In April 2022, the UK government published a discussion paper on a proposed 10 year plan for mental health, alongside a call for evidence with specific questions on the proposal. This document sets out a summary of our response.
In General
We welcome the cross-government approach to the upcoming Mental Health and Wellbeing plan.
- This approach recognises that mental health depends on a so much more than NHS services. It relies on good housing, financial security, supporting people to work and volunteer, tackling structural racism, social connectedness, and social care, as well as timely access to quality treatment and support. For this reason, a holistic approach – including actions for every government department to improve mental health, is right.
- The plan must tackle areas of government policy that are in direct conflict with or undermine the government’s ambitions to improve the nation’s mental health. This includes the full participation of all government departments in the implementation of the new Mental Health policy tool, which will measure the potential mental health impact of new policy proposals.
- We expect that this plan should generate new policy commitments across government in the short and longer term, and over and above those that have already been made.
- The plan needs to be properly funded. Additional budget must be allocated for any new workstreams generated by the plan, so as not to displace funding from existing departmental settlements, which could in turn have unintended consequences for mental health.
- This plan must prioritise action on prevention and early intervention. Frontloading prevention work to be delivered earlier on in the 10 year plan should result in lower demand for services toward the end of the period. However, the plan cannot be seen as an alternative to properly funding and resourcing mental health services.
- To ensure the eventual plan is meaningful, it must be co-produced in partnership with a representative group of individuals with lived experience, alongside small charities and community organisations.
Our recommendations
Ensuring people with severe mental illness can live well in their local community
The Mental Health and Wellbeing Plan must include action for:
- The Treasury to provide long-term sustainable funding for the provision of adult social care.
- The Department of Work and Pensions to introduce a better-funded social security system designed to meet the needs of those living with a mental illness.
- NHS England to extend its target to ensure 100% coverage for Individual Placement & Support (IPS) service access for eligible people severely affected by mental illnesses by 2028/29, and the Treasury to provide sufficient joint funding that will allow the NHS and Department of Work and Pensions to work together to achieve this target.
- The Department of Health and Social Care to commit to the delivery of a Recovery and Respite Plan for carers that includes wellbeing support for carers, with a longer-term view towards delivering a national Carers Strategy.
- The Department of Health and Social care to include connection to the rollout of the Community Mental Health Framework within key criteria for assessing applications for funding linked to the integration of housing, health and care.
Addressing wider determinants of poor mental health
The Mental Health and Wellbeing Plan must include:
- Action for The Department of Work and Pensions to reform the Work Capability Assessment and Personal Independence Payment Assessment so they better cater for people living with a mental illness.
- Action for the Department of Work and Pensions to regularly raise social security rates in line with inflation. (We recommend frequency of twice a year).
- A commitment for the government to extend and develop Mental Health Crisis Breathing Space beyond the pilot phase if the evidence from the pilot demonstrates positive impact on mental health.
- The government to commission a full, public inquiry into cases of serious harm and death linked to the social security system and establish a new, independent body to investigate any future cases of serious harm that do arise as a result of the social security system.
- The Home Office to identify the points in the immigration system where Home Office practices cause or exacerbate mentally ill health in order that measures can be put in place to address these. This should include but not be limited to:
- implementation of the 28 day time limit on immigration detention
- joined-up and coordinated care for people when they are bailed.
- a review of family reunion rules to ensure that forced separation of families does not unnecessary cause or exacerbate mental ill health.
- Department of Health and Social Care and NHS England (NHSE) to publicise new NICE guidelines for workplace mental health and establish a scheme to evaluate compliance by employers.
Addressing health inequalities
The Mental Health and Wellbeing Plan must include:
- Acknowledgement of institutional racism in application of the Mental Health Act.
- Action for the government to thoroughly review the issues that contribute towards inequitable application of the Mental Health Act.
- Action for the Department of Health and Social Care to publish clear annual targets to progressively reduce disparities by 2025.
- Action for the Treasury to commit long-term resourcing of all the recommendations pertaining to racialised groups outlined in the Mental Health Act (MHA) Review, including the long-term provision of effective culturally appropriate advocacy services informed by the outcomes of the current pilot scheme.
- Action for The Treasury, the Department of Health and Social Care and NHS England to provide resources to ICSs to identify and meaningfully work with their PLUS communities.
- Action for NHS England to reduce barriers and ensure that statutory funding linked to the rollout of the Community Mental Health Framework reaches organisations embedded within and closely working with black and minority ethnic communities, including infrastructure funding to ensure these organisations have sufficient capacity to meaningfully engage their communities in system change.
