Why mental health services have been left so far behind

As one doctor puts it, imagine presenting a breast lump and being told to come back in three years to see how you’re doing’. Peter Blackburn and Ben Ireland examine the stark disparity between physical and mental healthcare in the UK

- Peter Blackburn and Ben Ireland

She was bright, kind, caring - and had a real sense of justice and wanting the world to be a fairer place."

Moira Durdy is remembering her daughter Jess - a talented young engineer who died by suicide aged 27. Jess had a history of mental health difficulties but often kept her struggles to herself. "She loved us, and we loved her to bits, but I kind of always had a feeling there was a bit of her that was hidden," Durdy says.

Jess died on 16 October 2020 while at a mental health crisis house in Bristol, having moved in five days before. A seriousincident report found failings in her care, including that demand on services had "exceeded human capacity to perform all tasks".

It also found "poorly defined" strategies around escalation of risk and a care system "losing clarity under pressure". It also reported a lack of links between primary and secondary care.

For Durdy, her daughter's interactions with health services before her death suggest a crisis in mental healthcare that can now be seen across the country: GPs managing patients too complex for primary care, a lack of communication between primary and secondary care, underfunded specialist services with workforces whose training hasn't been invested in, and insufficient inpatient beds.

Problems are exacerbated in a health landscape in which institutions have been through countless reorganisations and restructures, where reform has infrequently been followed by investment and where oversight and responsibility have been fractured or lost.

Some patients and families we spoke to were unable to access specialist support until they were in absolute crisis or were forced to break the bank for private care. Doctors describe a system and workforce stretched to breaking point.