Parliamentary Briefing: The Future of Adult Social Care – Mental Health

Overview

We are pleased that the government has begun to rise to the significant challenges facing the social care sector. However, what has been announced so far does not represent the detailed vision for reforming social care that is so desperately needed.

The government’s latest announcements currently amount to a funding arrangement in response to record NHS waiting lists. The government must now publish proposals for the delivery of adult social care in England that include detailed provisions for working-age adults in receipt of social care, many of whom have severe mental illnesses.

Key messages

• We need a vision for social care reform. While this is a good first step, it is a far cry from the detailed plans promised by the Prime Minister in December 2019.
• The government’s announcements currently focus narrowly on funding the response to the NHS elective backlog, not on resolving issues in social care long term.
• £1 in every £12 spent on social care goes to support people severely affected by mental illness. No plans for reform can be considered comprehensive without it.

The government's announcements on social care

The proposals announced on 7th September are based on recommendations put forward by the Dilnot Commission in 2011, which proposed solutions that would allow older people to receive care and protect their assets. This does not take into account the huge pressures put on the social care system has taken over the last ten years, with real-terms spending on social care only returning to 2010/11 levels last year, amid a picture of significantly rising demand.

Focusing on protecting assets, and to a lesser extent, on the workforce, still leaves many problems with the current social care system in place. The funding will on the most part be used to cover the costs that would have otherwise been paid by individuals themselves.

There is still time over the coming months for the government to provide significantly more detail on how this new funding will address the range of challenges currently facing social care, such as quality and access.

What needs to be done

Mental health social care plays a vital role in supporting people living with severe mental illness to recover following hospital care, stay well and prevent further crises. Too often, their needs are ignored as the debate on social care focuses exclusively on the needs of older people.

The government must set out reforms for the adult social care sector that include detailed provisions for working-age adults and an appropriate funding settlement that goes further than just a cap on care costs, as many people severely affected by mental illness are unlikely to have the financial assets to meet that threshold.

Mental health social care

• People who need social care because of a mental illness are often forgotten about in these discussions. This plan should be judged on whether the needs of people living with mental illness are at its heart.
• The fact that a third of all people in receipt of social care are working-age adults, accounting for nearly 50% of the social care budget, must be front and center in people’s minds.
• Mental health social care enables people who are severely affected by mental illness to live equal lives, independently in their communities. It aids and supports recovery. Without fair and sustainable funding, we simply place ever more pressure on stretched NHS resources.
• However, we will not succeed in reaching a point where people can be confident they can access the health and social care they need if mental health is not genuinely included in planned reforms. Alongside people living with mental illness and their carers, we call for reassurance that their needs will be met.

Mental health social care must be at the center of Government plans for social care reform with appropriate funding to ensure the provision of the following services which local authorities have a duty to provide under the Care Act 2014, Mental Health Act and Mental Capacity Act:

• Community preventative support – support in the community to prevent an individual’s needs from escalating, including peer support and personal budgets.
• Social workers and care coordinators – support with care planning and a central point of contact for the system.
• Employment support for people finding or returning to work.
• Welfare rights, information, debt and money advice – including support to access benefits and linking up with national offerings such as national advice and information helplines.
• Supported living/housing
• Continuity of support for those discharged from hospital – including Section 117 aftercare for all entitled, who were formerly detained under the Mental Health Act.
• Advocacy services – the Mental Health Act review could soon lead to increased scope and role for mental health advocacy which local authorities will be required to fund.
• Crisis services – including crisis houses, cafes and floating crisis support.
• Specific carers support reflecting the unique needs of carers of people living with severe mental illness, for example the significant fluctuations in their caring periods.
• About Rethink Mental Illness

Rethink Mental Illness is the charity for people severely affected by mental illness. No matter who a person is or how bad their situation, we are here to help them get the information and support they need to live a better life.

We work tirelessly to ensure people living with mental illness and their carers are listened to, treated fairly and have easy access to services that meet their mental health needs and wider physical health, financial, housing, work and volunteering needs.

We do this by providing our own services, campaigning on a local and national level, and working with a wide range of other organisations to create communities that care.

We ask that you use this briefing to hold the government to account of its continued failure to respond to the challenges facing adult social care. This has gone on for too long.

There is a hugely positive story to be told on the benefits mental health social care can bring to individuals living with severe mental illness, as well as its role in reducing wider system pressure and NHS care. Rethink Mental Illness is keen to work with policymakers to turn this story into a reality for all around the country.

For more information about this briefing, please email campaigns@rethink.org