Analysis reveals significant reductions in mental health workforce amid austerity in England

NHS mental health workforces have fallen significantly during the cuts, with notable differences in staffing levels across the country, a new study has found.

The uneven growth of the mental health workforce in recent years is highlighted in the new analysis from the University of East Anglia. While overall there is evidence that the mental health workforce in 2023 will be larger than the mental health workforce in 2009, there appear to be notable differences between regions in how the workforce has grown.

The figures show that in 2009 there was a 39% difference between the best served (North East and Yorkshire) and least served (East England) regions.

By 2023, there is now a 54% difference between the best served (London) and least served (East of England) regions. Furthermore, the growth of the mental health workforce appears to be around half of the growth of the wider clinical workforce, suggesting that ambitions to create an 'equal esteem' between mental and physical health problems are not reflected in the workforce.

The new analysis is based on existing data, but because it is adjusted to population, it makes it much easier to see changes in the labor force and make comparisons between regions. “Mental health workers in England: regional trends and differences” is published in the British Journal of Mental Health Nursing.

Author Dr. Peter Beazley, from UEA's Norwich Medical School, said he carried out the analysis because he could see that the NHS was publishing data on the entire time equivalent (WTE) workforce but did not provide an adjustment for population growth.

He said: “Adjusting for population density provides a fairer comparison, not least because population growth in recent years has been quite uneven across the country. Here at UEA we train a number of mental health professionals, and I felt motivated to implement this. analysis after hearing concerns about unmet needs firsthand from our interns and supervisors working in the region

“It's a fairly simple analysis, but without this kind of data we cannot effectively plan for future needs or ensure fair distribution of resources between regions.

“Plans to further develop the mental health workforce must take into account observed regional differences, but must also take into account expected population growth. This kind of long-term planning is not necessarily very exciting, but is especially important for institutions like ours involved in training the mental health workforce of the future.”

Key findings from the report highlight:

• Differences between the mental health workforce and the broader clinical workforce – The mental health workforce grew by just under 10% overall between 2009 and 2023. On the other hand, the wider clinical workforce within the NHS grew by almost 20%. Such a difference is surprising in the context of broader social concerns and demands for mental health care.
• Mental health workforce reductions during the years of austerity – The analysis shows that the mental health workforce was particularly hard hit during the years of austerity, with some regions hit harder than others. This reduction in the size of the mental health workforce was greater than the total clinical workforce in the NHS.
• Post-COVID-19 Workforce Growth – While the mental health workforce has experienced significant growth, especially since the COVID-19 pandemic, it has only relatively recently surpassed 2009 levels. Although there are no figures showing that the workforce is at different clinical qualification levels, Dr. Beazley that the rapid increase in workforce was likely caused by hiring less qualified personnel. This highlights concerns about the quality and sustainability of this growth.
• Regional differences – Although data points to national improvements in recent years, the East of England and South East England regions appear particularly underserved when it comes to the share of the mental health workforce compared to the regional population. However, limitations in the way data are recorded mean that these findings should be treated with caution, as services offered in one region may be provided by a provider based in another region.

Dr. Beazley said the analysis does not take into account the fact that people living on the edges of certain geographical regions may receive NHS services from a neighboring geographical region; For example, a hospital in London could serve people in the South East.

In addition, some NHS services are highly specialized and are therefore delivered in a centralized location with funding from other regions. This may go some way to explaining the need for additional facilities in London.

Dr. However, Beazley said: “There are a number of factors that influence how generalizable the data is, but I still think it's difficult to argue with some of the findings. The increasing gap between the mental health workforce and the wider clinical workforce appears to reflect poorly on wider ambitions to achieve an 'equal valuing' of mental health.”