Seventy-five percent of patients with a mental illness in Great Britain are not getting any treatment for their condition, a scathing report by researchers at the London School of Economics has revealed.
According to the report, How mental illness loses out in the NHS, mental illness now accounts for nearly half of all ill health in people aged 65 and under.
But despite the fact that it is “more disabling than most chronic physical disease”, it seems to be falling massively under the National Health Service radar, with just a quarter of patients getting any medical help.
“It is a real scandal that we have 6,000,000 people with depression or crippling anxiety conditions and 700,000 children with behavioural problems, anxiety or depression. Yet three-quarters of each group get no treatment,” the report notes.
A key reason for this is the failure of NHS commissioners to adhere to recommendations by the National Institute for Health and Clinical Excellence when commissioning mental health services, it says.
And yet, according to the report, spending more money on the most common mental disorders would actually be cost neutral to the NHS.
This is because untreated mental illness often exacerbates physical illness, and the extra physical healthcare caused by mental illness now costs the NHS at least £10 billion.
“When people with physical symptoms receive psychological therapies, the average improvement of physical symptoms is so great that the resulting savings on NHS physical care outweigh the cost of psychological therapy,” it claims, because the cost of such therapy is low while recovery rates are high.
Savings can also be made to the economy in terms of boosting productivity and increasing employment, given that mental illness accounts for nearly half of all absences at work and half of incapacity benefits.
Even when taking the burden of premature death into account, mental illness accounts for 23% of total burden of disease, but despite the existence of cost-effective treatments, it receives only 13% of NHS health expenditure.
‘Glaring’ health inequality
According to the report’s authors – a team of economists, psychologists, doctors and NHS managers convened by Professor Lord Layard of the LSE Centre for Economic Performance, “the under-treatment of people with crippling mental illness is the most glaring case of health inequality in our country”.
The experts have also slammed commissioners for not making use of the £400 million in baseline budgets allocated for 2011-2014 to complete the national rollout of Improved Access to Psychological Therapy (IAPT) which, by 2014, aims to be treating 900,000 people suffering from depression and anxiety.
They call on the government to include IAPT targets in the NHS Outcomes Framework, and recommend better training for GPs and improving recruitment to psychiatry to help turn around the situation.
Commenting on the report, Professor Clare Gerada, Chair of the Royal College of General Practioners noted that “GPs face tremendous challenges in caring for patients with mental health problems in primary care and we welcome any development which will help us improve their care”.
Also welcoming the report, the BMA said it is “concerned about the poor physical health and early death of many with serious mental health problems, and views this as a major inequity that must be addressed”.