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The Tories have underfunded mental health services while boasting of their generosity

The overall economic and social costs to our society of poor mental health are estimated to be more than £100bn a year.

In that context, a bill of £70,000 is, of course, a drop in the ocean. That was the cost to the Metropolitan police for dealing with almost 9,000 emergency calls from sufferers in 2017.

But the fact that all those calls came from just five people helps to force home a broader truth: when mental health services are underfunded by the government, the cost invariably shows up elsewhere. It manifests in increased demands on the police, the courts, prisons and the regular health service. It also shows up in rough sleeping.

And then there are the intangible costs. Things like disrupted education, family breakups, lost jobs, derailed careers, and of course the personal anguish for suffers and those close to them.

That's how you get to £100bn, or around 5 per cent of UK GDP.

The government spent around £12bn on mental health services in England in 2017-18, around a tenth of the total health budget. Perhaps that sounds a lot. But the reality is the ministers have indeed underfunded mental health services, along with most other public services, in the age of austerity.

In 2012 ministers made a commitment to "parity of esteem" between physical and mental health, essentially a promise that people with mental health problems would get the same access to care and treatment as those with physical ailments. Yet research by the King's Fund think tank has shown that in the following three years almost half of the 60 NHS mental health trusts saw their cash budgets fall, while most regular acute trusts saw an increase.

There was an improvement for most mental health trusts in 2016-17, but evidence suggests that their level of funding in real terms remains below the level seen before 2012. And demands on the service have grown over that period as the population has increased.

Data on total mental health spending over time is unreliable for various technical reasons, but it's likely that, per person, and adjusting for inflation, funding will have gone down under the Conservatives and the coalition. The government's own independent Mental Health Taskforce in 2016 complained about "chronic underinvestment in mental healthcare across the NHS in recent years".

If you spend less on a service, or keep funding spending below demand, the quality and availability of the service will suffer. Moreover, if that service is the treatment of people with mental health problems, there will likely be spill-over social harms. The economy will prove a false one. Ministers seem to have been in denial about this simple fact.

On World Mental Health Day in 2017 the former health secretary Jeremy Hunt boasted to MPs that there are "30,000 more professionals working in mental health than when my government came into office".

It soon emerged that the reality was an increase of around 700 and Hunt had to correct the official parliamentary record. Moreover, this small increase was driven by an expansion of psychotherapists. The number of mental health nurses is 5,000 lower.

There are some 215,000 specialist mental health posts in England and around 20,000 of them are currently filled by temporary agency staff. A survey of mental health staff last year indicated shortages of personnel and a rise of violent incidents. And a recent report by the Care Quality Commission regulator this year showed many young people are finding it particularly difficult to access treatment.

Have ministers finally got the message that the system is failing? Philip Hammond announced in the budget earlier this month that funding would grow as a share of total NHS spending over the next five years and that a "mental health crisis service" would be established.

Yet clinicians and commissioners have called for any extra funding to be ring-fenced, indicating concerns that any extra money risks being syphoned off to meet other health spending demands and that "parity of esteem" remains more of a slogan than a reality.

Given the shameful recent history of mental health treatment - the underfunding, the broken promises, the political denial - who can blame them?


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