The incoming president of the Royal College of Psychiatrists has said that less than a third of people with common mental health problems get any treatment at all – a situation the nation would be aghast about if they had cancer.
While the health secretary, Jeremy Hunt, has pledged to deliver “parity of esteem” for mental and physical health services, the treatment gap is now so huge that it may prove impossible to bridge in the current financial climate, said Professor Simon Wessely of King’s College London in his first interview since election to the post.
“People are still routinely waiting for – well, we don’t really know, but certainly more than 18 weeks, possibly up to two years, for their treatment and that is routine in some parts of the country. Some children aren’t getting any treatment at all – literally none. That’s what’s happening. So although we have the aspiration, the gap is now so big and yet there is no more money,” he said.
Wessely said there would be a public outcry if those who went without treatment were cancer patients rather than people with mental health problems. Imagine, he told the Guardian, the reaction if he gave a talk that began: “‘So, we have a problem in cancer service at the moment. Only 30% of people with cancer are getting treatment, so 70% of them don’t get any treatment for their cancer at all and it’s not even recognised.”
If he were truly talking about cancer, he said, “you’d be absolutely appalled and you would be screaming from the rooftops.”Wessely said he had asked Simon Stevens, the NHS England chief executive, how the gap would be bridged but was told that resolving the issue would involve a “much longer conversation with the public”.
“I think what he means is basically, if people really want true parity in the sense of actual 90% of mental health patients treated within 18 weeks, just like they are for other disorders, that is going to have to mean money will have to move from acute to mental health. Genuine money. As there is no more money, that would mean significant losses in other sectors. I think he was saying we would need a pretty good political imperative – we would need to know that people were actually on board for that – and I don’t know the answer.”
The UK is also seriously short of psychiatric beds. “The fact that people are travelling hundreds of miles for a bed, the fact that bed occupancy is now 100% everywhere – in some trusts it is 110% and we’re hot-bedding – is a symptom of a system [in crisis]. Relatives and patients hate it. Junior doctors hate it – they spend all their time on the phone. Sometimes bad decisions are made just to get a bed. But we don’t think the answer is just let us have some more beds because those will probably fill up as well. We’ve been told for years that if we just get community care right we won’t need beds. That’s clearly not true. We will be announcing a commission on beds but it’s really on systems. Beds are symptomatic of a problem.”
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