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Bridging the Gap: The financial case for a reasonable rebalancing of health and care resources

Almost one in four British adults and one in ten children experience a diagnosable mental health problem at any given time.

This makes mental health problems the largest source of disability in the United Kingdom. However, despite the availability of effective, evidence‐based interventions, most people are not receiving treatment and services are often variable and fragmented.

Mental health problems account for 28% of morbidity, but spending on mental health services is only 13% of total NHS expenditure.

The gap risks becoming a gulf, with funding for adult mental health services in England actually falling in 2011/12, despite the government’s commitment to give mental health parity of esteem with physical health.

Bridging this gap would improve the health of the nation and improve productivity in the NHS.

Under‐investment in mental health services and a lack of integration with physical health services has created a bottleneck in health care improvement, constrained physical health outcomes and has impaired broader economic performance. The A&E crisis is just one example of the cost of the disparity and lack of integration between physical and mental health care.

We are calling for a rebalancing of health and care resources to ensure no one is denied the mental or physical health care they need. This requires action on many fronts.

This paper focuses on immediate improvements that can be made to the care and support offered to millions of NHS patients by enhancing mental health support within or on the interface with physical health services. These are provided as illustrative examples, and should not been seen as the only areas of mental health care which could improve both mental and physical outcomes if they were properly resourced. Nearly a third of people with long‐term physical conditions have at least one co‐morbid mental health problem. This can exacerbate the person’s physical condition and increases the cost of treatment by between 45% and 75% at a cost to the NHS of an estimated £10 billion per year. Medically unexplained symptoms, meanwhile, cost the NHS some £3 billion per year. Combining these figures suggests a total increased cost to physical health budgets of at least £13 billion, in addition to the £14 billion already spent on mental health services.