Mental health: Referrals in England sharply increase since start of Covid pandemic - but plummet in rest of UK

The number of monthly referrals to mental health services in England has hit a two year high - with some areas seeing demand more than double to pre-pandemic levels.

However, it is a mixed picture across the UK with Scotland, Northern Ireland and Wales all seeing a decline in referrals.

Here, a BBC data unit investigation shared with NationalWorld gives an insight into the number of referrals to mental health services across the four countries.

Sharp rise in number of referrals to mental health services in England

The number of monthly referrals to mental health services in England have hit their highest point in two years. Some clinical commissioning groups (CCGs) saw demand more than double compared to pre-pandemic levels.

Latest figures show that at least 279,995 referrals were made through 117 NHS CCGs in March 2021 - a rise of 19% from February 2020.

Urgent crisis care referrals - made when a patient is suffering a more serious mental health issue - are also at their highest in the country since January 2019.

Mental health charities in England have now urged the government to act in response to these figures.

Marjorie Wallace, chief executive of mental health charity SANE, said: “It is no surprise that we are seeing a jump in referrals, which could mark the start of a surge that lasts for many months, as people with severe mental ill-health who were discouraged from seeking help finally come forward.

“Yet services that were already overstretched before the pandemic may be even less able to cope with rising demand due to increasing staff absence, and with patients who are much more acutely unwell having not received early support.”

“We have to be prepared for a mental health crisis and people needing urgent treatment,” Ms Wallace said.

Mental health referrals in Scotland plummeted by 59% at the beginning of pandemic

Campaigners are now “bracing themselves” for a mental health surge after figures show 59% fewer referrals were made to services in Scotland in the early months of the Covid pandemic.

The latest national figures for March 2021 show referral rates have now recovered to pre-pandemic levels.

However, the Scottish Association of Mental Health (SAMH) said it expects referral figures to continue rising as more people come into the system.

Although national referral figures returned to pre-pandemic levels by March this year, the picture is mixed at local levels across the country.

SAMH’s chief executive Billy Watson said the reason for differences was hard to pinpoint, but suggested more rural areas had opened up quicker in Scotland, meaning people were able to access services easier.

He said: “In the system the danger is that people will become more mentally unwell as they wait.

“All the evidence would suggest that they will wait longer, and they were already waiting probably too long in the first instance. So that has the potential to manifest itself as an increase in crisis.”

Referrals dropped in Wales

Meanwhile in Wales, a leading mental health charity has called on the government to make it easier for people to access mental health services, as data shows referrals dropped by 72% across the country during the early months of the pandemic.

Similarly to Scotland, although the national figures had returned to roughly pre-pandemic levels by March this year, the picture is more mixed at local levels across the country.

Data shows some areas are dealing with 47% more referrals to mental health services than before the pandemic, while others are still referring around 20% fewer people than they were before Covid hit.

Glenn Page, senior policy and campaign officer for MIND Cymru, said: “There are certain groups that have been particularly negatively affected throughout this and targeted and urgent action is needed to address that.

“I’m talking about people living in poverty, children and young people, people with the existing mental health problems and people from black and minority ethnic communities as well.

“What we need to see for mental health services is much greater investment so that there is the capacity and resources within those services to meet existing and future demand.”

A Welsh Government spokesperson said the Government has provided an additional £42 million this year for mental health support and the refreshed Together for Mental Health delivery plan “also outlines actions in response to the impact of the Covid-19 pandemic.”

He added: “However, responding to changing mental health and emotional needs requires a multi-agency approach and we continue to work with our partners to do this.”

Non-inpatient mental health referrals drop in Northern Ireland

In Northern Ireland, latest monthly data for January 2021 shows non-inpatient mental health referrals are down by 29% compared to February 2020.

However, some Health and Social Care Trusts, such as the Southern trust, have seen levels fall by more than 50%.

David Babington, chief executive of Action Mental Health Northern Ireland, said: “We recognise that the pandemic has prevented people from seeking the help they needed due to the restrictions on movement, coupled with increased anxiety for some people at being in public spaces.”

Suggesting a way forward, Mr Babington reiterated the charity’s longstanding call for increased funding for mental health services.

He welcomed Minister Swann’s launch of the new Mental Health Strategy in June, and said: “We now know the size of the challenge that we face and the publication of the strategy is only the first step on a long road to help build better mental health for all, across Northern Ireland. The announcement of the strategy was accompanied by the recognition of the need to invest £1.2bn over ten years.”