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Shocking discrimination against mental illness in the health service

18 Jun 2012 | Centre for Economic Performance, LSE

New report from top economists, psychologists, psychiatrists and NHS managers

A report published today by the London School of Economics reveals the massive scale of mental illness in Britain - and how little the NHS does about it. Mental illness is now nearly a half of all ill health suffered by people under 65 - and it is more disabling than most chronic physical disease. Yet only a quarter of those involved are in any form of treatment.


The report by the Mental Health Policy Group - a distinguished team of economists, psychologists, doctors and NHS managers convened by Professor Lord Layard of the LSE Centre for Economic Performance - concludes that:

  • The under-treatment of people with crippling mental illnesses is the most glaring case of health inequality in our country. It is a shocking form of discrimination because effective psychological treatments exist but are still not widely enough available.
  • Therapies like cognitive behavioural therapy lead to rapid recovery from depression or anxiety disorders in over 40% of cases. If they were more widely available, this would cost the NHS little or nothing because of the savings on physical healthcare. The cost would also be fully covered by savings on incapacity benefits and lost taxes.

For these reasons the government started in 2008 an excellent 6-year programme for Improving Access to Psychological Therapy (IAPT). This is making the situation much better than it was, especially in some areas. However, in other areas local commissioners are failing to fund the necessary expansion and are even cutting mental health provision, especially for children.

It is essential that the IAPT programme is completed as planned, since even this will only provide for 15% of need. Beyond 2014 there should be another major expansion, aimed especially at the millions of people who have mental illness on top of chronic physical conditions.

Lord Layard says: "If local NHS Commissioners want to improve their budgets, they should all be expanding their provision of psychological therapy. It will save them so much on their physical healthcare budgets that the net cost will be little or nothing."

Lord Layard adds a call for the challenges of mental health to be placed at the heart of government: "Mental health is so central to the health of individuals and of society that it needs its own cabinet minister"


Mental Health Policy Group members

Professor Lord Richard Layard, (Chair), Director, Well-Being Programe, Centre for Economic Performance, LSE

Professor Sube Banerjee, Professor of Mental Health and Ageing, Institute of Psychiatry, King's College London; Clinical Director MHOA, South London and Maudsley NHS Foundation Trust; Head, Centre for Innovation and Evaluation in Mental Health

Stuart Bell, Chief Executive, South London and Maudsley NHS Trust

Professor David Clark, Professor of Psychology, Department of Experimental Psychology, University of Oxford

Professor Stephen Field, General Practitioner, Bellevue Medical Centre, Birmingham, Chair, NHS Future Forum & Chair National Inclusion Health Board; former chairman of Royal College of General Practitioners

Professor Martin Knapp, Professor of Social Policy, Director of the Personal Social Services Research Unit and Director of the NIHR School for Social Care Research, LSE; Professor of Health Economics and Director of the Centre for the Economics of Mental Health at King's College London, Institute of Psychiatry

Baroness Molly Meacher, Chair, City and East London NHS Mental Health Trust

Christopher Naylor, Fellow, Health Policy, The King's Fund

Michael Parsonage, Chief Economist, Centre for Mental Health

Professor Stephen Scott, Professor of Child Health and Behaviour, King's College London; Director, National Academy for Parenting Research

Professor John Strang, Head of Addictions Department, Institute of Psychiatry, King's College London

Professor Graham Thornicroft, Professor of Community Psychiatry; Head of Health Service and Population Research Department, Institute of Psychiatry, King's College London

Professor Simon Wessely, Head, Department of Psychological Medicine, Institute of Psychiatry, King's College London



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