The £343m NHS Mental Health Plan

The government has announced £343 million for 159 new NHS mental health facilities in England. 100 of these will be much-needed community mental health centres offering walk-in support without referral or a months-long wait. 59 will be mental health emergency departments for people in crisis who are medically fit and do not require support from A&E departments.

Bringing mental health support into the community is a step in the right direction. The new centres are designed around relationship-focused community care rather than the traditional medicalised approach to mental health issues. The plan for a system that has no thresholds, that you can walk in, phone or be referred to is refreshing and responds to many of the criticisms of the current system. Pilot projects have shown a reduction in referrals from GPs and people attending emergency departments although a full evaluation is yet to be reported. This all sounds incredibly positive and hopeful.

But when you break down the funding, it perhaps paints a slightly different picture. The £343 million divides into £187 million for a hundred community centres and £156 million for the fifty-nine emergency departments. That is roughly £1.9 million per community centre and £2.6 million per crisis unit. So, the first thing to notice is that this is not a shift of resources from crisis care into prevention. Both are expanding at once, with the crisis end better funded per site.

So, this is still a move in the right direction, one that many of us have been calling for. Maybe, but the second thing to notice is where this money is coming from. It comes from a £473 million fund set out for 2026 to 2030, and that fund is capital funding, purchases of assets such as building new premises and converting old ones. 57 of the new sites will be new builds and 102 will be conversions, many of them in libraries, former banks and other high street buildings. However, capital funding does not pay anybody's salary. Revenue does that and there doesn’t appear to be an equivalent revenue commitment for staffing these centres.

Which raises the obvious question of who will work in them. The government has recruited 8,500 additional mental health workers since June 2024 and met that target three years early. The government announced that this would cover increasing the number of psychiatrists, therapists, mental health nurses and support staff working across NHS trusts and community services. However, there is no published breakdown of how many of the 8,500 falls into each category. This matters, as there is a big difference between hiring 1,000 new psychiatrists, psychologists, qualified therapists and mental health nurses and hiring 1,000 early help practitioners. We need a mix of talent and experience in our mental health services, but my concern is that the government will prioritise cost effectiveness, hiring more support workers because you get more for your money, over psychiatrists, therapists, psychologists, etc., because their wages are higher. 

For example, the Royal College of Psychiatrists welcomed the recruitment of an additional 8,500 staff and then pointed out that more than a quarter of consultant psychiatrist posts in England are vacant or filled by temporary staff.

If the workforce does not grow faster, if the government does not invest in a diverse range of talent, not just the most economical; the people staffing these new buildings are the people already staffing the old ones and the demand placed on these lower paid employees may lead to increased burnout and staff turnover, a problem many NHS mental health services have struggled with.

Then there is the question of longevity. Much of the criticism of the current mental health service is that when you finally gain access to support, it is usually short-term. From my discussions with families, many feel forgotten once their cycle of support ends.

Six pilot centres have been running. Their funding ended before their formal evaluation reported, which forced local NHS systems to make decisions about their future without knowing what they had achieved. The Centre for Mental Health is still evaluating those first six and will report later this year. A hundred more have already been announced. The evidence base arrives after the decision it was meant to inform.

The whole point of the model is continuity. One team, ongoing relationships, no repeating your story. That is a therapeutic promise, and it is the right one. Short funding cycles or uncertainty around funding break that promise. A time limited service that is honest about being time limited does less damage than a service that offers relationship and then withdraws it when a contract ends.

At the Lewisham pilot the trust invested £800,000 in thirteen local voluntary and community organisations to work in partnership. In York the hub is delivered jointly by the NHS trust, the council and two local charities. That is genuinely how it should work with care held by people already in the community, through partnership rather than through a closed system.

However, organisations entering these partnerships need to exercise caution. Unfunded partnership, a collaborative relationship with no direct financial support, or one brought in on short-term, non-recurrent grants, may leave them absorbing everyone who does not meet the threshold for specialist mental health treatment. If this happens, the open door simply moves people out of the NHS system and into a less secure one.

I want this to work. Community based, non-medicalised, relational support, delivered by people who are already part of the places they serve, is the right direction. The government has now built the case for it better than most of us could have. What it has not yet done is fund the part that makes it a relationship rather than a building.