A “radical reform” of mental health services is needed to develop a workforce to meet people’s needs in the future, according to a new report by the Centre for Mental Health on behalf of the Mental Health Network, which is part of the NHS Confederation.
The report, The future of the mental health workforce, was commissioned by NHS Employers and supported by Health Education England. It is based on insights from service users, carers and professionals and outlines a list of recommendations for a sustainable mental health workforce. It emphasises the importance of prevention, including the role of GPs in supporting people before they reach crisis point.
The report describes commissioning of mental health services as in “crisis” with a “shrinking workforce, growing expectations and exhausting demands” putting pressure on staff across the country.
The report notes that a third of GP consultations involve mental health but fewer than half of GPs have mental health training placements.
The future of the mental health workforce makes recommendations including ensuring that all GPs should have significant and wide-ranging mental health training, and that mental health professionals should be given the time and training to consult with GPs and other public service staff to help them to respond to more people’s mental health needs. It looks at what the mental health workforce should look like in the medium to long term, beyond the next five to 10 years.
Other recommendations include:
· Professional bodies should join together to develop a range of clear career pathways for mental health professionals and offer greater flexibility for people wanting to move between professions and roles during their careers.
· Mental health services should reach out to schools and colleges to promote careers in mental health to young people.
· Mental health service providers should support the wellbeing of their own workforce.
Sean Duggan, chief executive of the Mental Health Network, which is part of the NHS Confederation, said:
“Those consulted felt that the skills of those working in primary care need to reflect the work they do: that if one in three GP appointments relates to a mental health issue, why have less than half of GPs completed a mental health training placement?
“Examples were given of work with primary care, which increased GPs’ capacity and skill in addressing mental health needs.
“One participant described how they had ongoing dialogue with GPs through regular phone calls, surgery visits and consultations. This helped GPs to understand better when to make a referral, which enabled primary care partners to use mental health systems more effectively.
“Participants discussed how trusts were trying to work better with primary care, for example by working with high referring practices in order to understand what drives the level of referral and what they needed.
“Several discussed the benefits of GP surgeries where psychiatric nurses were embedded to provide effective care at the right level.”
Centre for Mental Health chief executive Sarah Hughes said:
“Mental health care relies on people with the right skills, capabilities and knowledge to support others, often at times of crisis or vulnerability. It is all about people helping people, and having the right workforce is crucial for its effectiveness.
“Our consultations with people who use and people who work in mental health services have indicated a thirst for change and adaptation. The future mental health workforce will need to be skilled in coproducing services with those who use them; in educating and supporting GPs, teachers and hospital staff; and in engaging with communities. We need to attract young people to mental health work from school age and create lively, varied and challenging careers that change as people get older. And we must create compassionate organisations that support the wellbeing of those who work in them.”
Danny Mortimer, chief executive of NHS Employers, said:
“We were keen to commission the report because we think that mental health workforce issues are important and not always well understood.
“We hope that the recommendations gain traction across the system so that the mental health workforce is seen as a whole, maximising the contribution of existing roles and developing new roles where the evidence suggests these are required. We particularly welcome the recommendation to highlight the rewards of working with service users and their families and the focus on the development of the existing workforce.”
Professor Lisa Bayliss-Pratt, Director of Nursing and Deputy Director for Education and Quality at Health Education England, said:
“Health Education England very much welcomes this report and is looking forward to working with partners across the system on both recommendations from this insightful report, as well as our own mental health workforce plan ‘Stepping Forward to 2020/21‘ to ensure we provide the very best care possible to people and their loved ones who access mental health treatment and care.”
Don Bryant, service user representative at Mersey Care NHS Foundation Trust, said:
‘‘I am delighted to have been involved in this workforce report. It has been extremely reassuring and gratifying that consultation encompassing a wide range of stakeholders including a large number of service users and carers, has been undertaken and that, importantly, the views of all have been taken on board.”
Phil Hough, expert reference group member and Carer Consultant at the Mental Health Network, said:
“As a carer, I know the impact of good services to support individuals in their recovery and continue to enable people to live the lives they want to. Staff are the biggest part of mental health services and are vital to ensure we keep receiving quality care.
“This report shows the commitment of the Mental Health Network and the other organisations involved to ensure the voices of service users and carers are at the heart of what they do.”