Millions of young people unable to access mental health services in England, says watchdog

Millions of people in England are unable to secure much-needed mental health support, with treatment delays particularly acute for young people living with eating disorders, a spending watchdog has revealed.

The National Audit Office said in a report released on Thursday that the expansion of mental health services in recent years had failed to keep pace with rising demand.

Between 2016-17 and 2021-22, the NHS mental health workforce increased by 22 per cent. However, referrals to mental health services over that period rose by as much as 44 per cent, from 4.4mn to 6.4mn.

While spending on mental health through the NHS has risen in recent years, there has been a reduction in other support services that support young people. At the same time, psychological problems became more widespread when the country was in lockdown.

The report found that waiting times for treatment had increased following surges in demand during the Covid pandemic.

Between April and June 2022, “just 68 per cent of young people who had been urgently referred for eating disorders were seen within a week, against a standard of 95 per cent,” it said.

The report warned that by 2023-24 there would still be sizeable treatment gaps. An ambition for 1.9mn people to access talking therapy services by the end of next year represented “just a quarter of those with a diagnosed need estimated before the pandemic”, it said.

According to NHS England, 8mn people with mental health needs were not in contact with the services they required, as of 2021, underlining the scale of unmet need.

Retaining staff was becoming “an increasing challenge”, the NAO found. During 2021-22, around 13 per cent of staff had left the NHS mental health workforce.

Gareth Davies, head of the NAO, said the department for health and social care, and NHS England, had made commitments to improve mental health services, but had not defined what achieving full “parity of esteem” for physical and mental health services would entail.

The commitment was to increase annual mental health spending by £3.4bn in cash terms by 2023-24, compared with 2018-19.

Although on track to reach that target, in the four years up to 2020-21 the percentage of local expenditure by clinical commissioning groups only rose from 11 per cent to 11.4 per cent.

Saffron Cordery, deputy chief executive of NHS Providers, said that with demand for services rising — and appointments postponed because of the continuing strikes by NHS workers — pressure would continue to mount.

“More capital funding is desperately needed to provide more therapeutic, safe and appropriate environments for people with acute mental health needs,” she said.

Andy Bell, interim chief executive of Centre for Mental Health, said the government must commit to putting in place new access and waiting time standards.

He adding that urgent focus was needed on tackling the causes of mental ill health like poverty, poor housing, racism and discrimination.

Tom Quinn, director of external affairs for Beat, a charity that supports sufferers of eating disorders, said it was “very concerning but sadly not surprising” that children and young people were waiting for long periods for treatment.