Recommendation 4

There is still no clear definition of the end goal of ‘parity of esteem’ 12 years after the government first set out its ambitions. From 2011, the government set out long-term ambitions to improve support and services for people with mental health problems and achieve ‘parity of esteem’ between mental health and physical health services. While the number of people accessing NHS funded mental services substantially increased from 3.6 million in 2016–17 to 4.5 million in 2021–22, as reported by the NAO, this still only equates to around one third of people with mental health needs, with an estimated eight million not accessing services. NHSE acknowledges that sizable treatment gaps will persist under the current planned rates of service expansion set for 2023–24. In our January 2019 report on mental health services for children and young people, we recommended that the Department should define clearly the criteria it would use to measure progress towards ‘parity of esteem’—a recommendation accepted by government—and so are particularly concerned that there is still no detailed definition. Many stakeholders told us that a clear definition, objectives and roadmap are important to understand progress towards this end goal. NHSE would also welcome a definition, but the Department’s current position is not to specify one. Progress in improving NHS mental health services 7 Recommendation 4: In its update to us in six months, the Department should also set out what achieving full ‘parity of esteem’ between mental and physical health services means in practice, for example, comprehensive access and waiting times standards and outcomes, timescales, funding and workforce requirements.