Mental health target being ignored

Freedom of Information figures suggest a quarter of clinical commissioning groups are ignoring the target.

NHS England says it is investing more money in services, to help meet demand.

Early intervention

The waiting-time target requires that any patient aged 14 to 65 experiencing their first episode of psychosis – a mental health problem that can involve delusions or hallucinations – receives treatment within two weeks of referral.

But the FOI request, sent to the 209 CCGs in England by the Liberal Democrats, shows that in some areas this is not happening.

Of those that responded (170 out of the 209), 23% said they had applied the target to for 14- to 35-year-olds only. And more than three-quarters of those had no firm plans to extend it to 35- to 65-year-olds this year.

The package of intensive treatment that should ne provided, known as early intervention in psychosis (EIP), involves support for patients from a range of health professionals, including psychiatrists, mental health nurses and social workers, and should match the “best practice” blueprint contained in guidelines laid down by the clinical watchdog NICE.

Evidence-based treatment

But documents seen by the BBC suggest most mental health trusts in one part of England were unable to say whether their care package had been delivered in line with the NICE requirements.

NHS England estimates EIP should cost the NHS £8,250 a year per patient.

About 64% of the CCGs that responded to the FOI request did not or could not say what they were spending on EIP, and another 29% said they were spending below £8,250 per patient. Meanwhile, 32% of the CCGs could not say what their overall planned spending on EIP would be this year.

Liberal Democrats health spokesman Norman Lamb said: “It shows that across the country people are not getting the evidence-based treatment set out in the programme.

Psychotic symptoms

“It is like saying to a cancer patient, ‘You can have the chemotherapy, but you cannot have the radiotherapy.'”

Sarah Broadbent runs campaign group 25Percent, so named because, over the course of any one year, a quarter of the population is said to suffer from a mental health problem.

Her brother, Matthew, had his first breakdown and psychotic symptoms at the age of 18.

During the two decades since then, he has received care, in and out of hospital, she describes as “patchy at best, negligent at worst”.

Limited joy

At the start of her brother’s illness, EIP had not been launched in the NHS.

Had it been available, she said, her brother’s life would have been very different.

“I’m not suggesting he would have been one of life’s high-flyers, but I think he could have gone on to have had a life which has more stability and I think probably joy,” she said.

“Matthew’s life is very lacking in joy, and a life of 23 years gone by with limited joy and just torment is a pretty punishing way to exist.

Extra funding

“All the evidence supports the fact that early intervention can improve your educational attainment, improve job opportunities and physical health.”

An NHS England representative said: “There will be extra funding for 10% more people to be treated in two weeks from 2017-18, building to £70m a year by 2020-21.

“The evidence stacks up that these services help people recover and gain a good quality of life.”

Scotland and Wales have early intervention programmes for serious mental illness, but no standard for waiting times for treatment.

Northern Ireland does not have a similar service.