How the NHS’s ten-year plan promises to prioritise mental healthIvy Madziva
NHS England admit they may need a full decade to ensure that 100 percent of children and young people who need specialist care can access it.
Over the next decade investment in mental health will grow faster than support for physical health. Mental Health spending will nonetheless not grow much higher than 10 percent of the overall budget.
Last year’s independent review of the Mental Health Act prompted the government to commit to promoting choice and autonomy in crisis care through ‘Advance Choice Documents’.
The NHS’s new strategy says that by 2023/24 new models of care, “underpinned by improved information sharing”, will give 370,000 adults greater choice and control over their care, and support them to live well in their communities.”
Today’s document says its psychological therapy services “have evolved to deliver benefits to people with long-term conditions, providing genuinely integrated care for people at the point of delivery. More than half of patients who use IAPT [Improving Access to Psychological Therapies] services are moving to recovery, and nine out of ten people now start treatment in less than six weeks.”
By 2023/24, an additional 380,000 adults and older adults will be able to access NICE-approved IAPT services.
The NHS plans to ensure that a 24/7 community-based mental health crisis response for adults and older adults is available across England by 2020/21. Services will be resourced to offer intensive home treatment as an alternative to an acute inpatient admission.
Sanctuaries, safe havens and crisis cafes are acknowledged as a more suitable alternative to A&E for many people experiencing mental health crisis, usually for people whose needs are escalating to crisis point, or who are experiencing a crisis, but do not necessarily have medical needs that require A&E admission. These services will receive greater investment moving forwards.
Mental health nurses will become a feature of ambulance control rooms to improve triage and response to mental health calls.
‘Zero suicides’ is not held up as a target, despite expectations laid down by the current and former Health and Social Care secretaries, though a new in-patient safety improvement plan is referenced.
CHILDREN AND YOUNG PEOPLE
Children and young people’s mental health services will, for the first time, grow as a proportion of all mental health services.
Over the next five years, the NHS will expand access to community-based mental health services to meet the needs of more children and young people.
By 2023/24, at least an additional 345,000 children and young people aged 0-25 will be able to access support via NHS funded mental health services and school or college-based NHS Mental Health Support Teams. This patchy support is set to begin to arrive a full three years after mental health lessons enter the national curriculum. The make up of the support teams remains unspecified.
“Over the coming decade the goal is to ensure that 100 percent of children and young people who need specialist care can access it,” the ten-year plan states, in a target that may not reassure families currently suffering.
Children and young people who received intensive community follow-on support have been shown to make less use of crisis services compared to less integrated services. With a single point of access through NHS 111, all children and young people experiencing crisis will be able to access crisis care 24 hours a day, seven days a week, it is suggested.
Teams will receive information and training to help them support young people more likely to face mental health issues – such as Lesbian, Gay, Bisexual, Transgender (LGBT+) individuals or children in care.
“NHS work with schools, parents and local councils will reveal whether more upstream preventative support, including better information sharing and the use of digital interventions, helps moderate the need for specialist child and adolescent mental health services,” the strategy document suggests.
“It will thereby test approaches that could feasibly deliver four week waiting times for access to NHS support, ahead of introducing new national waiting time standards for all children and young people who need specialist mental health services.”
Selected areas will also develop new services for children who have complex
needs that are not currently being met, including those who have been subject to sexual assault but who are not reaching the attention of Sexual Assault Referral Services.
For 6,000 highly vulnerable children with complex trauma, this will provide consultation, advice, assessment, treatment and transition into integrated services.
A new approach to young adult mental health services for people aged 18-25
will support the transition to adulthood. Between the ages of 16-18, young people are more susceptible to mental illness, undergoing physiological change and making important transitions in their lives.
The structure of mental health services currently often creates gaps for young
people undergoing the transition from children and young people’s mental health services to appropriate support including adult mental health services.
NHS England will extend current service models to create a “comprehensive offer” for 0-25-year-olds that reaches across mental health services for children, young people and adults.
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