Epic drama Game of Thrones returned to our television screens this week amid excited reports that this season promises to be sexier, bloodier and more gripping than ever.
Set in a medieval fantasy land, the show presents a world of constant war where a sprawling cast battles it out for the throne. One character differs from the rest, though: Daenerys Targaryen stays out of the petty fighting and instead makes a long-term investment. She hatches three dragon eggs and waits for them to grow up, knowing that, by then, they will make her invincible.
Back in our non-magical world, we need our own visionary dragon breeders of the voluntary sector, thanks to public-sector cuts. Because, to extend the analogy further, government commissioners are behaving something like Daenerys’s rivals, looking for quick victories at a difficult time and ignoring strategies that could win them the war.
Slashes to public spending are disproportionately affecting early intervention, often the first to go despite overwhelming evidence that these services are crucial for preventing social problems such as mental health, educational achievement gaps, offensive behaviour and homelessness.
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A recent report from Rethink Mental Illness on Early Intervention in Psychosis (EIP) care shows that funding for early intervention has dramatically fallen away: 50 per cent of EIP services say their budget has decreased in the past year – some by as much as 20 per cent – and over half say the quality of their service has diminished as a result.
EIP care helps more than 10,000 people aged 14-35 to recover from a first episode of psychosis each year. One in three people under EIP care are in employment, compared to just one in eight of those under standard mental health care. EIP care almost halves the probability of someone being sectioned in the first two months of psychosis, and reduces the risk of the young people taking their own life from up to 15 per cent to 1 per cent after the first psychosis.
In the long term, such results could save the NHS £44 million each year through reduced use of hospital beds.
Charities are working hard to demonstrate their impact to commissioners, with payment-by-results driving the need for proof that an intervention works to get people an education, a job and an independent life. If a mental health charity can show that they are better at doing this than a commercial provider, the charity will get the public contract.
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It is harder to show outcomes that lie further down the line — to show that by helping people experiencing their first mental health problems now, we can reduce the risk of them developing a severe mental illness in ten years’ time. When money is short, commissioners want to see directly measurable results.
This means a funding gap is rapidly opening up; and so now, more than ever, we need private funders to make those long-term investments in society’s biggest problems. When government is forced by the economy to engage in short-term battles, philanthropists – by taking a strategic view like Daenerys – could be hatching our very own golden dragon eggs.
Cecilie Hestbaek is a researcher at NPC
