Between coercion, conditionality and abandonment: A descriptive analysis of English mental health spending and provision under austerity

While critical scholarship has demonstrated the harmful effects of austerity on public mental health, relatively little attention has been paid to austerity’s impacts on health services themselves. In response, this paper develops a descriptive analysis of mental health spending and provision in En...

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Main Author: Ed Kiely
Format: Article
Language:English
Published: Critical Public Health Network 2024-11-01
Series:Journal of Critical Public Health
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Online Access:https://journalhosting.ucalgary.ca/index.php/jcph/article/view/78931
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author Ed Kiely
author_facet Ed Kiely
author_sort Ed Kiely
collection DOAJ
description While critical scholarship has demonstrated the harmful effects of austerity on public mental health, relatively little attention has been paid to austerity’s impacts on health services themselves. In response, this paper develops a descriptive analysis of mental health spending and provision in England during the austerity period, from 2009–10 to 2019–20. It examines spending patterns at the national and local level, highlighting a major growth in funding that has been overlooked by prior studies. Then it interrogates national trends in mental health provisioning, utilisation and treatment. The paper argues that austerity has divergent impacts on localities which are best understood as multiple localised austerities. Meanwhile, the overall mental health service landscape under austerity is characterised by three trends, all of which have the potential to harm public health. Inpatient services are utilising more coercion; community services are increasingly conditionalised; and a significant population – too ill for work but judged too healthy for treatment – has been abandoned by services. For critical scholars and practitioners of public health, these findings highlight the complexity of the political, economic and institutional dynamics which distribute spending cuts and therefore mediate austerity’s effects on health.
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spelling doaj-art-b455fd223c9a4352a1cf025d8ec8dcb12025-08-20T13:49:18ZengCritical Public Health NetworkJournal of Critical Public Health3033-39972024-11-011210.55016/ojs/jcph.v1i2.78931Between coercion, conditionality and abandonment: A descriptive analysis of English mental health spending and provision under austerityEd Kiely0Queen Mary University of London While critical scholarship has demonstrated the harmful effects of austerity on public mental health, relatively little attention has been paid to austerity’s impacts on health services themselves. In response, this paper develops a descriptive analysis of mental health spending and provision in England during the austerity period, from 2009–10 to 2019–20. It examines spending patterns at the national and local level, highlighting a major growth in funding that has been overlooked by prior studies. Then it interrogates national trends in mental health provisioning, utilisation and treatment. The paper argues that austerity has divergent impacts on localities which are best understood as multiple localised austerities. Meanwhile, the overall mental health service landscape under austerity is characterised by three trends, all of which have the potential to harm public health. Inpatient services are utilising more coercion; community services are increasingly conditionalised; and a significant population – too ill for work but judged too healthy for treatment – has been abandoned by services. For critical scholars and practitioners of public health, these findings highlight the complexity of the political, economic and institutional dynamics which distribute spending cuts and therefore mediate austerity’s effects on health. https://journalhosting.ucalgary.ca/index.php/jcph/article/view/78931mental healthausterityconditionalityhealth serviceslocalisation
spellingShingle Ed Kiely
Between coercion, conditionality and abandonment: A descriptive analysis of English mental health spending and provision under austerity
Journal of Critical Public Health
mental health
austerity
conditionality
health services
localisation
title Between coercion, conditionality and abandonment: A descriptive analysis of English mental health spending and provision under austerity
title_full Between coercion, conditionality and abandonment: A descriptive analysis of English mental health spending and provision under austerity
title_fullStr Between coercion, conditionality and abandonment: A descriptive analysis of English mental health spending and provision under austerity
title_full_unstemmed Between coercion, conditionality and abandonment: A descriptive analysis of English mental health spending and provision under austerity
title_short Between coercion, conditionality and abandonment: A descriptive analysis of English mental health spending and provision under austerity
title_sort between coercion conditionality and abandonment a descriptive analysis of english mental health spending and provision under austerity
topic mental health
austerity
conditionality
health services
localisation
url https://journalhosting.ucalgary.ca/index.php/jcph/article/view/78931
work_keys_str_mv AT edkiely betweencoercionconditionalityandabandonmentadescriptiveanalysisofenglishmentalhealthspendingandprovisionunderausterity