The Royal College of Psychiatrists warned this week that addiction services in England are not equipped to treat the eight million people who are drinking at high risk during the COVID-19 pandemic. Research has also showed that the number of opioid-addicted people seeking help in April was at the highest level in five years.
Years of cuts mean that addiction services in England are not sufficiently prepared for the soaring numbers of people drinking at high risk and must receive a multi-million-pound funding boost in the upcoming spending review, said the College in a release on 14 September 2020.
The College’s analysis of Public Health England’s latest data on the indirect effects of COVID-19 found that more than 8.4 million people are now drinking at higher risk, up from just 4.8 million in February.
At the same time, more people addicted to opiates are seeking help from addiction services. Statistics from the National Drug Treatment Monitoring System (NDTMS) show 3,459 new adult cases in April 2020 – up 20% from 2,947 in the same month last year – the highest numbers in April since 2015.
But the deep cuts made to addiction services since 2013-14 mean that higher risk drinkers and hundreds of additional people with an opiate addiction needing help could miss out on life-saving treatment.
Psychiatrists are calling for government to use the upcoming Comprehensive Spending Review to reverse the cuts and enable local authorities to work towards investing £374 million into adult services so they can cope with the increased need for treatment.
Dr Adrian James, President of the Royal College of Psychiatrists, said: “Addiction services have been starved of funding in recent years meaning many are not able to treat and care for the huge numbers of people who are drinking at high risk.
“More lives will be needlessly lost to addiction unless the Government acts now and commits to substantial investment in public health, including adult addiction services, in the Spending Review,” James continued.
“I urge the government to implement the recommendations in our report which would see mental health services expand to be the biggest in Europe, with a much-needed focus on tackling inequalities.”
[b]Next steps report[/url]
The College’s recently published Next Steps for Funding Mental Health Care in England: Prevention report also makes the case for an additional £43m for children’s drug and alcohol services and £30m for new buildings and updates to existing ones – also known as capital projects.
Latest data shows there were 4,359 drug-related deaths in England and Wales in 2018, the highest on record, while the 1.26 million alcohol-related hospital admissions in 2018-19 were also the highest on record.
Professor Julia Sinclair, Chair of the College’s Addictions Faculty, said: “COVID-19 has shown just how stretched, under-resourced and ill-equipped addiction services are to treat the growing numbers of vulnerable people living with this complex illness.
“There are now only five NHS inpatient units in the country and no resource anywhere in my region to admit people who are alcohol dependent with co-existing mental illness.
“Drug-related deaths and alcohol-related hospital admissions were already at all-time highs before COVID-19. I fear that unless the government acts quickly we will see these numbers rise exponentially.”
The report warns that people with alcohol use disorder are more likely to develop serious complications if they catch COVID-19, including acute respiratory distress syndrome. People using drugs such as heroin and benzodiazepines are also more vulnerable to the virus.
Unfortunate situation
Responsibility for the delivery and funding of addiction services was taken out of the NHS and given to local authorities following legislative changes in 2012.
Following the move to local authorities, funding for addiction services in England for adults and young people combined fell by £234 million (25%) in real terms from 2013-14 to 2018-19.
The most recent data from Public Health England on the wider impacts of COVID-19 shows nearly one in five (19%) adults drinking at higher risk in June, up from one in 10 (10.8%) in February. The College calculates that when applied to the population of England some 8,410,045 people are now drinking at higher risk.
Public Health England defines higher risk drinking as those people scoring eight or more on the AUDIT, a 10-question clinical questionnaire that assesses the amount of alcohol consumed and frequency, and levels of harm and dependence.
Next steps for funding mental healthcare in England
Delivering the Long Term Plan
Ahead of the publication of the National Health Service (NHS) Long Term Plan (LTP), we called on the Department of Health and Social Care, NHS England & Improvement, and other arm’s-length bodies of the NHS to:
Commit to the biggest expansion in access to mental health services across Europe, empowering the disempowered with a much-needed focus on tackling inequalities, fit for a modern NHS.
Enable the NHS to become the safest, most effective, and transparent health system in the world with mental health NHS trusts leading the way.
Empower mental health leaders to develop the healthcare services of the future through Integrated Care Systems and Providers (ICS/ICPs).
Build a strong and resilient mental health workforce.
Invest in mental health services so that spending on mental health by Clinical Commissioning Groups (CCGs) and NHS England rises from 10.8% in 2017-18 to around 13.1% in 2028-29 of the total estimated NHS England budget.
The NHS Long Term Plan was underpinned by a revenue funding settlement of an extra £20.5bn for NHS England by 2023-24 (after inflation). This included a commitment that mental health services will grow faster than the overall NHS budget – with a ring-fenced increase in investment worth at least £2.3 billion a year by 2023-24.
Transforming mental health services in England
An ambitious programme of work is now underway to improve and transform mental health services in England, including a pledge to introduce waiting times standards for children and young people’s mental health services, emergency mental health services, and adult and older adult community mental health teams, building on the progress made by the Five Year Forward View for Mental Health.
We have identified four areas that must be fully and sustainably resourced if access to quality of mental health services that have been promised by Government is to be realised. These are: infrastructure; prevention; people; and technology.
Infrastructure
This paper focusing on infrastructure is the first in a series of papers covering these four areas. It considers the next steps for funding mental healthcare in England, with a specific focus on the Department of Health and Social Care’s total departmental expenditure limits covering capital spending (CDEL).
Prevention
This paper focusing on prevention is the second in a series of papers covering these four areas. It considers the next steps for funding mental healthcare in England, with a specific focus on public health and prevention, promoting resilience in social care and budgeting for workforce growth, education and training.
[link url="https://www.rcpsych.ac.uk/news-and-features/latest-news/detail/2020/09/14/addiction-services-not-equipped-to-treat-the-8-million-people-drinking-at-high-risk-during-pandemic-warns-royal-college"]Addiction services not equipped to treat the 8 million people drinking at high risk during pandemic, warns Royal College[/link]
[link url="https://www.rcpsych.ac.uk/improving-care/campaigning-for-better-mental-health-policy/next-steps-for-funding-mental-healthcare-in-england"]Next steps for funding mental healthcare in England[/link]