The long-awaited and recently published Social Care Reform White Paper includes a commitment to offer upwards of £70m to ‘increase the support offer across adult social care to improve the delivery of care and support services, including assisting local authorities to better plan and develop the support and care options available’.
Unfortunately, in common with much of the White Paper, this commitment might be described as a good start at best, but one which fails to cover the ever-growing needs of mental health social care adequately.
In his first speech in August 2019, the Prime Minister pledged to ‘fix the crisis in social care once and for all’, in order to ‘give every older person the dignity and security they deserve’. Leaving aside that social care is, of course, not purely for the elderly, he could have had no knowledge at that point of the impending pandemic, which has seen social care brought to the forefront of public attention like never before. I was privileged to support the work of the Social Care COVID-19 Support Taskforce, as co-chair of the Mental Health and Wellbeing Advisory Group, and amongst our conclusions we noted that the pandemic has highlighted the essential role of adult social care in meeting the needs of people with mental health conditions, keeping them safe and preventing future mental ill health.
As we have done throughout the pandemic, the Association of Mental Health Providers continues to work closely with Department of Health and Social Care (DHSC) colleagues and other Government departments, to consider the impact of the pandemic on people with mental health conditions. We have collectively explored how services have been affected and how both providers and people can be supported through the crisis and beyond.
Our members’ reach is vast, meeting the needs between them of what we believe to be over eight million people with mental health needs in England and Wales, through a combination of services commissioned by local authorities, social care and services run independently of either of those. They provide vital community social care services including counselling and advice, advocacy, supported living and housing, forensic and crisis services, carers support and personal assistants, employment support and much more. Crucially, this social care and support allows people with mental health needs to build resilience and autonomy in their lives.
Our members not only promote and support recovery, but they also enable people to lead fulfilling lives. So, we need to build a greater understanding of the value of social care and its role in healthier communities, whilst also acknowledging the essential role of the workforce in achieving this.
The association has continued to support the Government’s work through our Mental Health and Wellbeing Policy and Oversight Group, which informed the Adult Social Care Winter Plans for both 2020 and 2021, as well as the Review of the 2020/21 Plan. Our group has representation from the VCSE mental health service provider sector, people with lived experience and their carers, as well as other key stakeholders. It has become a key vehicle for informing policy colleagues in Government on the priorities for social care in mental health. We continue to work together, taking forward these recommendations to address the care and support needs for those people experiencing poor mental health and illness. In addition to working with the group and our members, we have also been able to work collaboratively with our partners in the VCSE Health and Wellbeing Alliance to engage on the reform White Paper.
Our collaborative working encompasses our membership, the wider sector and, most importantly, people with lived experience and their carers. We know this takes time and resources to really listen, understand and construct systems appropriate for the individuals using them, their families and the wider community. Gratifyingly, the White Paper does draw on the specific experience of people using mental health services, specifically Isaac Samuels, Co-Chair of the Association’s Lived Experience Advisory Group, illustrating in compelling terms how high-quality social care has helped him to recover from mental illness and maintain his mental health and wellbeing. This powerful example of lived experience, and so many others like it of which the association hears from our members on a regular basis, highlights the essential value of social care, people at the point of real need, directly accessing care and support, and benefitting from the input of the social care sector into their future choices, their sense of control and their capability for independent living.
Local authorities, of course, play a crucial role in the commission of mental health services; indeed, through their duties for adult social care under the Care Act 2014 and the Mental Health Act, they are currently the major commissioners of the association’s members, all of whom are voluntary and community mental health providers. Those providers offer a whole range of essential services, from prevention and crisis intervention to community support, all for people who experience poor mental health and/or severe mental illness. That ties in to an understanding that we need to dispel that longstanding belief that social care is solely about older people and care homes. The sector provides for all our citizens, including working-age adults and families receiving a range of care and support services.
However, amidst all of this we must recognise the stark reality that the mental health social care sector is in a workforce crisis. However willingly our members’ services are commissioned by local authorities, those services cannot adequately provide for people’s needs without the workforce to do so. The association’s members report daily of the need for urgent funding to meet the overall rise in wages, so that they can retain skilled staff and continue to deliver services safely. However, the White Paper does not put forward an urgent solution for this crisis. Without prompt action, there will not be sufficient workforce to deliver services and those with poor mental health and illness – those whom the White Paper seeks to place at the heart of care – will not be able to receive that care and support, personalised or otherwise. We believe the social care sector does not just require a 10-year plan, but it needs a ‘now’ plan as well to address the challenges being faced by the sector urgently.
In a recent blogpost, ‘Social care reform: making mental health a priority’, I ended by saying: ‘My resolve remains steadfast. Only by working together can we truly transform and improve the health and wellbeing of our nation.’ There is vision in this White Paper and it offers some light at the end of what continues to be a very dark tunnel. We can see that the paper talks about the crucial elements for good care and support that the association has long advocated for – choice, control, quality, accessibility – but the money promised is not enough to meet the rising costs and demands for social care.
My hope, and that of the association, is that we can take our concerns and recommendations back to the Minister, and to colleagues in Government, and move forward collaboratively. We want to work together to reshape the plans set out in the White Paper, to fully meet the expectations of people with poor mental health and illness, and those of their families and carers, so that they can access and receive the social care and support they are entitled to and deserve.
Which key areas would be in your plans for mental health reform? And how has the Government recognised the impact of the pandemic on people’s mental health? Leave your comments below.