Prioritise services for adults with severe mental illness, says All Party Parliamentary Group on Mental Health

09 October 2023

“People are being tipped into crisis waiting for treatment…” 

Adults with severe mental illnesses are struggling to get support, as ‘core’ mental health services have been left behind by the government’s mental health strategy, according to a report published by the All Party Parliamentary Group (APPG) on Mental Health today.

Published ahead of the NHS long-term plan next month, the APPG on Mental Health inquiry concludes that core services are all but overwhelmed for lack of resource, with growing demand resulting in waits for treatment measured in months rather than weeks and patients travelling the length of the country to find treatment.

People with severe mental illnesses, such as schizophrenia and bipolar disorder, rely on core services for their treatment. Around 700,000 people in England are receiving help from community mental health teams, a type of core service which delivered 14 million care contacts in 2016/17.

While investment in specialist services such as perinatal and early intervention in psychosis has produced massive successes, core services still need urgent attention.

The report, titled ‘On the road to parity’, recommends increased investment in core mental health services to prevent people who are most ill receiving the worst care. This call follows the Prime Minister’s repeated commitment to invest in mental health until there is ‘parity of esteem’ between physical and mental health.

Core mental health services are the community mental health teams, crisis teams and inpatient units that provide support to adults and older adults severely affected by mental illness. 37 per cent of core mental health services were rated as ‘requires improvement’ and 2 per cent as ‘inadequate’ by the CQC at July 2018.

One service user told the inquiry that they had been told to lie to services designed for mild to moderate conditions about the severity of their psychosis to get help; another service user received treatment for her secondary diagnosis of an eating disorder because there was no adult core service able to treat her primary diagnosis of personality disorder.

Chair of APPG on Mental Health Helen Whately MP said: “We know change is possible because we have achieved so much since 2016, with 89% of people receiving treatment in IAPT within six weeks and 74% of people experiencing their first case of psychosis getting treatment within two weeks. But it cannot be right, as we heard in the inquiry, that people severely affected by mental illnesses are being told to lie and downplay the severity of their symptoms in order to get help.

“It is absolutely vital that core services for adults with severe mental illnesses are made a priority in the long-term plan.”

Brian Dow, deputy CEO of Rethink Mental Illness said: “People are being tipped into crisis waiting for treatment. That means more lives at risk and more strain on the system – just look in A&Es across Britain. Core mental health services, like community mental health teams, need to be able to treat people and to help them manage their conditions.

“From the strong statements she has made on mental illness, the Prime Minister understands that we need a once in a generation push to bring mental illness in line with physical health. With the forthcoming NHS long-term plan, it’s time to put the investment in place to do that.” 

Dr Andrew Moore, the Royal College of Psychiatrists said: “The FyFV-MH has some good, carefully selected areas of peripheral vision, but also a large central blind spot over the deteriorating condition of vital core services. Core services form the backbone and foundation of the whole service; if they are struggling, which the evidence and opinion suggests they are, then the whole system will inevitably struggle too.  Future refocusing urgently needs to redress this imbalance. 

The report makes 23 wide-ranging recommendations but identifies improving core mental health services as an area requiring urgent attention, alongside increasing and diversifying the mental health workforce and establishing better oversight and collective responsibility for mental health.

The report is the sum of over 70 pieces of evidence from service users, professionals and stakeholders including NHS England National Mental Health Director Claire Murdoch and NHS Improvement Tim Kendall.

Rethink Mental Illness and the Royal College of Psychiatrists jointly provide the secretariat for the All Party Parliamentary Group on Mental Health and co-authored the report.