There will be a "catastrophic impact" on people with mental health issues if key risks facing the voluntary organisations providing them with public services are not addressed, according to a new report.
Arm in Arm, published today by the Centre for Mental Health, says 1.5 million people each year access mental health support from voluntary organisations that have contracts with clinical commissioning groups, making it the largest form of provision.
The report says NHS and local government commissioners are aware of the extra value charities bring, but key risks could undermine it.
The risks include funding cuts, contracts demanding more for less, short-term or rolling contracts, complex and unfair framework agreements and slow decision-making processes.
Competition between providers is also identified as a major concern.
"It reduces collaboration between organisations that should be working together; it limits the ability of organisations to share knowledge and expertise; and it can lead to some, mostly smaller, voluntary, community and social enterprise organisations going out of business altogether," the report says.
Smaller organisations are particularly at risk, the report adds, after the NHS's introduction in 2016 of integrated care systems, which limit their ability to compete for funding.
Kathy Roberts, chief executive of the Association of Mental Health Providers, which represents voluntary sector mental health organisations and commissioned the report, says in the foreword: "This report shows the critical issues that our members and the wider voluntary, community and social enterprise sector are facing, which, if not dealt with, will only create more risk for the sector and have a catastrophic impact on people’s lives."
The document says monitoring and accountability cause tension in the relationship between commissioners and charities.
It says commissioners need to know public money is being well spent, but most voluntary sector organisations do not have the data-collection capabilities of NHS trusts or larger private sector companies.
About a dozen commissioners and providers of voluntary sector mental health support were interviewed in February and March for the report, which cites the Living Well Network Alliance in the London borough of Lambeth as an example of good practice.
"The alliance was commissioned jointly by the clinical commissioning group and local authority, and it is a single contract which covers all adult mental health spend in Lambeth," the report says
"It is an ‘outcomes-based contract’ with five partners, including the local NHS mental health care provider, which is due to last for at least seven years."
Sarah Hughes, chief executive of the Centre for Mental Health, said: "Voluntary and community organisations have an essential role in complementing what statutory services can offer for our mental health.
"We must ensure that their voice and role continue to be heard and valued."