22 May 2023

Is parity enough for mental health?

By Jennifer Turner, Account Executive, Evoke Incisive Health & James Maxwell, Account Manager, Evoke Incisive Health

Achieving ‘parity of esteem’ has long been the ambition of mental health campaigners; the principle that mental and physical health are seen as just as equally as important as each other. Throughout the history of the NHS, mental health care and treatment has too often been left in the shadow of physical health, without the funding or prioritisation needed to drive sustained improvements or create new capacity. To some extent, the lack of focus on mental health was historically reflective of social attitudes, and to this day, services continue to lag behind that expected of a modern healthcare system.

The Government’s embrace of parity of esteem in the 2010s was supposed to rectify this situation. Ringfenced funding was introduced, policy plans written, and a new age of improved mental healthcare seemed in the offering. 

To some extent, we saw the culmination of this approach this week with a new call for evidence for the proposed five-year major conditions strategy. By bringing mental health together with five other groups of major conditions, the Government believes the plan will address the interlink between mental and physical well-being and bring parity that one step closer.  

However, as the UK celebrates Mental Health Awareness Week 2023, mental health services are unquestionably facing a severe crisis. Demand spiked during the pandemic, leaving mental health services with extraordinary waiting lists and demand far outstripping capacity. In particular, children and young people’s services are facing huge backlogs, and the inability of adult services to recover are a contributing to the economic inactivity problem

With plans for a 10-year mental health plan now being wrapped up into an integrated care strategy, it is important to consider whether the needs of mental health patients are at risk of getting lost amongst the other major (physical) conditions. Given the scale of the crisis facing mental health services, which seems to be as severe if not more than the rest of the NHS, is the new focus on ‘parity of approach’ enough to improve mental health services? 

The 2018 review into the Mental Health Act by Professor Sir Simon Wessely laid bare the inadequacies of the current approach to mental health. The legislative framework which governs how services are run dates back to 1983, and carries with it many of the societal assumptions about mental health which existed at the time. Five years on, the law continues to be unreformed, despite a draft bill being presented before Parliament.

The NHS mental health estate is, too, outdated, with buildings and facilities crumbling and the environment it creates running counter to the type of healing care which the health service inspires to achieve. The cost to fix this is immense, and with no room for manoeuvre on capital spending, the challenges in delivering high-quality care are set to continue.

Given these challenges, it is not surprising many in the mental health community criticised the move away from a 10-year plan for mental health towards a five-year plan which incorporates many different major types of conditions, each with their own set of challenges. 

While the inclusion of mental health in the major conditions strategy represents progress towards parity of esteem, it is an insufficient step to addressing the unique complexities of mental health. It is therefore vital to consider what comes after the strategy and prioritise the development of comprehensive, dedicated initiatives that promote improved mental wellbeing for all.

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