Parity of esteem has never been delivered

New Statesman​

19-05-2025

A fan holds a sign promoting mental health awareness, outside Wolverhampton Wanderers' Molineux stadium. Photo by Dan Mullan / Getty Images.
Before becoming an MP, I worked in the NHS for 22 years, primarily in mental health services. In my previous profession, I had seen the worst of it: children as young as nine self-harming, and people taking their lives whilst on waiting lists. The so-called 'parity of esteem' the coalition government had spoken about was never delivered. In fact, mental health services were some of the first to be cut as the NHS's budgets tightened in the austerity period.
But since then we have seen drastic social changes which have worsened young peoples' mental health. Generation Z are more dependent on social media and more isolated from their peers. Technology has become both more central to their daily lives and accessible from an early age. As a result, their need for mental health services has increased at a time when they have been depleted and it's harder than ever to access treatment.
Our system and attitudes towards mental health are outdated. The fact it has taken 42 years to update the UK's primary piece of mental health legislation is perhaps the biggest indictment of how reluctant we have been to address it. I was pleased to hear in the King's Speech that this government is ready to grasp the nettle of mental health reform and pass a new Bill that addresses the multifaceted issues caused by the 1983 Mental Health Act. That includes the lack of autonomy given to patients, and the class and racial disparities of those detained under the provisions of the law.
Many patients are reliant on the NHS for long-term care after being discharged, and we cannot solve the crisis unless we look at a wider approach which encompasses social care, local agencies to support patients who need rehousing, and, most importantly, rethink what we expect from the NHS. Legislation can only take us so far. I know from my own experience that recruitment and retention is something the government must consider in their Workforce Plan – expected to be published this summer. Fewer people want to become mental health nurses, and it's understandable why: hours are long, and the pay is low compared to the private sector. This means that we rely on huge numbers of foreign workers, which is unsustainable. The long-term solution is to incentivise local people to begin lifetime careers in the NHS. That means investing in the workforce, not trying to constantly do more with less.
We must be willing to talk about the merits of other reforms outside of the healthcare system – such welfare reforms in the government's Get Britain Working plans. I know from my previous profession that many people with mental health issues and long-term health conditions can thrive in the workplace when given the necessary support, and it can hugely benefit their mental wellbeing. The Work and Pensions Secretary Liz Kendall was correct in her assessment that health and welfare are 'two sides of the same coin'. This can be seen most of all in young people. The Neet population (not in employment, education, or training) has been growing – it is around one in eight people aged 16-24. These people have disproportionately high mental health issues. We currently have 2.8 million people locked out of work due to long-term health conditions – 200,000 of whom are actively searching for employment. Part of the future of the mental health system will be providing the correct support for people – helping them raise their living standards and improving their mental health.
The mental health system will be in a constant state of evolution. My former colleagues in the mental health sector will be learning to grapple with issues faced by a generation increasingly dependent on technology which makes them more connected with the rest of the world, yet more isolated from their peers and more in need of mental health services than ever before.
This article first appeared in the 15 May Spotlight policy report on Healthcare. To read the full report click here.
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