The community and family-orientated approaches outlined in the independent review of Health and Social Care in Wales provide a great sense of optimism: that individuals will stop being viewed in isolation, with a community public mental health approach underpinning the recommendations.
The independent panel outlined how "bold new models" of care are required to meet the needs of individuals, families and communities alike, emphasising prevention throughout. Each of the four mutually-supportive goals – "the Quadruple Aim" – presented in the review recognise the importance of looking upstream to address the root causes of mental health challenges.
They are continual to:
- improve population health and well-being through a focus on prevention
- improve the experience and quality of care for individuals and families
- enrich the well-being, capability and engagement of the health and social care workforce
- increase the value achieved from the funding of health and care through improvement, innovation, use of best practices and elimination of waste
Strategic, system-wide activity is necessary to take advantage of the opportunities to improve mental health at all stages of life, particularly at times when individuals, families and communities experience adversity and during times of transition from one life stage to another.
If we are to rise to the challenge of reducing the prevalence of mental health problems, we will need to revise how we view mental health and where it is owned. We will need to move from a dominant mental health 'deficit' model to one which views mental health as a universal asset to be strengthened and protected.
It is particularly encouraging to see the report identify children’s mental health and well-being as a priority
In reducing the prevalence and the distress caused by mental health problems, we recognise that to make the biggest difference. We need to start at the earliest point, focusing a good deal on child development in the early years. The delay in identifying children at risk and providing effective early intervention means that many young people enter adulthood with untreated conditions. At the same time, other symptoms may only develop once they have reached adulthood.
Socio-economic disadvantages like poverty (but also exposure to abuse and other adverse experiences) place people at greater risk of developing mental health problems. Children and young people living in these circumstances are two to three times more likely to develop mental health problems. This sets the scene for a disadvantage spiral that accumulates all too often across life. When mental health problems are established, these can lead to a series of detrimental effects on people's life chances.
The report's sense of urgency to achieve its vision of "the Quadruple Aim" presents a real opportunity to address the stark health inequalities identified across Wales.
We urge the Welsh government to mirror this appetite for change and accept the recommendations from this review in full. We will detail how the recommendations will be funded and how progress will be measured to ensure they are delivered fully.