NHS ‘Failing to deal with big rise in mentally ill’

Mental illness now accounts for almost half of all ill health among people of working age and has the same impact on life expectancy as smoking, according to a devastating report published today.

A panel of experts says that the NHS is failing to provide even the most basic treatment for mental illness to millions of people, with children particularly poorly served, and gives a warning that services are being cut back even farther because of budgetary constraints in the health service.

They say mental illness has reached an “horrific scale” in Britain and the under-treatment of the condition by the NHS “is a shocking form of discrimination”.

Today’s report, How Mental Illness Loses Out in the NHS, is written by a distinguished team of economists, psychologists, doctors and NHS managers convened by Lord Layard, of the London School of Economics.

Writing in The Times today, Lord Layard says: “Mental illness is the great hidden problem in our society. But cost-effective treatments exist. The tragedy is that so many people cannot get them, and under a third of those who need help are in any form of treatment.

“This is shocking discrimination. If your leg is broken you automatically get treated, but if your spirit is broken you do not.”

According to the report, about six million people suffer from depression or crippling anxiety conditions while 700,000 children have problem behaviours, anxiety or depression. Yet three quarters receive no treatment at all, in breach of recommendations set by the regulatory National Institute for Clinical Excellence (NICE).

One in every three families now has someone who is mentally ill, according to the report, which found widespread evidence that mental health services, particularly those for children and young adults, were being cut back disproportionately during the recession.

The report found that half of all child mental health services had their budgets cut this year, in some cases by 25 per cent or more. Some 50 per cent of mentally ill adults had a history of problems before the age of 15, and 30 per cent of all crime is committed by people who had a clinically diagnosable conduct disorder in childhood or adolescence.

The experts argue that there is an urgent need for the NHS to spend more on mental health services, despite the present financial constraints, because more expenditure on treating the most common disorders would produce significant savings in the longer term, as well as better outcomes for patients. Mental illness often increases the scale of physical illness, they say, and now accounts for avoidable expenditure of about £10 billion a year. Yet a typical cycle of therapy costs £750.

This would also bring significant benefits to the wider economy, reducing the number of working days lost and making it easier for people to return to employment. Mental illness accounts for nearly half of all people on incapacity benefits. The Centre for Mental Health estimates that mental illness reduces GDP by 4.1 per cent or £52 billion a year.

“Mental illness is central to so many of our problems,” Lord Layard said.

“Until we give more care to our troubled souls we shall struggle to build a better society. So, to all NHS commissioners we say, ‘Please give more priority to mental health. It could even save you money’.”

Marjorie Wallace, the chief executive of the mental health charity Sane, said: “Lord Layard and his colleagues highlight what we are conscious of from our daily experience at Sane. We are at an all-time low in the response of mental health services to people with severely disturbing mental illness.”

Sean Duggan, the chief executive of the Centre for Mental Health, said: “It is shocking that only a quarter of adults and children who have a mental health condition receive any treatment at all.”

Case study

Simon Lamb, 36, was diagnosed with bipolar disorder in 2008 and received excellent treatment from the NHS, combining medication and cognitive behavioural therapy.

When he became ill again at the end of last year, he was shocked to be shown the door by his local mental health services.

“I went back to where I had received my treatment before. I was told there were no services available and no staff for my kind of treatment. I subsequently received a letter saying unless I was about to rape or kill someone or posed some other sort of serious threat to others there was no prospect of treatment,” he said.

Mr Lamb, who lives in South London and was forced to give up his job as a chef when he was taken ill, is now retraining in sports massage. In the absence of proper treatment he tries to handle his condition with exercise and diet.

He says it is shocking that mental illness is treated so casually. “It is inconceivable that someone with a physical illness would be handled like this. Imagine someone with diabetes being sent home and told ‘there is nothing we can do for you’.”

by Martin Barrow