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NHS: 70 years of mental health care

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For the past seven decades, the NHS has transformed mental health services to ensure that more people are receiving the right care in the community and to minimise the amount of time people need to spend in hospital.

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NHS: 70 years of mental health care

  1. 1. For the past seven decades, the NHS has transformed mental health services to ensure that more people are receiving the right care in the community and to minimise the amount of time people need to spend in hospital. A transformation in mental health care since 1948
  2. 2. ASYLUM 1954 The Percy Commission, created by Churchill’s Government, recommended that mental health treatment be part of the wider health system and integrated in the NHS. A new Mental Health Act was passed, providing a legal framework for medical treatments to be given to detained patients and making their rights clearer. The National Service Framework for Mental Health was a 10-year agenda for improving mental healthcare in England and set quality standards covering all major mental health services for adults. The Improving Access to Psychological Therapies (IAPT) programme has transformed treatment of adult anxiety disorders and depression. Over 900,000 people a year now access evidence-based psychological therapies. 1983 1999 2008 Improving Access to Psychological Therapies
  3. 3. £ 2015 The independent Mental Health Taskforce brought together health and care leaders, charities and services users to create a strategic approach to improving mental health. The Five Year Forward View for Mental Health covers care and support for all ages and represents the first national strategy to improving mental health outcomes across the whole health and care system. NHS England published its Implementation Plan in July 2016 to present the blueprint of how mental health services are going to be transformed by 2020/21. 2016 2021
  4. 4. 0 20k 40k 60k 80k 100k 120k 140k 160k 1950 1960 1970 1980 1990 2000 2010 Mental health inpatients 0 100 200 300 400 500 600 700 800 900 1000 1950 1960 1970 1980 1990 2000 2010 Average length of stay (days) 70 years ago, mental health care was provided by a system focusing on acute and long-term care based in large institutions. It has steadily been replaced by one in which most care is being provided in community settings by multidisciplinary mental health teams. From 1950 to 2010, the number of people with mental health issues that had to stay in hospital to receive treatment dropped by 84%. The number of people receiving treatment without staying in hospital was multiplied by 4 during that period.
  5. 5. Following the adoption of the new Mental Health Act, the number of people compulsorily detained dropped by 85% (to 17,200 people in 1960) as people could now receive care in the community for the first time. Three maximum security hospitals provided most secure care until the development of medium and low secure services from the 1980s, and now community forensic services are a key part of the model of care. Community Mental Health Service Community Mental Health Service
  6. 6. 0 10k 20k 30k 40k 50k 60k 70k 1950 1960 1970 1980 1990 2000 2010 Clinical psychologists Consultant psychiatrists Mental health and learning disabilities nurses Since the creation of the NHS, the mental health workforce has steadily increased. By 2020/21, at least 1,700 more therapists and supervisors will need to be employed to meet the increased access targets set up by the Five Year Forward View for Mental Health.
  7. 7. An ambitious programme to transform mental health services in England By 2020/21: • £1 billion investment since 2015/16 to support 1 million extra people of all ages • All acute hospitals will have all-age mental health liaison services • 70,000 more children will access mental health care • At least 30,000 more women each year will access evidence-based specialist perinatal mental health care • 600,000 more people with common mental health issues will access psychological therapies • 280,000 people with serious mental health issues will have access to physical health checks and interventions
  8. 8. The future of mental health NHS England recognises there is further to go before mental and physical health are on an equal footing and that we need to take advantage of digital innovations to make this happen. Technologies are changing fast. For the future of mental health this could lead to: • remote therapy through virtual and augmented reality • mobile virtual working becomes the norm • more shared versatile community hubs • virtual therapists able to meet patients’ needs faster and at any time

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