Improving physical health of people with severe mental illness
The Mental Health and Wellbeing Plan must include action for:
- NHS England to encourage the system to mainstream approaches for the promotion and delivery of Physical Health Checks for people with severe mental illness (SMI) that centre voluntary sector and peer-led approaches.
- NHS England to work with partners such the British Medical Association to adapt the conditions for payment for delivery of Physical Health Checks under the 2023-24 Quality Outcomes Framework to necessitate referrals for follow-up support.
- The Department of Health and Social Care to incorporate the recommendations of the Mental Health and Smoking Partnership within the next Tobacco Control Plan.
- The Department of Health and Social Care to encourage local authority commissioners to embed physical activity into service specifications for community-based mental health social care services, including those that centre peer support.
- NHS England to expand the Moving Medicine programme to upskill health and social care staff working in the local community to better understand the benefits of physical activity and signpost to services.
- NHS England to take forward and put into practice NHSX’s previous proposal to collect more granular data on Physical Health Checks.
Raising awareness of mental illness and reducing stigma
The Mental Health and Wellbeing Plan must include action for:
- The Department of Health and Social Care, the Office for Health Inequalities and Disparities, NHS England and partner organisations to work together to address stigma and discrimination experienced by people severely affected by mental illness. This should include work co-produced with people who with lived experience to:
- Raise awareness of the symptoms of severe mental illnesses.
- Better understand the current common language and framing of mental health and the impact this has on people with mental illness as well as the public perception of mental illness.
- Define severe mental illness.
- Review use of more problematic terminology such as ‘behaviour disorder’.
- Promote healthier language and framing via public information campaigns and professional guidance.
- The Department of Health and Social Care to ensure provision of Mental Health First Aid training across professions most likely to serve as a first point of contact for individuals in crisis.
Improving quality of and access to treatment and support in the community
The Mental Health and Wellbeing Plan must include:
- Action for the Department of Health and Social Care to ensure Primary Care Networks invest in mental health navigation or equivalent services.
- Action for NHS England to set an extended access standard target for Early Intervention in Psychosis services, alongside delivery of the current quality-focused target for 70% of services to be provided to a NICE level 3 standard.
- Reaffirmation of the Department of Health and Social Care and NHS England’s intention to deliver a long-term workforce plan alongside likely timescales for delivery.
- Action for NHS England and Health Education England to explore options for training more staff with relevant aptitudes and experience to deliver psychological therapies.
- Action for NHS England to continue to grow the number of Peer Support Workers in England beyond current targets for 2023/24.
- Action for the government to engage further with pharmaceutical companies and look to co-ordinate and provide incentives into research on new mental health treatments.
Ensuring joined-up treatment and support
The Mental Health and Wellbeing Plan must include action for:
- The Department of Health and Social Care to expand the remit of the Better Care Fund to include ringfenced funding to support integration in mental health.
- The Department of Health and Social Care to explore options to expand the introduction of Shared Care Records to include Voluntary Community and Social Enterprise (VCSE) sector organisations working in partnership with statutory organisations to deliver care.
- The Department of Health and Social Care to monitor the implementation of the Health and Care Act in local areas to ensure the rollout is delivering the original white paper’s positive intentions around integration in practice.
Preventing and responding to crisis
The Mental Health and Wellbeing Plan must include action for:
- The Department of Health and Social Care to build on the Suicide Prevention Grant Fund within the upcoming Suicide Prevention Plan, offering longer-term grant funding through a process that greater enables the participation of smaller, community-based organisations, and prioritises innovative, co-produced approaches linked to the plan’s strategic objectives for receipt of funding.
- NHS England to share learning from efforts thus far to broaden the range of complementary and alternative crisis services to maximise the coverage of these services across the country.
Improving care in inpatient and criminal justice settings
The Mental Health and Wellbeing Plan must include action for:
- NHS England to introduce quality standards, including metrics relating to patient experience of care, to measure achievement of the commitment to improve the therapeutic offer available within inpatient mental health services.
- NHS England to produce a formal evaluation of Provider Collaboratives for specialist mental health.
- The Ministry of Justice to reduce its commitment to build 20,000 new prison places, and explore rehabilitation in non-prison settings as an alternative.
- The Ministry of Justice to invest in programmes that support people’s mental health whilst in prison, including extending trauma-informed training to all prison staff and innovative schemes such as therapy dogs.
For more information, please contact Harvey Crawford, Policy Manager: Harvey.Crawford@rethink.org
Muslim Mind Collaborative
Head of Community Engagement, Kaneez Shaid, is also a member of the Muslim Mind Collaborative, a collective which aims to widen the parameters of the agenda on mental health to consider the needs of faith communities.
View the open letter, a collective response from the Muslim Mind Collaborative on the government’s 10-year review on mental health and well-being.