Five Year Forward View for Mental Health: what progress has been made?

A year has passed since the Mental Health Taskforce published the Five Year Forward View for Mental Health, which sets out a road map for improving mental health in England.

The Forward View had many valuable recommendations for improving the size, shape and access to NHS mental health services, which were accepted by the Government and planned implementation is underway by NHS England and the other health related arm’s length bodies.

One of the interesting features of the public input to the Taskforce work was the high priority given to a call for increased help to prevent people developing mental ill health and for much earlier intervention.

The Mental Health Foundation endorses the Taskforce belief that "prevention matters – it’s the only way that change can be achieved".  However, we had some concerns that this was not as effectively translated and embedded into the final recommendations as some other areas.

Progress has been made on some prevention-focused objectives, such as the development of a prevention concordat, however the lack of real financial backing for this brings the risk of a watered-down version of the earlier Crisis Care Concordat.

If we do not take the real opportunities that exist to prevent mental health problems early then even the best services will continue to be overwhelmed. Indeed, Anthony Jorm, from the Melbourne School of Population and Global Health, recently looked at why increased investment in mental health services in Australia had not resulted in any reduction in prevalence and concluded that the missing part of the strategy had been prevention.

Our NHS and social care are under huge pressure. A vital way to enable a closer match between available services and ill health is to tackle the causes. The causes and potential solutions to mental health problems can be identified in our schools, workplaces and communities, providing us with a vast array of opportunities to identify those most at risk and to intervene at the earliest point.

Findings from the recent Adult Psychiatric Morbidity Survey show that prevalence rates for most (common) mental health problems have either remained unchanged or deteriorated since the last survey was conducted in 2007.

This deterioration is predominantly being observed among women, particularly young women. While this is not a new trend, the stark increases in rates of mental health conditions experienced by women indicate that if we do not understand and tackle the causes with determination, women’s lives will be blighted unnecessarily. A Women’s Mental Health Taskforce has been established, which I have been pleased to join and this will report later in the year.

Increased focus on prevention and early intervention do not negate the need to address and treat diagnosed mental health conditions effectively and at the time the need arises. The Five Year Forward View for Mental Health gave the call for mental health services some real momentum but fell short in the area of improved population wide mental health.

The next step is for a transformation in the thinking we apply to this issue: how do we create the circumstances for people to thrive mentally, not just survive? And it is that issue that The Mental Health Foundation will be exploring in this year’s Mental Health Awareness Week between 8 and 14 May.

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