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It really is 'Time to Change' both attitudes and provision for mental health illness

4 December 2017

With one in four British workers affected by conditions like anxiety, depression and stress every year, changing attitudes and providing better support for people with mental health problems has never been so important.

That's why HEE joined a growing movement of more than 500 employers who have pledged their commitment to change the way we think and act about mental health in the workplace. To support this we recently started work on a Health and Wellbeing Strategy with contributions from colleagues across HEE.

For me personally, our pledge to the Time to Change campaign, which is being led by the charities Mind and Rethink Mental Illness, underpins a much broader commitment to mental health as a key priority for all of us.

Stepping Forward to 2020/21

Recently, HEE published Stepping Forward to 2020/21: the Mental Health Workforce Plan for England.

This Plan sets out our vision of the workforce, training and education improvements needed to deliver a major transformation of mental health services. It forms a key part of our response to the review of mental health care carried out by the Independent Mental Health Task Force on behalf of the NHS and the Department of Health in 2016.

The Task Force set out the improvements needed in the Five Year Forward View for Mental Health.

They include:

  • Improved access to services at an earlier stage – with an extra one million people able to access mental health services by 2020/21
  • More services accessible at the right time – 7 days a week, 24 hours a day when needed
  • Mental health Services delivered in a more integrated way – including more mental health services in physical healthcare settings, expanded access to places of safety and improved crisis support
  • "Hard wiring" mental health services into the NHS – through improved data, the right workforce and more investment in research.

This all adds up to an exciting but ambitious programme.

HEE's Workforce Plan aims to help local regions and STPs around the country deliver this vision by offering a high-level road map from which local workforce plans are developed.

Such is the scale and complexity of the task we face that our Workforce Plan makes clear that only by working in partnership with providers, commissioners, local government and many other partners will we be able to make the improvements needed.

Within my region in the South, I have asked Wessex Local Director, Ruth Monger, to lead this work. This will involve coordinating the support given to the STPs in my area, not just by HEE, but also across many other partners such as NHS England, NHS Improvement and Public Health England. The first network meeting of the South Mental Health People Matters Group took place recently, it was a great opportunity to learn together and develop our approach to the local STP mental health workforce plans.

The challenges ahead

A recent presentation to our Local Education and Training Board underlined for me the challenges ahead.

In the South, it is estimated that by 2021 the number of people accessing treatment will increase by 92%. Rapidly expanding our mental health workforce is therefore critical.

We estimate that across the South we will need an additional 4,000 posts to meet rising demand. Nationally, to achieve the workforce requirements outlined in the Mental Health Workforce Plan, an additional 19,000 staff are needed by 2020/21. The problem is, recruitment for mental health care, whether in to training, particularly for psychiatry, or in to key vacancies, has not been easy, whether locally or nationally.

There are opportunities to improve the retention of existing mental health staff as the turnover of staff in mental health is higher than in other areas of health care.

We also need to up-skill both existing and future staff to provide new models of care in new settings so we can meet a changing range of mental health needs in the future.

Despite these challenges, I feel hopeful about the task ahead of us and the future. Improving both attitudes to and services for those with mental health needs, whether in the workplace or across healthcare, is clearly on the agenda not just for HEE but for government and our partners.

The government has committed £1.3 billion a year to be invested in mental health services by 2021 and it has pledged reform to the Mental Health Act. In the NHS and among partners we are also starting to see exciting innovations which are successfully transforming services. Above all, there is a feeling of a real consensus about what needs to be done and a genuine desire to improve our approach to mental health.

And that is why I believe, if ever there was a "Time to Change", then it really is now.

Posted by Patrick Mitchell, Regional Director - South, Health Education England

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