The past year has been incredibly difficult for us all. Public health fears, economic uncertainty and social isolation created the perfect environment for mental ill health to thrive. This, coupled with the fact that health services have had to radically redeploy staff to focus all efforts on the immediate pandemic response, means we now have to grapple with a mental health crisis.
Even prior to the pandemic, mental health services were in a perilous state following a decade of underfunding by consecutive Conservative governments. Despite promises of parity of esteem between physical and mental health, the reality was anything but. Though NHS services were not being expanded swiftly enough to meet demand, the real damage was done through cuts to services and organisations conducting essential, proactive, preventative work.
Public health budgets have been decimated since 2010, creating a significant knock-on impact on mental health. Local authorities have been forced to strip back services following cuts from central government, impacting the effectiveness of local communities in supporting their own mental health and preventing a crisis in the first place.
Punishing policies on benefits from the Conservatives and the erosion of employment rights have ensnared families in cycles of poverty, hugely increasing risk factors for mental illness. Latest government figures show that the number of children living in poverty has increased to 4.3 million, with 75 per cent of them living in a working household. Financial instability is one of the leading drivers of poor mental health and 50 per cent of mental health issues are established by the age of 14. By not giving each child an equal start in life, it creates a society where children from the poorest backgrounds are four times more likely to have a diagnosable mental health condition than their more affluent peers. This is fundamentally wrong.
The pandemic has laid bare the health inequalities at play in society – these cannot be ignored any longer.
[Read more: How to solve the mental health crisis]
This inequality was undoubtedly worsened by the pandemic. Social inequalities that persisted before have been deepened, and demand for support has rapidly increased. Rates of depression have doubled, anxiety levels have reached all-time highs, and referrals to services have spiked. Research from the Centre for Mental Health found that up to 10 million people in England alone may require mental health support as a result of the pandemic.
As we look to the post-Covid recovery period, it is essential that mental health is a priority for the government. Action to address the increase in mental health problems should already be underway, yet it is barely even an afterthought for this government.
The postcode lottery in terms of service provision has only worsened throughout Covid, meaning you are more likely to access support based on where you live, as opposed to your need. Many people are stuck on waiting lists for months while others have their referrals closed altogether, without an appointment. Overcoming this barrier in access is crucial to tackling the mental health crisis.
The previous Children’s Commissioner for England stated in their 2021 annual report that child and adolescent mental health services were not expanding fast enough to reach the government’s own targets of access based on pre-pandemic levels of need. With the increased prevalence of mental health challenges as a result of Covid, services will now need to expand at an even faster rate. Workforce capacity is often cited as the biggest barrier to scaling up provision, therefore the government must act urgently to ensure that anyone with a mental health problem as a result of the pandemic gets the help they need.
It must be acknowledged by this government that mainstream services are not appropriate for everyone. Community-led support can be especially effective in improving well-being in minority communities, which are too often let down by mental health services. Black people, for example, are less likely to access treatment and four times more likely to be sectioned under the Mental Health Act. The development of strong partnerships between local government, the NHS and community groups is vital to ensuring no one falls through the cracks.
With the correct resources, local authorities can be leaders in coordinating an effective, local mental health strategy. They can work with other organisations to identify need and plug gaps in access – but they need support from central government.
Ensuring everyone can access support is an important first step – however, the best mental health strategies are ones that seek to prevent mental health issues from occurring in the first place. Action to actively promote positive mental health and policies designed to reduce mental health inequality are key.
Prioritising early years interventions will mitigate risk factors for mental illness, giving every child the best possible start in life. The establishment of Sure Start centres are synonymous with this approach, yet after more than ten years of Conservative governance their numbers are dwindling.
Strengthening rights at work, tackling racism and discrimination, and having an inclusive education system are all ways to close the inequality gap in mental health. But we have a government that revels in division, preferring to uphold inequality rather than reduce it.
By tackling the root causes of poor mental health we prevent issues from developing in the first instance. By ensuring services are accessible and appropriate for anyone who needs them we give everyone the support they need to overcome their difficulties. By reducing social and economic inequalities we create a society where no one’s well-being disproportionately suffers from factors outside of their control. These fundamental principles will guide Labour’s approach to mental health.
The pandemic must serve as a watershed moment in mental health. Not just in words and attitudes, but in actions. No more empty rhetoric and broken promises. Mental health in the post-Covid recovery has to be prioritised. Failure to do so will be disastrous.
To read the last Spotlight policy supplement on mental health click here.