Unsurprisingly, health spending will be a key part of Rishi Sunak's spending review announcements this afternoon, with the Chancellor expected to pledge £3 billion for the NHS as it recovers from the pandemic. Part of that will be a £500 million boost for mental health, which accompanies a 'winter care plan' that was published earlier this week. Ministers are very keen to say they recognise the pressure that the pandemic has put on services and people who may be developing mental health problems for the first time, as a result of the strain they have found themselves under this year.
But this money won't go very far. The Strategy Unit within the NHS has developed a mental health surge model, which suggests that new referrals alone will rise by 11 per cent every year for the next three years, and the cost of this will be over £1 billion a year. The analysis makes clear that 'these figures are in addition to the approximately 500,000 people that were not able to access services during the first national lockdown'. As with physical illnesses, it is not possible to press pause on a mental illness because a pandemic is underway, and so many of those 500,000 will have deteriorated, possibly to the point that they need a greater level of care than before.
There is an acceptance behind the scenes that those with a pre-existing mental illness have found this year almost impossible. But there is also a battle raging within Westminster about the effects of the pandemic on mental health more widely. Mental Health Minister Nadine Dorries has been pushing back against suggestions that suicides have risen recently, and has been keen in parliamentary debates to make a distinction between mental health and mental wellbeing, suggesting that the latter may well suffer as a result of the strain placed on many people by Covid, but that this is different to having a diagnosed mental illness.
It is true that the two are often unhelpfully conflated: feeling stressed and miserable because you have lost your job is not the same as having a mental illness. But it is also the case that the stress and misery of losing a job can lead to someone developing a mental health problem which does require treatment. So the distinction is perhaps not as important as some in government are suggesting: either way, there is a surge in demand that has yet to fully manifest itself. Given mental health services were under-funded and under-staffed before the pandemic, this £500 million will be stretched very thinly indeed.