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The government is working towards a ‘parity of esteem’ between mental and physical health, and there is some evidence that this approach is bearing fruit.
Over 700,000 more patients received cognitive behavioural therapy through the improving access to psychological therapies programme in 2016, compared with the previous year. Latest spending figures show clinical commissioning groups in England have increased their spending on mental health by 6% (compared with a growth in budgets of under 4%) and national spend on specialist mental health is up by 3%.
The figures look impressive but everything on the ground is far from rosy. Thousands of patients are waiting more than six months for access to talking therapies (with many people waiting for longer than a year), budgets are still well below 2011 levels and patients with mental health conditions are still being placed in residential care far away from where they live.
The National Society for the Prevention of Cruelty to Children released figures showing that nearly 35,000 referrals were made by schools for children requiring mental health treatment, up by a third between 2014–2015 and 2017–2018. Although there may be many reasons for this, the NSPCC said that a third of those referrals did not result in any treatment because they did not meet the criteria for the service.
In this environment, it is essential that all sectors play their part. A Royal Pharmaceutical Society paper published on 6 June 2018, in conjunction with the charities Mind and National Voices, outlines a new role for pharmacy in supporting people with psychological problems and says the sector offers the “greatest untapped potential”. And this is true.
Pharmacists could make a real difference: helping to identify patients early before their condition gets more serious, reviewing their medications after a diagnosis and improving their wider wellbeing. But capacity has to be built into the system for this to work.
Specialist mental health pharmacist expertise is scarce and community pharmacies are far too busy to carry out this work routinely without adequate resource. For example, embedding mental health into the new medicines service — as planned by the PSNC — could make sense, but adequate resource and training has to be in place.
Of course, locally, there are some inspiring examples of what pharmacy can do. Take a recent pilot in Sussex, which saw community pharmacies carrying out physical monitoring of children with attention deficit hyperactivity disorder, measurably improving their care and freeing up local child and adolescent mental health services by 40%. This shows the potential of what can be achieved, but a national push to provide additional resources and break down organisation and cultural barriers between pharmacy and other sectors could achieve even more.
Pharmacy can make a real difference to the nation’s mental health, but it requires concrete change in order to allow it to do so.
