Is there ‘parity of esteem’ between mental and physical health?

Mental health has long been regarded as a poor relation of the NHS. Years of under-investment means that people with mental health problems often experience poorer access to services and lower quality of care than those with physical health conditions. For example, long waiting times are still common for psychological therapy; many people receive care in facilities outside of their home area because they cannot get the right care locally; and services for children and young people are widely regarded as inadequate.

In response to this, the Health and Social Care Act 2012 created a new legal responsibility for the NHS to deliver ‘parity of esteem’ between physical and mental health, which the coalition government subsequently committed to achieving by 2020. Parity of esteem means equal access to effective care and treatment; equal efforts to improve the quality of care; equal status within health care education and practice; equally high aspirations for service users; and equal status in the measurement of health outcomes (Royal College of Psychiatrists 2013).

(…)The commitments made in The five year forward view for mental health build on ongoing work designed to put mental health on a more equal footing with physical health. One component of this is the new waiting time standards introduced for psychological therapies and for early intervention services for people experiencing a first episode of psychosis. This is the first time that access targets, which have been used in some parts of the NHS for many years, have been set for mental health, providing an important driver for improving access to these services. The five year forward view for health recommended extending the scope of these standards to include a wider range of services over the next few years.

However, despite the increased profile of mental health at the national level, within local health systems much of this is overshadowed by concerns about funding. An analysis conducted by The King’s Fund found that in 2015/16, 40 per cent of mental health trusts in England received a real-terms decrease in their operating income. This is despite clear expectations from NHS England that clinical commissioning groups (CCGs) should increase mental health spending at least in proportion to overall growth in their budgets.

Full article from the Kings Fund, 12 May 2017