The future of mental health services

Read more about what the current challenges are; future priorities; the proposals for change, and how Healthwatch have been involved in this process.

What are the current challenges?

The challenges faced by Mental Health services across Sussex and East Surrey are varied and complex. These include:

• Since 2013/14, funding to support mental health care services has dropped by 22% and NHS funding in our area has also dropped slightly from 10% of the overall NHS spend to 9.9%.
• There are striking health inequalities for people with serious and enduring mental health conditions such as psychosis, schizophrenia and longstanding depressive illness. People with these conditions are likely to die up to 20 years earlier than people who do not have these conditions.
• One third of all GP consultations currently include an element of mental health need and there is a strong link between physical and mental health.
• The incidence of dementia is 25% higher in our Partnership area than nationally, but diagnosis is 5% lower. We also have a higher than average growth in the older population who may go on to develop dementia.
• People are most likely to develop mental health problems (excluding dementia) before they are 25 years old, but there is concern that young people in our area are not engaging with mental health services as well as in other parts of the country.
• 25% of people in touch with mental health services have told the NHS that they do not know what to do in a crisis. Only one in seventy people in contact with secondary mental health services report having a crisis plan.
• Across the Sussex and East Surrey Partnership people with common mental health issues such as anxiety, depression and worry already have access to psychological services in line with national standards. However, there are also national targets to increase this aspect of mental health care to cover 25% more people and action is needed to ensure that this target is met.
• In our area, there may be a gap in service provision for those whose needs are complex, but who do not require secondary care assessment and treatment.

What are the priorities?

The Partnership has identified what its priorities are going forward. These include:

• Targeted services for young people aged 14-25 years;
• Adults:
  • Closing gaps in current service provision;
  • Improving crisis care;
  • Treating more people via GP-led services freeing up hospital beds for people who need this type of care;
• Improving dementia care;
• Better integration of physical and mental health care provision.

Future plans for change

Our Partnership is working towards the development of a comprehensive plan to address the issues it has identified.  Once drafted, this will require the endorsement of all the Partnership organisations.  The following recommendations give an indication of how things may change in the future:

• Increase access to therapies to include those people whose needs are too complex to be managed by existing psychological services.
• Provide more community support for people with psychosis, serious and enduring mental health problems.
• Coordinate health and care planning for dementia to avoid people getting ‘stuck in the system’ and spending too long in hospital beds waiting for longer-term care arrangements to be agreed.
• Co-produce a youth service with young people that offers support beyond traditional health and care services.
• Improve crisis care and planning to reduce confusing multiple access points to services and unnecessary visits to A&E.
• Address physical and mental health issues together; reduce stigma associated with mental health care.
• Reduce costs and strike a better balance in spending with a reinvestment of around 35% suggested for any savings generated.
• Reduce reliance on temporary staff.

Working together in partnership

The Sussex and East Surrey Partnership aims to develop plans and improve services by working alongside the people who use mental health services, their carers, the voluntary and community sector, and Healthwatch Brighton and Hove. This approach will establish a true partnership that reflects the principle of ‘no change about me without me’.

Healthwatch Brighton and Hove can endorse that mental health services in our Sussex and East Surrey Partnership have set about this journey of change in that spirit of co-production.  The Partnership’s publication of its draft ‘Case for Change’ was produced following planning meetings that included people with lived experience of mental health issues and those who care for them.  The process also included the voluntary and community sector and local Healthwatch.  Healthwatch Brighton and Hove very much hope this approach will be replicated across the Partnership, in our local communities.

David Liley, Chief Officer, Healthwatch Brighton and Hove              13/8/2017