10 October 2019
Policy lags behind the public when it comes to prioritising mental health
Benedict Wilkinson and Alexandra Pollitt
The NHS has a long way to go to meet public expectations for mental health services
With an eye towards her legacy as prime minister, Theresa May announced a raft of mental health reforms in the final days of her premiership back in June. These measures built on what researchers and campaigners call “parity of esteem” – the idea that mental health should be valued as much as physical health. It’s a principle that was enshrined in law by the coalition government in the Health and Social Care Act 2012.
New research for World Mental Health Day shows the British public overwhelmingly support this principle – but they’re not convinced that the health system is putting it into practice. The study, by the Policy Institute at King’s College London and Ipsos MORI, finds that four in five Britons say mental health is equally as important as physical – but just one in five think the NHS treats it that way.
The May government’s reforms – which include mental health training for teachers and suicide prevention training for NHS staff – are all well-intentioned and positive steps. But as things stand, funding for mental health lags way behind that for physical health. Only about £1 in every £10 spent by the Department of Health and Social Care goes towards mental health services. And while this is higher than it once was, when taken as a proportion of the overall DHSC budget, mental health spending has remained virtually static, at around 9 per cent, over the past five years.
This is at a time when mental health problems represent over 20 per cent of the UK’s disease burden. So while Health Secretary Matt Hancock said this week that “our health – both mental and physical – is an asset that needs to be nurtured”, that is not being reflected in funding and therefore not in the delivery of care. The public feel that mental health services get short shrift too, with two-thirds saying the health service prioritises physical health over mental.
Our research also shows that Britons recognise the value of boosting funding to improve our mental wellbeing: only 7 per cent consider increased spending on mental health services to be a waste of money, compared with 80 per cent who do not.
Favourable views on greater funding in this area should not come as a surprise since Britain is today a relatively tolerant nation when it comes to mental health. Over three-quarters of us think mental illness is an illness like any other – the highest of all the countries we surveyed.
Three-quarters also say we need to adopt a far more tolerant attitude to people with mental illness, while more than two-thirds say seeing a mental health professional is a sign of strength, with women (74 per cent) more likely than men (62 per cent) to agree with this statement.
And Britain is second only to Sweden for acceptance of public officials who have experienced mental health issues, with just 12 per cent saying anyone with a history of mental illness should be excluded from public office. By contrast, the same figure for Russia is 76 per cent, making it the least tolerant country by this measure.
Attitudes are not as positive in many other countries. Almost half of people in India think most adults diagnosed with a mental health condition would get better over time without the help of doctors. And South Koreans are least likely to say we need to be a lot more accepting of people with mental illness, with just 31 per cent agreeing.
Britain’s relative tolerance compared with other nations is cause for celebration, and has no doubt been helped by prominent public figures sharing their own experiences of poor mental health and campaigning to improve awareness. Initiatives like Time to Change have worked tirelessly over the past decade or so to tackle stigma and discrimination. And this week an advert for the NHS’s Every Mind Matters campaign narrated by members of the royal family generated so much public interest that it crashed the campaign’s website after it was aired.
So progress is certainly being made. But the NHS faces a real challenge in meeting rising demand for services, while mental health problems impact our homes, schools, workplaces and communities. Understanding the social factors that drive mental ill health and how we can address them will be essential in the coming years. That’s why King’s College London has recently established a Centre for Society and Mental Health, bringing world-leading experts together to research and tackle these challenges.
Britons expect mental health to be prioritised to the same extent as physical. It is up to this government and future administrations to not let them down. On World Mental Health Day, we should be celebrating how tolerant the British public have become and working towards providing the services they deserve.
Dr Benedict Wilkinson is Associate Director and Alexandra Pollitt is a Senior Research Fellow at the Policy Institute, King’s College London.