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All the Ways Jeremy Hunt Is Messing Up Mental Health Care in Britain

He's made promise after promise, but services are still in disarray.
NHS Confederation

Proof, if you need it, that Health Secretary Jeremy Hunt is living up to the accidental nickname given to him by Jim Naughtie on BBC Radio 4's Today programme: last week, every health secretary of the last 20 years, two former NHS chief executives and seven former junior health ministers signed a letter in the Times condemning the "enduring injustice" faced by patients with mental illnesses, saying they are "dismayed" at what they say is a failure on the NHS' part to honour its pledges – such as David Cameron's 2015 promise to treat mental health in the same way as it would treat physical health. One of the signatories, former health secretary Norman Lamb, called the current state of mental health services a "stain on our country".

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You've got to wonder where you went wrong when the previous nine people to do your job are openly telling people you're rubbish. But Hunt has flat out denied that they could have a point. "We are making progress against our goal to address the difficulties faced by those with mental health problems," he said in response. "Spending by clinical commissioning groups has increased by £693 million; every area in the country has put together plans to transform children's mental health services; and our suicide prevention strategy is to be refreshed, all backed by added investment."

So there you go. But given that Hunt has refused to accept that literally every single person to do his job over the last two decades could have a point, we thought we should help him see the bigger picture, by compiling a list of all the ways he's screwing up mental health services.

He's Hidden The Figures

We can't know if the £693 million figure he's quoted is true because the government axed statistics on changes to mental health funding in 2013, when one study dared to show that funding had fallen.

If Hunt is fudging the figures, it wouldn't be the first time. Just three months after he took up office, the UK Statistics Authority – an independent watchdog – upheld a complaint by Labour that Hunt had falsely claimed that spending on the NHS increased under the coalition.

The Department of Health is yet to reply to a request for comment on these points.

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He Promised Spending But Budgets Were Actually Cut

Since he's stopped the figures being published, Labour MP Luciana Berger tried to find the numbers by submitting Freedom of Information requests to clinical commissioning groups – which plan healthcare for a local area – to ask what percentage of their budget they spend on mental health services, and whether they plan to spend more or less than last year in 2017.

Of the 211 clinical commissioning groups in the UK, 128 responded to the latest request, with 57 percent saying they would spend less on mental health next year compared to 2015/16. Some of these groups still haven't responded to the request for figures. Berger says this could be because they're planning to cut mental health spending, too – so the national picture is likely to be even bleaker.

A Department of Health spokesperson told VICE that "NHS England's latest projections show that Clinical Commissioning Groups do plan to increase mental health spending." When that will happen is unclear.

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The Money he Promised to Young People's Services Hasn't Arrived

This kind of patchy, opaque funding means the help you may or may not receive is totally based on where you live. It's what commenters call a "postcode lottery". Some children are waiting up to two-and-a-half years to access mental health services, depending on where they live.

Professor Dame Sue Bailey, chair of the Children and Young People's Mental Health Coalition, says last year the government promised a £1.25 billion investment in child and adolescent mental health services. "To date, very little of this seems to have reached the front line," she says.

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"Transforming services will take sustained commitment, equitable investment and a more consistent approach. It is equally important that any investments in services are ring-fenced," she added.

When approached by VICE, the Department of Health said the money would all be made available "over the course of this Parliament as we promised" – but it was still not clear when, over the next four years, that would actually happen. "All the plans put together to receive funding for children's mental health were robustly tested and overseen to make sure the money is properly spent," they said. "In part due to that rigorous process, in future years we will invest in more new staff and innovation to provide the transformation we want to see in mental health provision."

People Have To Wait Until They're In Crisis Before They Get Any Help

Policy wonks say the worst-affected services are those that focus on prevention and early intervention.

But the way Hunt's cash-strapped system works, vulnerable people are offered services based on criteria such as whether they have been unwell for long enough for their condition to be considered serious. This doesn't account for the fact that when someone is struggling with mental health problems, their first meaningful involvement with a professional is often after things reach crisis point.

"By stepping in early, crisis can be averted, yet as a nation we have a shortsighted approach to mental health," says Marguerite Regan, policy manager at the Mental Health Foundation.

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Regan points out that removing funding for frontline services has just made it harder for the government to keep up with the number of people looking for help in an emergency. "All services are part of a larger system," she says. "When you remove funding and collapse one part of the system, the pressure naturally amasses elsewhere. So even if we increase funding for crisis care, we are simply running to stand still with increased demand."

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Even People In Crisis Can't Get Help

Step back from the numbers and the strategies and you'll find a system failing those who most need help.

Just this week, stories have emerged about a patient kept waiting on a hospital bed for two days. Self-harm is on the rise, especially self-poisoning among young girls. Psychiatrists who treat people with eating disorders have said that in some parts of the country patients who are very unwell have to lose more weight to qualify for treatment. Mental health sufferers are still being held in police cells while they wait for treatment, sometimes with fatal consequences.

Professor Dame Til Wykes, Vice-Dean of Psychology and Systems Sciences at the Institute of Psychiatry, Psychology & Neuroscience, King's College London says that, at this point, people cannot have failed to understand the consequences of poor mental health on individuals, families and the economy. "Yet, despite promised investment in mental health services," she says, "they have suffered the opposite – cuts. Why? It is just unfathomable. If this was a physical health problem like cancer or heart disease people wouldn't stand for it."

Paul Farmer CBE, CEO of mental health charity Mind, says the letter in the Times is an important first step in getting people the help they so desperately need, but that the government must follow through on its commitments before the situation improves. "The next 12 months are going to be critical for that delivery to be achieved," Farmer says.

It will also be a critical 12 months for Hunt's legacy as Health Secretary, already tarnished by battles over the seven-day NHS, junior doctors' contracts and calls for him to resign from health professionals and patients. They will be hoping that the one promise he doesn't break is one he made when he became health secretary in 2012: to step down in 2017.

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