News / Capital investment standard would improve equity for mental health

‘We need substantially more capital investment in mental health services to boost trusts’ ability to better meet rising demand and to modernise out-of-date buildings and facilities to give patients the right environments for treatment,’

Increased capital funding, a dedicated infrastructure plan and a mental health investment standard for capital allocations are all needed alongside a long-term mental health plan, according to the countries leading mental health charities.

The organisations, including the Centre for Mental Health, Mind and the Royal College of Psychiatrists,  have published a report – A mentally healthier nation – calling for a 10-year, cross government mental health strategy to reverse worsening mental health across the UK due. It said that the cost-of-living crisis, the Covid-19 pandemic, austerity and other challenges had all contributed to the country’s declining mental health. 

With proposals to improve prevention, equality and support, the report also called for the government to make a long-term commitment to funding NHS and local authority social care services ‘at levels that enable them to expand the workforce sufficiently to meet rising levels of need’.

 It highlighted specific concerns about underinvestment in the mental health estate, with sufficient capital funding needed to modernise, invest in digital services and ensure all buildings are fit for purpose. Nearly 16% of mental health and learning disability sites were built before the NHS was established, compared to just 9% of general acute sites. And in eight trusts, more than a quarter of their estate was erected before 1948.

It also pointed out the relative low priority mental health is given in terms of major capital projects – just two of the 40 schemes originally announced by the government as part of its new hospital programme were for mental health facilities. And high-risk backlog maintenance – a problem for all parts of the NHS – has trebled in the last three years to £48m across mental health and learning disability sites.

The government has committed to eradicate dormitories across England and has made £150m of capital available to upgrade mental health crisis response infrastructure over this year and next. But while this was welcome, the report said it was ‘a small step on the road to sustained investment in mental health services’.

The report said that a mental health specific infrastructure plan would drive improvements in outcomes and focus on the elimination of mixed-sex accommodation, improvements to IT infrastructure and essential safety improvements.

It also called for a mental health investment standard specifically for capital allocations. The existing revenue-based investment standard requires integrated care boards to increase spending on mental health services by more than allocations growth. A similar arrangement for capital could ensure that ‘funding is fairly apportioned to mental health redevelopment and improvement schemes – both within integrated care systems and nationally’.

Lade Smith, president of the Royal College of Psychiatrists, said that mental illness had to be treated with the same urgency as physical illness. ‘Years of underfunding and lack of investment in mental health services has left many people without the life-changing and life-saving support they need,’ she said, adding that the report provided strong recommendations to address this.

‘This includes building a sustainable mental health workforce, requiring additional funding and not just reallocations from existing stretched budgets, expanding access to mental health support for children and young people and tackling long waits for all ages.’

Miriam Deakin, director of policy and strategy, NHS Providers, said the pressure on mental health services demanded long-term investment in prevention and early intervention. ‘We need substantially more capital investment in mental health services to boost trusts’ ability to better meet rising demand and to modernise out-of-date buildings and facilities to give patients the right environments for treatment,’ she added.