No Health Without Mental Health: The First 100 Days and Beyond

29 May 2015

The Mental Health Foundation is a member of the Mental Health Policy Group, alongside the Centre for Mental Health, Rethink, RCPsych, Mental Health Network, NHF Confederation, and Mind. As part of the Mental Health Policy Group, we have published ‘Improving England Mental Health: The First 100 Days and Beyond’ to advocate for a range of actions that we believe are vital for the new Government to undertake.

A historic opportunity

Given the unprecedented attention on mental health - both in the run up to the general election and in the Queens Speech this week- and the general consensus across parties that a new approach to mental health is needed, the new Government is now in a strong position to drive forward their ambition of parity of esteem for mental health.

The stark reality is that the United Kingdom cannot afford to not act. The economic and social cost of poor mental health amounts to more than a £100 billion a year in England. It has been forecast that over the next 15 years the number of adults with mental health problems will increase to approximately 2 million more than there are today - a frightening statistic given the low funding mental health currently receives, but one that we can reduce by placing more emphasis on prevention.

The Mental Health Foundation is advocating for the following actions to be undertaken by the new government over its first 100 days in power and beyond, so it can initiate a change in momentum.

1.) Investment in research

The new government needs to address the current imbalance in funding and commit more money and resources to mental health research to create a solid evidence base of what works, especially in relation to prevention and promotion of mental wellbeing, children’s mental health, and the links between mental and physical health, where there is large knowledge deficit.

Currently, only 5.5% of the UK health research budget is dedicated to mental health, despite mental health problems accounting for a quarter of all ill health. Research on understanding the causation and development of mental health problems, the pattern of risks and prevalence across different individuals and groups needs to be emphasised in the Governments plans, as a solid knowledge base will ensure prevention and early intervention approaches are more successful. Therefore, during the first 100 days of government, the Mental Health Foundation are calling on new government to commit to increased investment in mental health research to better reflect the prevalence of mental health problems and their cost to society.

2.) Emphasis on prevention

As David Cameron’s said himself during his first speech since his re-election "we know we need a completely new approach to public health and preventable diseases. A real focus on healthy living". The Mental Health Foundation hopes that this new focus will also extend into the realm of public mental health as equitable investment in mental health prevention is sorely needed.

Public spending is currently focused almost entirely on coping with crisis, with only insignificant investment in prevention. We believe it is time to change the model and to move spending upstream to prevent problems occurring. We know that investment in early interventions saves money in the long run by preventing mental health problems from developing, so this is a worthwhile area of investment for the UK government. The MHF are advocating for the government to develop tailored public health programmes for people with mental health problems, with a particular focus on Public Health Englands priorities of obesity, smoking and harmful drinking.

By investing upstream in evidence based prevention and early intervention we can reduce the demand on mental health services, and achieve improved mental health for the whole population as well as groups who experience higher risk of developing mental health problems.

Key areas of focus for prevention:

• Maternal mental health

• Children and Young People

• Those in the care of the state (prisoners, young offenders, etc)

• Black and ethnic minority groups

• Later Life

3.) Equity

Equity – or fairness – should underpin all UK public policy. But stigma and discrimination; a disproportionate lack of investment in mental health services, prevention and promotion; ‘institutional bias’ against mental health in health services; and public policy that fails to recognise or mitigate its damaging effects on people’s mental health all leave those with mental health problems disadvantaged. We would particularly like to see a focus on addressing inequalities in access, experience and outcomes - particularly for people from black and minority ethnic communities, homeless people, survivors of violence and abuse, LGBT groups and people with disabilities - in the next iteration of the NHS Mandate.

People with severe mental illness experience some of the starkest health inequalities- dying, on average, between 10 and 25 years earlier than the rest of the population. They are less likely to receive treatment than those with physical health problems, and have to wait longer for it. We are advocating for the new government to consult on what a quantified national reduction in premature mortality among people with mental health problems should look like, and commit to introduce this.

There can be no health without mental health and we look forward to working with the new Government to achieve their promise of parity of esteem for mental health over the coming five years. To achieve this, the MHF would like to see the development of a framework for assessing the impact of all national funding decisions against principles of parity of esteem. We believe the government must ensure mental health is addressed in all public polices, and not only dealt with through policy, as there are clear links across all social determinants including housing, education, community safety, employment, social connections and physical conditions.

Marguerite Regan, Policy Manager at the Mental Health Foundation, works to inform and influence evidence-based policies across the UK that impact on mental health and learning disabilities.