IF Manifesto Audit 1: Mental Health

IF Junior Researcher Melissa Bui looks what different parties are promising on mental health ahead of the 2019 UK General Election

Although the Intergenerational Foundation is a strictly non-party political think tank, we strive to place intergenerational fairness at the forefront of the political agenda. It is therefore in our interest to examine what the different parties are promising and how intergenerationally fair they are ahead of the December 12 election.

For this purpose, we have produced a full manifesto audit in chart form, the findings of which will be summarised in a collection of short, concise blogs, each covering a key policy area of interest. In this blog we will be focusing on mental health.

To make things easier for our readers, we have also incorporated a traffic-light system in this audit to signal how intergenerationally fair we consider these offers to be. We grade intergenerationally fair pledges as “green”; “yellow” if intergenerationally neutral; “orange” if some progress has been made, but more needs to be done; and “red” if intergenerationally unfair. 

Mental health prevention – the economic case

When thinking of what mental ill-health costs, we typically think of the direct costs incurred: hospital services, medication and supported accommodation. But there are extensive indirect, or “invisible”, costs associated with mental ill-health that desperately require our attention. Mental ill-health can impact an individual’s life outcomes through determining their educational attainment, the number of sick days they take, as well as their productivity at work.

There are, of course, strong arguments to invest in mental ill-health prevention purely based on moral grounds, but since mental ill-health often competes for priority in spending over other commitments, it is also important to put forward the economic justifications. When aggregated across the lifetime, the cost of leaving these individuals untreated can be substantial. The King’s Fund estimated the costs borne from lost employment for common mental disorders in 2007 to be £26.1 billion, exceeding the NHS and social care bill of £22.5 billion to treat them.

Given that half of all mental health conditions start by 14 years of age, this presents an economic incentive to invest in the mental health of young people – when disorders are in the early stages of the development – to minimise the cumulation of the costs we have outlined.

Early intervention

This demand for more spending on early intervention seems to be acknowledged in the Labour manifesto. The Labour Party is promising to inject £845 million into young people’s mental health services, placing emphasis on establishing networks of mental health hubs. They are also promising to recruit 3,500 qualified counsellors in schools. As the Making the grade report suggests, schools play a key role in shaping the environment that students are consistently exposed to and need more funding to ensure that it is healthy and nurturing for young people.

Interestingly, the only other party examined in this audit that promises further money for mental health services is UKIP. UKIP are offering an increase in mental health expenditure of £500 million per year, some of which will be dedicated to improving the delivery of current services. As IF believes that the priority with mental health is to invest in young people, we have awarded these pledges from Labour and UKIP with a “green” colour to indicate their fairness on intergenerational grounds.

Although the Conservatives express commitment to treating mental health equally to physical health, there is no mention of improving services, or mental health spending at all. As the Conservatives seem to miss the mark on mental health spending, IF has given them an “orange” label to indicate that more needs to be done.

Health assessment of new mums

However, investing in early intervention may not be enough in all cases. Mothers are more likely to experience mental ill-health during and immediately after pregnancy. However, this impacts not only the birth-giver.

Research has suggested that symptoms of depression amongst mothers can have a devastating and long-lasting impact on the child. These children are at risk of developing insecure attachment, poor self-control, as well as difficulties in cognitive functioning and in social interactions. As such, we have also graded declared commitments to more investment into mental health assessments for “new mums” – proposed by both Labour and the Lib Dems – with a “green” colour.

Waiting times

Although the subject of mental health spending is noticeably absent in the Lib Dem and the Greens’ manifestos, these parties have pledged to improve current services.

One the key concerns with the operation of current services is the waiting times. Although the recommended upper limit to waiting times under NICE guidelines is two weeks, the average waiting time for entering treatment from the point of referral in England was estimated to be 23 days in 2018, with the gap between the first and second treatment increasing to 41 days.

For many, this is far too long to wait. It can force people to rely on antidepressants instead, which vary in quality and can come with serious side effects (insomnia, muscle pain, headaches) – a potentially dangerous alternative for a young, developing body.

Labour’s proposed solution is to introduce 24-hour crises services, which will grant access to psychotherapies to those in most need at any time of the day. The Green Party, on the other hand, have declared their commitment to ensuring that everyone requiring access to therapies receives it within 28 days, which would bring waiting times close to the national average. As the actual waiting time varies substantially across the country – reaching as high as 135 days in Leicester – if such a promise were to be fulfilled, we would see drastic improvements in access across many cities. Both of these offers have received a “green” colour for the predicted benefits they will bring for younger people.

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