A briefing published by The King's Fund said that large-scale changes in mental health services in the UK are "a leap in the dark," leading to negative effects on patient care.

According to the report called "Mental health under pressure," the mental health sector is undergoing a lot of strain as an estimated 40 percent of mental health trusts received cuts in 2013-2014 and 2014-2015. This is in stark contrast to what the acute sector is experiencing, where over 85 percent of its trusts saw income increases for the same period.

The report also showed that as trusts are forced to reduce costs, they turn to large-scale transformation programs geared towards shifting demand from acute services to self-management and recovery-based care. This means evidence-based services are taking a backseat to favor care models and pathways with limited proof.

One of the examples cited in the report is the how early access to psychosis services and specialist crisis resolution home treatment teams merge into more generic community health teams. Evidence also suggests that the teams formed are usually unable to offer the kind of support that patients need, increasing pressure to have more inpatient beds and reducing quality of care.

Other findings highlighted in the report that show poor-quality care has become rampant include:

• Just 14 percent of patients said they were provided with appropriate care during a crisis;
• A 23-percent increase in out-of-area placements in 2014-2015 for inpatients was seen; and 
• Rates for bed occupancy often exceeded recommended numbers.

With quality of care expected to drop further as financial situations deteriorate, the report called on the mental health sector to focus on providing evidence-based solutions to improve practice and cut back on variations with care. To do this successfully, however, it acknowledged the need for stable funding.

Helen Gilburt, the author of the report, explained that mental health services have historically been the first to see cuts in funding, which forces a lot of trusts to focus instead on programs that will offer them the most savings. Unfortunately, this shift in focus from hospital care to self-management and recovery, leads to problems with scope that usually matches the pace and scale of an implemented change.

Photo: Ryan Melaugh | Flickr