Statistics on expenditure

It is not possible to give a total figure for the Government’s investment in mental health, as there is no ring-fenced allocation and mental health services are commissioned variously by NHS England, Clinical Commissioning Groups (CCGs), local authorities and schools.

CCGs are responsible for commissioning the majority of mental health services, including psychological therapies and child and adolescent mental health services (CAMHS). CCG spending accounts for around 60% of total health spending.

CCGs spent a total of £7.8 billion on mental health services in 2013/14 and £8.3 billion in 2014/15. CCG expenditure for 2015/16 is forecast to be around £8.6 billion.[1]

NHS England is responsible for commissioning specialised mental health services, including specialised inpatient and some specialised outpatient services, and secure psychiatric services.

Figures for NHS England’s total spend on mental health are not available, as direct commissioning spend on mental health services is not routinely split into the different categories of expenditure.

Local authorities also commission some mental health services. As part of their public health functions, local authorities are responsible for commissioning public mental health programmes, including mental health promotion, mental illness prevention and suicide prevention, and a range of services that may support people with mental health problems, such as smoking cessation. For children and adolescents, local authorities may commission educational psychologists, parenting programmes, social worker teams and mental health in schools services.

An investigation by the Mind charity found that local authorities spent, on average, one per cent of their public health budgets on helping people avoid developing mental health problems in 2014 – 2015.[2]

Recent Government investment

Additional investment for mental health

In the March 2015 Budget, the Chancellor of the Exchequer announced £1.25 billion of additional investment in mental health. £1 billion will be provided over the next five years to start new access standards for children and adolescent services, which the Government anticipates will see 110,000 more children cared for over the next Parliament. The Government have also committed to investing £118 million by 2018-19 to complete the roll-out of the Children and Young People’s IAPT programme, to ensure talking therapies are available throughout England. Alongside this, £75 million will be provided between 2015 and 2020 to provide perinatal and antenatal mental health support for women. The Department for Education will also invest £1.5 million to pilot joint training for designated leads in CAMHS services and schools to improve access to mental health services for children and young people.[3] In August 2015, it was announced that £75 million will also be allocated to support CCGs to work with local partners to develop local transformation plans, which will overhaul mental health services for children and young people in their areas.[4]

NHS England has published how tranches of funding will be spent on children and young people’s mental health services: http://www.england.nhs.uk/2015/08/03/cyp-mh-prog-launch

In the Spending Review and Autumn Statement 2015, the Chancellor announced an additional investment of 600 million in mental health services:

Investing an additional £600 million in mental health services. Additional investment will mean that significantly more people will have access to talking therapies every year by 2020. NHS England’s Mental Health Taskforce will report in early 2016 and the government will work with them to set out transformative plans, including for perinatal mental health and coverage of crisis care.[5]

CCG spending on mental health

NHS England’s planning guidance for 2015/16 set an expectation that CCGs should increase spending on mental health in line with their funding allocation increase:

The Mandate from the government to the NHS is broadly stable, apart from the introduction of new and important access standards for mental health. These form part of our wider ambition to achieve a genuine parity of esteem between mental and physical health by 2020. To support that ambition, we expect each CCG’s spending on mental health services in 2015/16 to increase in real terms, and grow by at least as much as each CCG’s allocation increase.[6]

In September 2015, the Government said that about 90% of CCGs had planned to do so:

Planned expenditure on mental health for each CCG was collected as part of the planning process and checked to see whether the planning requirement had been met. Approximately 90% of CCGs either met or exceeded the planning requirement. Any CCG that did not meet the planning requirement was subject to further assurance through the planning process to ensure that there was a clear rationale for the planned level of investment.[7]

However, the Shadow Public Health Minister, Luciana Berger, submitted Freedom of Information (FOI) requests to each CCG in England in August 2015. It was reported that 50 of the 130 CCGs who responded planned to reduce the proportion of the budget they allocated to mental health for this financial year. It was reported that on average the figures suggested that in 2015/16 CCGs were planning to allocate 10% of their budgets to mental health, compared with 11% in 2014/15. In response, the Department of Health said “We do not recognise these figures”.[8]

Further reading

Further information is available in the Library briefing on Children and young people’s mental health – policy, CAMHS services, funding and education.

The King’s Fund, Mental health under pressure (12 November 2015): http://www.kingsfund.org.uk/publications/mental-health-under-pressure

[1]     PQ 16386 [on Mental Health Services: Finance], 24 November 2015

[2]     Mind, Public Mental Health in England 2015 

[3]     HM Treasury, Budget 2015, March 2015, pages 59-60

[4]     Gov.uk, Better mental health for the young: where, when and how to target funding, 12 August 2015

[5]     HM Treasury, Spending Review and Autumn Statement 2015, page 31

[6]     NHS England, THE FORWARD VIEW INTO ACTION: PLANNING FOR 2015/16, December 2014, page 5

[7]     PQ 8657 [on Mental Health Services: Finance], 14 September 2015

[8]     Ministers accused of failing to keep mental health pledge, BBC, 24 August 2015

 

 

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