Mental health care provision in the UK is "overwhelmed and at breaking point", with devastating consequences for patients and knock-on effects on the rest of the health service, health leaders warned.
The NHS Confederation marked World Mental Health Day to express concern that as mental health "slipped down the Government's list of priorities", demand was "washing up on the shores" of emergency departments and other NHS services.
It came as a new survey of 4424 nursing staff published by the Royal College of Nursing (RCN) revealed that 95% of respondents believed that equality between mental and physical health care was not being achieved, despite a commitment to this within the NHS Constitution in England since 2013.
The RCN said that NHS services were still not treating people holistically by joining up physical and mental health care, even though some patients with mental health issues had their lives shortened by 15 to 20 years. Despite significant new investment in mental health services since 2019, "levels of distress are rising faster than services can grow to meet them", the College warned.
Mental Health "the Poor Relation in the NHS"
Mental health remained "the poor relation in the NHS", with nursing staff reporting that patients were being forced to wait for months and travel miles for treatment, or were resorting to paying for private mental health care. Vacant mental health nursing posts were disproportionately high – almost one-third of all nursing vacancies in England, compared with only 13% of the nursing workforce.
Professor Nicola Ranger, RCN chief nurse, said: "Despite many years of promises and commitments for equal treatment of physical and mental health care, nursing staff are seeing things heading in the wrong direction. Governments across the UK are failing to provide the funding and resources that mental health care services need, with serious care consequences for patients and service users."
Responding to the survey, Saffron Cordery, deputy chief executive of NHS Providers, said it revealed the "urgent national problem" and echoed the call for action with more long-term investment, including for staff, capital to transform dated facilities, and early intervention and prevention.
There were 1.9 million people on waiting lists for mental health care, she said, and lists were lengthening. "Stretched mental health services" had "a capacity crunch", with too few staff and resources to meet growing demand.
"NHS trusts are extremely concerned that so many people, especially hundreds of thousands of children and young people, have long waits for the help they need," she said.
"National Emergency" – Mental Health Patients in Crisis
The NHS Confederation said that neglect of community mental health services and lack of suitable hospital beds meant that mental health patients were frequently turning up in A&E "in crisis because of a lack of alternative and more appropriate options".
Once there, they faced waits of up to 80 hours. Recent data had shown that mental health patients were more than twice as likely as other patients to wait 12 hours or more in A&E, with nearly one in five waiting for over half a day in June 2023.
The "growing crisis" was having "profound effects on patients and the wider NHS", the Confederation warned. Thousands of mental health patients were being admitted into inappropriate acute hospital beds, which both risked their mental health deteriorating further and delayed treatment for patients who were physically ill, it said.
Mental Health Patients and Services Being "Forgotten"
Matthew Taylor, chief executive of the NHS Confederation, said that the current focus on elective recovery, industrial action, and GP access, meant that mental health had "slipped down the Government's set of priorities", and patients and services were being "forgotten". The "national emergency" was having "serious consequences across the board", he said.
Increasing demand for mental health support, with limited supply in the community, was "washing up on the shores of wider NHS services and having a knock-on effect on the care of other patients, waiting times, and recovery efforts".
He called on the Government to make urgent and targeted investment in community mental health teams, temporary step-up beds, and specialist staff, ahead of the winter months. However, many solutions lay outside the NHS, "not least with the need for more supported housing and social care support".
"No Health Without Mental Health"
Also marking World Mental Health Day, Dr Lade Smith, new president of the Royal College of Psychiatrists, called on all political parties during the current conference season to prioritise mental illness, "because there is no health without mental health".
More than 2.5 million adults across the UK were currently out of work due to long-term sickness, she said, of which 1.35 million had mental health problems. While waiting for treatment, "too many will end up in A&E in crisis", and often had to wait days for an inpatient bed.
"These delays make recovery from mental illness so much harder and cost the NHS and the economy more in the long run." The crisis was having a "devastating effect" on the lives of thousands of people, particularly children and young people, she said.
"I implore our political leaders to focus on the public mental health emergency gripping our country."