A missed opportunity on prevention

David Cameron

Today’s announcement by David Cameron is the first time a Prime Minister has made mental health the main theme of a speech, and that should be celebrated as a milestone for mental health.

The equity focus of David Cameron’s speech, to target the most vulnerable in society is a welcomed one, as poverty is intrinsically linked to poor mental health.

While it can only be seen as a positive thing that the Prime Minister has again shown the privileged position mental health now holds on the government’s agenda, after many years of neglect, it feels like a lost opportunity to make an announcement into care and support without pledging anything to prevention. This shows a real chasm between what the government and the public feel is needed for change, with a public engagement report by the Mental Health Taskforce last autumn placing prevention as a top priority for individuals and organisations.

There is a clear moral and economic case for preventing people from needing services in the first place. Mental health problems cost the UK economy an estimated £70 Billion every year, and are putting the NHS under extreme pressure. The absence of prevention from today’s announcement and the cuts to public health budgets announced in the Spending Review, show how little commitment there currently is to prevention of poor mental health.

We know that with the right information and tools people can take steps to understand, protect and sustain their own mental health and that of those in their families and communities – resources that need to be targeted to where they can have the most impact and at groups who are at higher risk as well as the general population, given everyone can benefit from actions to improve mental health. There is an obligation to inform the public of what works, based on evidence, and put the right infrastructure in place to prevent poor mental health, which is unfortunately not being undertaken by the current health and social care system. A shift from frontline care to prevention is enabling us to create a physically healthier nation, so there is no reason why we cannot also work toward being mentally healthier.

As has been the case with previous announcements of this nature, absolute clarity is needed around the extra investment pledged. It is unclear if this money is in addition to the £1.25 billion announced in March 2015 for children and young people's mental health, and the £600m announced by the Chancellor George Osborne in last autumn’s Spending Review. Transparency about what will be spent, where and when is essential if there is to be any buy-in by stakeholders.

Today’s announcement comes before the official launch of the Mental Health Taskforce’s eagerly awaited five-year plan, which is expected in the coming weeks. Hopefully there will be further announcement of support for the report’s recommendations, particularly those concerning prevention and early intervention, coming in the near future.

In short, of course every step to increasing access to treatment and support is to be welcomed by those of us working within mental health as a positive. But, if the Government really wants to transform peoples life chances, I believe they need to refocus upstream. To halt the predicted 2 million additional cases of adults in the UK with mental health problems by 2030, a national preventative mental health strategy should be developed, fully resourced and implemented.