Mental Health, News

New BMA report highlights ‘broken’ mental health system


Persistent lack of funds and trained staff, combined with soaring demand, are placing unprecedented strain on NHS mental health services, new report finds.

A new BMA report, based on first-hand accounts from doctors working across the NHS, reveals the state of England’s ‘broken’ mental health services.

The current annual economic cost of poor mental health has been conservatively estimated at more than £100 billion in England alone, and £117.9 billion across the whole UK. The report from the BMA, “It’s broken.” Doctors’ experiences on the frontline of a failing mental healthcare system, identifies that a compound of funding, staffing, infrastructure and systemic challenges have led to the “dysfunctional” and “shocking” deterioration of NHS mental health services.

Without concerted efforts from central government to resource mental healthcare according to demand, which continues to outstrip NHS capacity, as well as societal change, the report argues that the future is bleak for those suffering from poor mental health, especially children and those with neurodevelopmental disorders.

Despite there being a greater focus on mental health from successive recent governments, the report finds that words have rarely translated into action, and that there has been no overall improvement to services in the last decade.

This is partly attributed to a lack of adequate resources within the system, but also to the impact of wider social determinants, such as housing, unemployment or financial concerns. It accuses the government of failing to grasp “the significance of the issue and how failing to tackle these wider societal issues is increasing demand for NHS mental healthcare.

Among its recommendations, the BMA report calls on the Department for Health and Social Care to “plan for and incentivise the expansion of the professionally trained workforce, including within psychiatry and general practice,” as well as to “embed mental health social care within the NHS, for example through in-house social workers.”

It also makes argues that attempting to quantify how much extra funding and staff levels are needed is incredibly difficult due to a lack of consistent data on the prevalence of mental illness, and echoes recommendations from Healthwatch that NHS England collect and publish national data on referrals and waiting times.

The BMA carried out in-depth interviews with doctors across the mental health system, including those working in psychiatry, general practice, emergency medicine, and public health. “[Support for people with mental health conditions] is shocking,” said a practicing psychiatrist quoted in the report. “We would not accept this in any other area of medicine.”

Quotes in the report:

“Mental healthcare in this country is dysfunctional. It’s broken.” – GP, Nottingham

“Patients always know that they can come into the emergency department…between spring this year and spring 2022 there was a doubling of Mental Health Act assessments in the emergency department. Which I think is fairly indicative of more systemic issues and obviously it impacts on our workload.” – Consultant psychiatrist working in A&E, Oxford

“Everybody wants to do the right thing. Everybody’s trying really hard, but we’re just not putting our money where our mouth is when it comes to saying we need to invest in prevention and early intervention.” – Public health consultant, West Yorkshire

Dr Andrew Molodynski, a consultant psychiatrist in Oxfordshire and the mental health lead at the British Medical Association, said: “As doctors struggling to provide mental health care, we know only too well that the system has crumbled. Some of our patients wait as long as four years for treatment, meaning too many people – including children – continue to fall through the gaps, and all the while funding remains insufficient. We’re having to make hard prioritisation choices that leave many patients without care and support that they urgently need.​

“The demand for mental health services has changed dramatically, but funding has not kept pace. Mental healthcare funding must be based on what people need today, instead of being based on what we spent yesterday, which was inadequate even then.

“We need these changes to the system to be able provide good quality care and tackle the huge cost of mental health to people’s lives, the NHS, and the economy.”