In their election manifestos, Labour has promised more than 8,000 new psychological therapists, the Conservatives have pledged to increase access to "talking therapies", and the Liberal Democrats say they would improve access to counselling and protect mental health care.
Yet despite such promises, Monitor, the independent regulator of NHS foundation trusts, sent out a letter to the organisations it oversees this month warning UK mental health providers to prepare this year for extra cuts, which mental health charity Rethink estimates could amount to £50m.
"Mental health providers face a different set of risks to those in the acute sector," according to Monitor. "Historically, during these periods of financial pressure in the healthcare system, expenditure on mental health activity has fallen more rapidly than [that] in other areas."
Rethink estimates the cuts will result in around half a million people with mental health problems having less access to vital services such as crisis care, psychological therapies and skilled staff.
On average, two people with mental health problems kill themselves every day, with half of all schizophrenia sufferers attempting to take their own lives at some point. But unlike heart disease and cancer, mental illness is more difficult to measure. There are no life-saving operations or transplants – and fewer heroic stories for the annual reports.
Mental illness could almost be called the invisible killer, which is why it is the first to be neglected when there are cuts to be made. However, the current downturn has created a greater demand for mental health services, as Roehampton University in south London found this month. Its study with children's charity Elizabeth Finn Care showed that 71% of people who lost their jobs last year displayed symptoms of depression.
We only have to look at what happened the last time mental health services suffered major cuts to anticipate what is to come. In 2004, the Healthcare Commission performance ratings revealed these services had the highest number of no-star trusts compared with other health services. Two years later, Rethink uncovered that cuts of £30m – affecting more than 30 areas of England – had been made to mental health services.
The figures didn't mean much until the damage was assessed. A women's ward in Wandsworth, south London, had been made mixed-sex. Three day centres had been closed in East Sussex. Norfolk suffered a recruitment freeze. "I am extremely worried," one service user told Rethink researchers. "I had a relapse this year but was not admitted to hospital due to a lack of beds."
Today, services are still overstretched. This week, it emerged that temporary staff are to be dismissed from mental health services at Camden and Islington NHS foundation trust, north London, as bosses tighten belts for the coming year.
In February, during an inquest into the suicide of Neil Stanhope, a jury criticised Springfield Hospital in Tooting, south London, for poor staffing levels. Stanhope was found hanging in a shower room after being taken off 24-hour observation – despite telling staff he may kill himself.
These may be isolated incidents, but they are symptomatic of a wider need to invest more, not less, in mental health services. We like to think that progress has been made over the last decade, but the bottom line is that mental health is still the poor cousin of other frontline services.
Eleanor Harding is Mind journalist of the year.
