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14 Feb 2023

SANE’s response to the National Audit Office report on mental health services

Millions of people with mental health problems, including children with eating disorders, are missing out on NHS treatment or face lengthy waits, according to the National Audit Office.

In a new report, Progress in improving mental health services in England, the spending watchdog said that while the number of people getting care has increased overall to 4.5 million in England, some targets are not being met.


Commenting on the report, Marjorie Wallace, SANE chief executive, said:  “We are not surprised that the National Audit Office highlights the huge discrepancy between the pledges and reality of what people need when they seek help and because of a lack of treatment they reach crisis point.

“The relentless agenda to close psychiatric beds has caused widespread distress and neglect. The core of the problem is a serial failure of the NHS to recruit and retain a sustainable mental health workforce particularly nurses, leading to unacceptable levels of care and treatment.

‘Avalanche of need’

“The increase in funding for mental health services is very disappointing in the face of the avalanche of need, particularly among young people where the rate of probable mental disorders has more than doubled in the last five years.

“It remains concerning that children and young people, those from minority ethnic groups, LGBT people, and those with more complex needs are more likely to have a poor experience of treatment.

“We call on the Government to ensure that any new money reaches the frontline and that it is the responsibility of every trust to provide adequate crisis and recovery beds, community teams and therapies to meet the escalating needs of patients. The cost to future generations will be immeasurable if they fail to act now.”

Report findings

  • NHS mental health services achieved new waiting time standards for talking therapy services and early intervention in psychosis services, but not for eating disorder services for children and young people.
  • The NHS mental health workforce increased by 22% between 2016-17 and 2021-22, but staff shortages and the speed of expanding the existing workforce remain a major constraint.
  • Some groups had poorer experiences accessing or using services, including children and young people, those from minority ethnic groups, LGBT people, and those with more complex needs or more than one diagnosis.
  • Post-pandemic, demand for services is higher than the 2019 NHS Long Term Plan anticipated, particularly among young people.
  • From 2017-2022, the proportion of young people with probable mental disorders increased by 50% for 7- to 16-year-olds and more than doubled for 17- to 19-year-olds. This is likely to mean it will take longer to reduce the gap between demand for mental health services and provision
  • The share of funding for mental health services has increased slowly, reflecting the pace set by NHSE’s targets.
  • The NHS is on track to meet commitments to increase health spending by £3.4 billion by 2023-24, between 2016-17 and 2020-21 the percentage of local funding spent on mental health services only went up from 11.0% to 11.4%.

The report concludes that, while funding and workforce for mental health services have increased and more people have been treated, both DHSC and NHSE must learn the lessons from their efforts to date and demonstrate a firmer grip on the significant ongoing risks to their ambitions to ensure value for money in their expansion efforts.

They must also set out what is required to achieve equality between mental and physical health services.

For more information visit:

Progress in improving mental health services in England – National Audit Office (NAO) report

Mental health – NHS (

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