The government’s neglect of pandemic mental health support is about to lead to a huge crisis

If the rhetoric from ministers about prioritising mental health were matched by anything resembling reality, the UK would not have too much to worry about on this vital issue. Sadly, normal service has continued during the coronavirus pandemic: despite promises by successive governments for mental health to enjoy parity with physical health, it is again the very poor relation.

At the start of the crisis, our politicians were understandably anxious to avoid a repeat of the gruesome television pictures showing Italy’s overwhelmed hospitals. Putting hospitals first had a terrible impact on care homes, after up to 25,000 hospital patients were discharged to them without being tested for the virus.

Like social care, mental health is an unglamorous and often invisible part of our “cradle to grave” system. Ministers would much rather be filmed in shiny new hospitals; the cameras rarely capture them visiting mental health units or care homes. It is hard to imagine a Nightingale mental health facility miraculously appearing. Boris Johnson likes to trumpet his 40 “new” hospitals, even though more than half involve rebuilding projects or extra units on existing sites. Only two are mental health facilities.

Although the government announced the removal of mental health dormitories in a £1.5bn package in June, this will take four years and the emergency top-up also covered hospital construction and maintenance and accident and emergency capacity. An extra £10.2m has been given to mental health charities. But one, the Centre for Mental Health, predicts that up to 10 million people in England, almost one in five of the population, will need mental health support as a direct result of the pandemic.  Two-thirds will be people whose existing problems have been made worse, while a third will have developed new problems.

NHS Providers, which represents hospital, mental health, community and ambulance services, has accused the government of  “structural discrimination” against mental health by ignoring the huge psychological damage in the crisis.  While saying some progress has been made in the past decade, the NHS bosses fear the government has lost focus at a critical moment. The result is cancelled appointments, delayed or no treatment, condemning many people with depression, anxiety and post-traumatic stress disorder to “distress, pain and suffering”.

According to the centre, 1.5 million of the 10 million likely to need treatment will be under 18. The months of lost schooling, anxiety over examinations, reduced contact with friends and less physical activity will all take their toll. Anne Longfield, the children’s commissioner for England, points out that a third of children are worried about their future, with one in six likely to have a mental health condition. She is right to call on the government to address this problem in next month’s spending review, and ensure every school has a mental health counsellor; at present, fewer than half of England’s schools do.

Nor should the impact on university students, especially those living away from home for the first time, be underestimated. Then there are the NHS and care staff who, having hardly paused for breath since the pandemic began, must go through the fire again in what will likely be a very long, hard winter. As we reported on Sunday, mental health problems account for up to 20 per cent of absences at leading hospitals.  

There is merit in Labour’s proposal for a mental health and wellbeing guarantee, including a “care for carers” package with a 24/7 phone line for health and care workers.

Mental health must not remain at the back of the queue behind Covid treatment, the alarming backlog of people with non-Covid conditions such as cancer, and the economy. Rishi Sunak, the chancellor, wants the latter to be given a higher priority in the government’s decision-making and in the information it makes available to the public. Of course, ministers must perform a difficult balancing act as they try to protect lives and livelihoods. But the health element of the equation must be about more than hospitals.

The emerging evidence about “long Covid” is worrying enough. The government must act now to prevent a mental health crisis becoming the pandemic’s awful legacy.