Isabel Hardman Isabel Hardman

Covid has forced ministers to reassess mental health

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Has the pandemic really been good for the way the NHS treats mental health? That’s the rather startling claim I report on today in my i paper column. Ministers have started to talk — equally surprisingly, it has to be said — about the possibility that they are close to reaching parity of esteem between the treatment of mental and physical health, and that the chaos of Covid is partly responsible.

Covid has certainly made it harder for the government to just offer talk and no cash on mental health

Now, it slightly depends on what your definition of ‘parity of esteem’ is. If it’s just that party strategists and purse-string-holders in the Treasury now see announcing pots of money for mental health as being equally politically beneficial as a new fund for treating cancer would be, then we probably do have cause for celebration. Mental health has gone from a niche issue to something politicians are always keen to be talking about — just look at the way things have changed since I wrote this column on how Tories were starting to think it might be worth doing something on mental health back in 2014. But the key word in that last sentence is ‘talking’: there’s been a lot of that from politicians in recent years but rather less in the way of funding.

Covid has certainly made it harder for the government to just offer talk and no cash on mental health, but that’s largely because even people with no previous experience of mental illness would generally say that the pandemic hasn’t been great for their mental wellbeing. It is also the case that demand for psychiatric services has risen, and those already in the system have found it harder to access help because of the restrictions placed on those who treat them, such as the move to video appointments. Someone with a particularly dark sense of humour might also argue that parity of esteem could be closer merely because any physical health condition that isn’t Covid has fallen down the list of priorities and there are now gargantuan waiting lists for elective surgery. The recent planning guidance issued by NHS England did state that mental health was a priority, and not just at an acute level — but it also contained detailed instructions on dealing with this backlog for physical conditions. Thus, there is likely to be parity of delay and deteriorating outcomes — but that’s not what anyone wants.

What Whitehall insiders are keen to emphasise, though, is it’s not just about the way the NHS is responding to the mental health challenge any more, but communities coming together to set up better support networks during the pandemic. The government needs to work out how it can support — or at least not make life more difficult for — these new charitable and voluntary forms of mental health help. But it also does have a huge task on its hands to bring mental health care up to scratch, as the number of missed targets in the Five Year Forward View for Mental Health planning document, finished this week, shows. So are things at least going in the right direction? Well, perhaps if you place all your emphasis on the word ‘esteem’. But it’s a bit harder to argue that the government can celebrate a job well done when it comes to waiting times, quality of treatment, and outcomes. Which is surely what matters.

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