely affected by mental illness.
The problems that have emerged with the roll out of Universal Credit are well documented. Unless they are addressed, we believe that the lives
of people severely affected by mental illness could be damaged as their needs go unconsidered. At a minimum, we believe that disability elements which have been lost through the transition to the Universal Credit system must be restored. Almost half (45%) of people with debt
have a diagnosis of a mental illness. Mental Health UK, which Rethink Mental Illness is a part of, runs the Mental Health and Money Advice service to support people with debt they can no longer cope with. In its first year, the service supported 1,198 people through its telephone service, completed 406 debt cases and 635 benefit cases, but there are many more people who need help. We recommend that the government commits additional funding to the service to the increase the number of people the service can support with tailored financial advice.
Employment and volunteering
For some people severely affected by mental illness, working will be too much of a challenge – but we know there is an appetite among many others in this group to engage with some form of appropriate volunteering or paid work. Just 8% of people with schizophrenia are employed in the UK.5 We believe the disability employment gap can be halved over the course of the next parliament. Supporting more people severely affected by mental illness to retain employment while managing a mental health condition requires legislative and non-legislative change. Employers must be supported to do more for employees with mental illness and the law must better protect people with mental illness against discrimination. That’s why we’re calling for the Equality Act 2010 to be broadened to include specific reference to mental illnesses.