'A clear message needs to be sent'

The union Unite have organised an 'Applied Psychology Lobby of Parliament' for 20 March. They are calling on the Government for action around mental health funding, the protection of psychological roles in the NHS, and an end to 'the downbanding, downgrading and deskilling of psychologists all across the NHS'.

The campaign website says: 'A clear message needs to be sent from Psychologists to legislators. The provision of Psychology Services from 'cradle to grave' to the public is currently inadequate. Psychologists are now speaking out across the country to change this. The current climate is making life harder for many people, pulling away their safety net and pushing them into crisis. The rates of mental health problems are escalating, especially in children and young people. We know that early help is important and can prevent a cycle of chronic mental health problems, which can affect the next generation.'

According to the union, 'Time needs to be called on the erosion of higher skilled posts, the introduction of targets which can set up perverse incentives and evidence of a bullying culture against staff in these services… We need to spell out that we want to get on with our jobs of helping people, which is what we are trained to do, rather than creating an environment where services focus on rationing resources and denying people the help they need.'

The lobby takes place on Tuesday 20 March, 13:30-16:00, in Committee Room 12 of the Houses of Parliament. Other suggested actions on the campaign website include writing to constituency MPs.

A British Psychological Society spokesperson, Acting Director of Policy Dr Lisa Morrison Coulthard, said that the Society echoes the group's call to 'Protect highly skilled and professional psychological roles in the NHS and recognise their fundamental contribution to healthcare in the UK'. She added: 'We are focusing our efforts on creating positive and sustained impact in parliament. There are numerous workstreams and we have a set of key policy asks… you can read more about them elsewhere on the Society website.'

We also spoke to Dave Munday, Lead professional officer (mental health) for Unite the union.

Every few months there's the promise of significant amounts of funding for mental health. What's happening to this money?

Five years after Parity of Esteem was pledged, mental health care providers continue to receive far smaller budget increases than hospitals. A recent Kings Fund report showed a widening gap with budgets for MH trusts rising less than 2.5% in 2016/17, far less than the 6% increase received by acute trusts (between 2012/13 and last year MH got 5.5% and acute got 16.8%).

The Royal College of Psychiatrists also produced a report last month based on their analysis that showed mental health trusts have been left with less funding than 2012 due to government cuts. "The total amount of income that mental health trusts in England received in 2016-17 was £11.829bn. While the figure has risen overall in each of the past two years, it remains £105m lower than in 2011-12 at today's prices".

There have also been examples like: 'Money earmarked for mental health diverted to balance NHS books'.

Is there an argument that some change in our healthcare system – in the form of a greater focus on self-care, e-health, and manualised approaches – are desirable ones, even if they come at some personal cost to qualified and skilled psychologists?

Our healthcare system is constantly changing. Any efforts to improve outcomes, through such foci on things like self-care are welcome. However, this isn't about needing less staff because the demand isn't there anymore (due to innovation or anything else). I'd argue the opposite is true. Health Education England appears to agree with me. In their workforce consultation they highlight that "21,000 additional posts would be needed to deliver the specified [mental health] service improvements" and at the same time, 'patients accessing mental health services' are forecast to increase to 1.88 million by 2021 (fig. 12). 

In a political and economic climate where all sorts of health and social care services are being cut to the bone, is there really a strong enough argument that psychologists should be protected from this? In other words, if psychologists lobby their MPs and get a 'That's just the way it is, unfortunately' response, what comes next?

It's not about psychologists arguing that they should be protected so another service should be cut/cut more. It's about a healthcare professional arguing for the best care for their clients. In fact, their HCPC Code requires that they do this, including:

'Registrants must: promote and protect the interests of service users [and] carers; and report concerns about safety'. Hopefully MPs will be more receptive, especially when they are faced with the person actually doing the job, explaining why current government policies are actually making their job harder, and the lives of their constituents worse.

Maybe the only way to effect enough change in this situation is with a change in government, but even though this would be a preferred outcome, there's things that can be done now. Just as a very current example, the finance bill currently going through the House of Commons needs amendments to improve 'Breathing Space' to include '#RecoverySpace'. There is a real chance that this can be achieved by people lobbying for the amendments. 

- Read our follow up interview with Dave Munday.