The pursuit of happiness: A new ambition for our mental health

Burstow, Paul, Jenkins, Paul, Adebowale, Victor, Bailey, Sue, Farmer, Paul, Greatley, Angela and Rose-Quirie, Alison (2014) The pursuit of happiness: A new ambition for our mental health. Discussion Paper. CentreForum, London. Full text available

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In February 2011, I published the Coalition Government’s mental health strategy, No Health Without Mental Health. It was widely welcomed for its emphasis on parity of esteem between physical and mental health and the promotion of wellbeing. Three years on, the strategy still sets the right direction. But translating it into practice has been painfully slow. Despite the evidence base, the NHS remains doggedly stuck in a model of care that separates the physical from the psychological and the social. Yet it is only by bringing them together that we can hope to make the best use of the resources available and improve the wellbeing of the nation. This institutional bias against mental health was brought into sharp focus recently by the decision of NHS England to raid the budgets of Mental Health Trusts to help Acute Trusts deliver the recommendations of the Francis Report, as if the same issues did not arise in mental health. Some good may come from this sorry episode, if statements by NHS England translate into deeds, but the bias runs deep. Over the past twelve months, the Mental Health Commission has taken stock of where we are today and what we need to do to realise the ambition of the mental health strategy. Our goal has been to identify the key changes that will reduce the number of people experiencing lifelong mental health problems over the next 5 to 10 years and help those who suffer mental health problems to recover. The Commission has identified five big shifts in policy and practice for England. First, make the mental wellbeing of the nation or the ‘pursuit of happiness’ a clear and measurable goal of government. The tools are available to evaluate policy and measure its impact with wellbeing in mind. This needs leadership from the top of government and sustained action to tackle stigma. Second, roll out a National Wellbeing Programme led by Public Health England to foster mutual support, self-care and recovery. They would be locally tailored by Health and Wellbeing Boards to make the best of the skills and talents in communities up and down the country, building up community capacity where necessary. Third, prioritise investment in the mental health of children and young people right from conception. By scaling up what works, we can transform the life chances of hundreds of thousands of children and reduce the costs to society of low educational attainment, negative behaviour, worklessness, crime, and antisocial behaviour. Fourth, make our places of work mental health friendly. The cost to business in terms of sickness absence and lost productivity runs to £23.5 billion. There is good practice, it should become the norm, and it would save money. Government must take the lead in its own employment practice and set the standard in its procurement. Fifth, close the treatment gap that leaves almost one in ten of the adult population needlessly suffering from depression and anxiety and 1-2 per cent of the adult population experiencing a severe mental illnesses such as schizophrenia. These people do not receive the parity of care and outcomes which you would expect if you had a physical illness such as cancer. Equip primary care to identify and support the mental and behavioural health needs of its patients. Integrating mental health and social work expertise into the primary health care teams to ensure a holistic approach. The Commission believes that NHS England should be set the clear goal of achieving parity of funding for mental health over the next decade. We are under no illusions about the difficulties of making these changes over the next five years against a backdrop of financial constraint. However, we believe that the case for spending to be rebalanced towards mental health is overwhelming. For example, poorly-managed long-term mental and physical health problems cost the NHS £13 billion a year. The cost of doing nothing, or simply settling for gradual change, runs to billions of pounds, but the real cost is measured in human misery, misery for want of a determination to act on the evidence. Rt Hon Paul Burstow MP

Item Type: Monograph (Discussion Paper)
Department/People: Honorary Staff

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