Outgoing Mind chief exec warns of ‘significant damage’ from mental health cuts

Cutting mental health funding at a time when nearly 10m people are waiting for treatment or at risk of developing more serious problems would be “extremely concerning,” Paul Farmer, the outgoing chief executive of Mind has warned.

In an interview with HSJ, Farmer, who leaves Mind in January, said that the sector must be “very vigilant” to make sure that the NHS’s other pressures do not slow or stall progress in mental health.

Farmer said that mental health “must be part of the solution to the NHS’s wider problems.” He added: “Mental health services are increasingly seen as part of the solution, so the threat is that it just doesn’t get picked up and utilised. It’s not quite the secret weapon but it is an underutilised resource and I think that has historically been because services were not really seen as fit for purpose. The next step for me is seeing mental health as a key part of the way the NHS provides its care for people — when you look at liaison psychiatry in acute hospitals and effective discharge into the voluntary sector, community-based crisis cafes… these are part of the solutions to some of the bigger problems the health service is facing, particularly in urgent and emergency care.”

The cost-of-living crisis could have a “very profound” effect on people’s mental health, he told the publication: “We’ve got to be prepared for further increases in demand, particularly at mild to moderate levels.”

Time to reflect on success

Farmer also highlighted concerns about workforce. Noting the “extraordinary” achievement in exceeding a recruitment target of 15,000 in recent years, he added: “There is huge pressure on that workforce now, and I think there is now a danger that we end up with a very siloed model of trying to solve the workforce challenge. We need to create a system where you can support people to come and work in mental health, and ensure they are safe, while opening up those opportunities.”

In his 16 years at the helm of the UK’s largest mental health charity, Farmer has seen some notable improvements. He described NHS England’s Improving Access to Psychological Therapies (IAPT) service as “in many ways a huge success story”. He thought, however,  that it was “time to reflect on successes and think about what we need to do to respond to growing levels of complexity among those with mild to moderate needs.” Before the Covid pandemic hit, the target to eliminate inappropriate out-of-area placements had almost been reached, he said, showing that it was “doable”. However, he felt the NHS now needed a tighter focus on illnesses such as eating disorders, which are becoming increasingly common.