Holistic support for people experiencing mental health problems

The Department of Health has just released plans to invest £1.3bn in expanding and transforming mental health services, including by increasing the mental health workforce with 21,000 new posts by 2020.

These plans offer a more pragmatic and holistic vision of mental health care, which, if eventually realised, will be music to the ears of people with lived experience, and the current workforce that tries to support them. Such individuals well know that mental health services can provide all the medication and talking therapy there is, but if someone doesn’t have a safe place to sleep, or the bailiffs are coming knocking, such efforts can still sometimes come to nothing.

While more support for mental health services is always welcome, what is particularly interesting about the proposed workforce changes is the focus on increasing flexibility by introducing more non-professional staff. 11,000 of the new posts – more than half the total – will be for associate or assistant type positions, such as peer support workers, personal wellbeing practitioners, and nursing associates. They will deliver interventions like brief psychological interventions and case management, alongside colleagues from more traditional professions.

The idea is to free up the professional time of qualified practitioners like psychiatrists and nurses to focus on clinical work, while passing practical and pragmatic support to people with training that is more focussed on the specific task at hand.

This should be good news for those concerned about holistic care: it could mean having staff that are dedicated to helping with all the non-medical things that go into helping someone recover and stay well, such as having a safe place to live, a meaningful occupation, good physical health, and financial security. It is also encouraging that particular mention is given to the role of occupational therapists in considering these wider determinants of health and in providing support and consultation to other sectors such as care homes or physical health care.

The plans also emphasise integrating mental health care with physical health services and with other relevant systems such as social services. Detail is lacking as to the current extent and proposed reach of such integration, but in general this bodes well for those whose mental health difficulties are affected by, or impact on other areas of their life. Better integration would mean less time trying to get your mental health team to talk to your housing worker, or getting your employment support worker the information they need about your particular mental health needs.

Integration is also the key to dealing with interconnected issues that fall between services. Our focus as a charity, on financial difficulty and mental health problems, falls squarely into one of these gaps: people experiencing mental health problems are much more likely to be in problem debt, and this can severely worsen their chances of recovery, but their health condition can also make it much more difficult to access mainstream debt advice.

We are particularly glad to see that these new resources will be focused on areas where they can have the most impact, including adult talking therapies, and crisis care settings, as well as child and adolescent mental health services. Our research suggests that both the workforce and service users in these settings will benefit from having the resources to support people with the social factors which affect chances of recovery and of relapse. Our 2016 report The Missing Link showed how adult talking therapies could improve their recovery rates by integrating debt advice into their programme, while an upcoming project will be exploring what more is needed in this field in crisis care.

In principle, the plans announced earlier this week sound like good news for people whose financial difficulties are keeping them trapped in a downward spiral with their mental health. As with all such proposed investments and transformations, however, the proof will be in the practice. And, of course, these interventions will only work if combined with timely access to high quality clinical treatment – and there are serious questions around how the government will achieve its goals in this area.

You can read more about how health services across the UK currently deal with financial difficulty here.