Hugely welcome, but the NHS is still to do all the heavy lifting.

31/03/2021

Last weekend the government published its COVID-19 mental health and wellbeing recovery action plan. This document sets out the steps needed to prevent, mitigate and respond to the mental health impacts of the pandemic. This blog from our policy team takes an in-depth look at the plan and what it means for people severely affected by mental illness.

The last year has had a profound affect on the nation’s mental health. For the majority, the effect will be temporary as we move out of the restrictions that have governed our lives over the last 12 months and return to our old way of life. But for some, many thousands of Britons, the pandemic will have a lasting impact on their mental health. Either exacerbating existing mental illness or leading to people experiencing severe symptoms for the first time. 

The publication of the Covid 19 mental health and wellbeing recovery action plan on Saturday is significant in that it clearly recognises the need to provide additional support for people severely affected by mental illness. To have a section on ‘serious mental illnesses’ in a government strategy is a marker in itself.

The £500m investment in mental health services which has attracted most of the headlines was announced last year, but the publication of the plan means we now have a clearer understanding of where that money will go.

The mental health and wellbeing recovery action plan builds on and supports the NHS Long Term Plan and accompanying Community Mental Health Framework(CMHF). The action plan announces £58m of funding, much of which will bolster efforts to make the vision outlined in this framework a reality. This is a once-in-a-generation opportunity to radically redesign community mental health provision – we welcome efforts to reduce the gaps in care and communication now as systems develop new models of integrated, person-centred care.

£87m will also be invested to support discharge from hospital. The period after leaving hospital is one where people severely affected by mental illness are often most in need of support and at increased risk of relapse. This new funding will help ensure the safety net is there to help more people at a critical moment.

Physical health problems are one of the key drivers of a mortality gap that remains unacceptably high for people severely affected by mental illness. Physical Health Checks for people living with severe mental illness seek to address this disparity, but in 2020, only 22% of those entitled to receive a full check did. £14m of funding to support outreach builds on work announced in the Government’s winter plan is a positive step to improve uptake of Physical Health Checks and vaccines, and address physical health inequalities more broadly.

Whilst the plan contains much we welcome there are crucial issues not addressed by it. A fulfilling life for people severely affected by mental illness is about more than what the NHS does and doesn’t provide. It is about the support available, and the absence of harm, in policies emanating from other areas too.

The plan rightly acknowledges the importance of social care to those living with severe mental illness and to the implementation of the Community Mental Health Framework. – a potential game changer for the integration of care and support.

It points to social care reforms being published later this year. The acid test will be what those changes mean for the people Rethink Mental Illness represents. The Mental Health and Wellbeing Advisory Group’s recommendations on social care are a good place to start. The availability of supported housing must be part of that conversation too.

The experience of people severely affected by mental illness in the welfare system is often characterised by punitive regime, lengthy and bureaucratic assessments, and a fight to access support that should be a right. Bold leadership is needed to deliver a radical change of approach within a system that compounds the problems it is designed to solve. Investment in other areas like the NHS is undermined if people in need of support are harmed, rather than helped, by the welfare state.

The plan acknowledges that welfare policies can be a ‘protective factor’ for mental health and cites a forthcoming consultation from the DWP later this year. The key thing here will be the extent to which any reforms address the fundamental unfairness that oftencharacterises the system today, as exemplified in previous Rethink Mental Illness research.

There is much to be heartened by in last week’s action plan. 2021 will be a key year is addressing some of the other fundamental questions that are touched upon within it, but have yet to be answered.

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