Specialist mental health services in England in 2014: overview of funding, access and levels of care

BACKGROUND: Since the economic recession began in 2008 anecdotal reports suggest that mental health services in England have experienced disinvestment, but published data to test this proposition are few. METHOD: This paper presents information from a wider range of official, research and grey literature sources aiming to: (1) assess whether governmental investment in publically funded mental health services has declined since the start of the economic recession in 2008; (2) to assess whether relative changes in mental health service investment over this period were or were not similar to trends in national investment in services for people with physical disorders, and (3) to interpret these findings in terms of met and unmet population levels needs for mental health care. RESULTS: The key findings are that: across England social service expenditure reductions have led to a decrease of 48 % in the number of people with mental illness who receive such care, while direct NHS expenditure was reduced in some local areas by up to 32 %. CONCLUSIONS: The results of this overview suggest that there have been substantial reductions in the resources dedicated to mental health treatment and care in England since 2008, that such reductions seem not to have been applied to physical health services, and that these findings appear to run counter to the government policy of ‘parity of esteem; for mental and physical healthcare.