2017 Autumn budget: what does it mean for mental health and wellbeing?

With Brexit still looming, the chancellor Phillip Hammond MP delivered his Budget against a backdrop of much economic, social and political uncertainty. But what did it do for the UK's mental health?

While the NHS saw a welcome £2.8 billion injection of new funding, this is not enough to maintain current levels of activity, falling well short of what Simon Stevens called for in his recent speech to NHS Providers. We and others working in mental health are seeking assurances from NHS England and the government that the promised improvements to mental health services will be honoured.  This is the minimum necessary for demonstrating that the government is truly committed to giving mental health parity with physical health.

Safe and secure housing

This said, we were encouraged to see £28 million pledged to provide counselling services and mental health support for victims of the Grenfell fire and for the regeneration of the surrounding area. To prevent such a tragedy ever happening again, investment needs to be made to ensure that not only do those who need social housing have access to affordable options, but they also need to be able to trust that the council is providing safe and secure housing where they can lay down roots, bring their children up and enjoy the benefits of community. 

The fire shone a light on the stark inequalities in London (which also exist across the UK), highlighting that we are still some way from creating a society where people who require any form of social welfare are treated with respect and dignity and ultimately are 'safe'.

The complex mental and physical health challenges faced by those affected by the fire may not present themselves immediately and it will require time to develop a trauma-informed approach to respond to their needs, and to ensure that the most appropriate specialists are made available. 
This work presents opportunities to learn and extend a trauma-informed approach to more public services, focusing in particular on those working with vulnerable children and young people, homeless people, and people who have experienced homelessness. 

What was missing?

However, this Autumn Budget stands out for what it doesn’t contain as much as what it does. The chancellor made no mention of affordable, safe or supported housing for those on low incomes, bypassing the urgent need for investment in this area with headline housing announcements focused on scrapping stamp duty for first-time buyers.

Having somewhere safe and warm to live is fundamental to our mental health and wellbeing. Housing provides vital shelter, but is also important for creating a secure and positive environment to support people as their lives progress.  

A mentally healthy home helps children to grow up resilient, and can prevent some mental health crises, promote recovery and reduce the burden on health services. 

In contrast, we know that poor, unstable housing and the threat or experience of being homeless affects adults and children alike, and increases their chances of experiencing stress, anxiety and depression.

We are concerned that the Budget’s focus on the housing market, without an acknowledgement of the need also to invest in social and affordable housing, will entrench and increase the inequalities experienced in the UK.  We know that mental ill health is much more common among people experiencing housing and welfare problems, and housing and welfare problems are more common among people who have poor mental health – the relationship works in both directions.  

Compared with the general population, people with mental health problems are more likely to experience instability with regards to tenancy agreements and twice as likely as those without mental health problems to be unhappy with their housing. Without safe and secure housing, people’s risk of mental distress increases, and a significant number are not able to access the support they need.

Universal credit

With this in mind, we are glad to see the Government assign an extra £1.5 billion to "address concerns" about its flagship policy, Universal Credit. Cross-party opposition to the new system resulted in welcome amendments including new eligibility clauses to enable claimants to a 100% advance before their claim comes through, alongside a repayment extension. While this is a loan and therefore represents the opportunity to create debt for the many who cannot afford to wait, it is an important recognition from the government that the system, at this point in time, is not fit for purpose.  

Having noted the relationship between housing and mental health above, we are extremely concerned that the system has already been shown to cause evictions. The new commitment to allow housing benefit to continue for an extra two weeks after the start of a universal credit claim is welcome, but not enough to prevent potential eviction for all those potentially at risk. We call on the government to address this with urgency and would like to work with the government to bring about such changes.

What now?

Tackling the ‘burning injustices’ around mental health that Prime Minister Theresa May championed early in her Premiership requires a cross-government, integrated approach with a shared goal of reducing the inequalities we see today. We are disappointed that this approach was not taken in the Autumn Budget. 

We urge the chancellor to address the key challenges we have identified and, looking forward, begin to adopt prevention measures to safeguard the nation’s mental health. In the long term, this approach will cut the social and economic cost of mental health, and – most importantly – will reduce the pain of mental distress and improve the quality of people’s lives.

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