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According to everyone from the Royal College of Psychiatrists to the Chief Medical Officer and the Deputy Prime Minister, mental health is a key priority for the NHS. So why does spending seem to be falling?

"It's time for us to bring mental health out of the shadows and to give people with mental health conditions the support they need and deserve." So said Deputy Prime Minister Nick Clegg in January this year, speaking at the launch of a government initiative called 'Mental health: priorities for change'. Eight months later, there continue to be dire warnings about a funding crisis from senior figures across the mental health spectrum, from clinical psychiatrists, psychotherapists and psychologists to mental health nurses and community psychiatric nurses.

In a recent interview with the BBC, Chief Medical Officer Dame Sally Davies echoed the sentiments of many mental health professionals in expressing concerns about cuts in mental health spending in real terms. A report in April by the Nuffield Trust showed that spending on mental health, one of the 'top three diseases categories in England', rose by more than a third between 2003 and 2011. However, according to figures released by the Health Services Journal in August, mental health trusts have suffered a 2.3% real terms funding cut between 2011-12 and 2013-14, and there has been a 6% reduction in mental health nursing staff. 

Freedom of information (FOI) requests to the country's 211 GP-led local NHS clinical commissioning groups (CCGs) by Luciana Berger, Shadow Public Health Minister, show that some spend as little as 6.6% of their budgets on mental health, even though it accounts for 28% of illness. According to Professor Sir Simon Wessely, President of the Royal College of Psychiatrists, while many CCGs are allocating budgets based on need, some are not, particularly those with the highest levels of demand. "Although many CCGs are certainly getting it right," he said in an interview with the website hospitaldr.co.uk, "there are those who need to urgently reconsider whether they are giving mental health parity of esteem with physical health, as their patients rightly deserve."

Perhaps most worrying is the impact on Children and Adolescent Mental Health Services (CAMHS). Leading charity YoungMinds recently warned of a national crisis in service provision. They've discovered, again through FOI requests, that 74 out of 96 CCGs and 59 out of 98 local authorities in England have frozen or cut their CAMHS budgets. Andy Bell, Deputy Chief Executive of the Centre for Mental Health, commented, "Three quarters of children with emotional and behavioural problems get no specialist help or support. Cutting early intervention services is a false economy that will leave children at risk of long-term mental and physical health problems and poorer life chances."

Care and Support Minister Norman Lamb has promised that, by next April, the coalition will introduce maximum waiting times for mental health treatment for the first time, so ending 'an institutional bias against mental health' in the NHS. It's a step in the right direction. But the people who work on the front line – psychiatrists, psychologists and mental health nurses – will no doubt be focusing on a different waiting time: how long it will be before mental health gets the funding it deserves. 

Do you work in mental health services? Let us know what you think by leaving a comment below or tweeting us @SanctuaryHJobs.

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