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Mental Health: Not Just 'One in Four'

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In the last month, the level of media interest in mental health and the lives of people with mental health problems has been higher than ever. A week of programmes on the BBC, a new five-year strategy for mental health care in England, a (first ever) speech by the Prime Minister and the Duchess of Cambridge's awareness-raising work about children's mental health have raised the volume significantly in the first couple of months of 2016.

In all of those discussions, it is often noted that at any one time about one in four of us will be experiencing a mental health condition, most commonly anxiety or depression. This widely quoted figure derives from the best available data about the prevalence of mental health problems, which among UK adults is 23%.

It is sometimes mistakenly stated, however, that one-in-four is the lifetime risk of mental ill health. Recently published survey data for the first time gives us a more reliable estimate of the real lifetime risk and, unsurprisingly, it is substantially greater. The 2014 Health Survey for England asked people whether they had ever experienced a mental illness and if they had been diagnosed. This identified that 44% of people had a mental health problem at least once in their lives, the vast majority of whom had already experienced a difficulty at least once by the age of 25. Among the 44% who had experienced a mental health problem, 26% had been diagnosed and 18% had not.

These important new statistics are an important reminder of just how common mental health problems are. Anything that affects almost half of us directly will by definition have an impact on every family and every community in the UK. It is not something that affects 'other people' in other families, schools or workplaces.

Efforts to put mental health on a par with physical health in the NHS and health policy have produced some significant successes but still have a long way to go. We now, for the first time, have two waiting time targets for mental health care. We have promises of 'new' funding for mental health services by 2020 amounting to around £1.3 billion. And we have seen commitment to improving mental health support not just from the NHS but from local authorities across the country (more than 70 of which now have member champions for mental health), from schools and from police forces nationwide.

But achieving true equality for mental health (and more importantly for people with mental health problems) is a job half done. Even with over a billion pounds more by 2020, mental health care is likely to receive the same share of NHS funding as it gets now (about 13% for 23% of all health need). People with mental health problems still fare badly at school, in the labour market, in the criminal justice system and many other areas of life. And poor mental health still too often goes hand in hand with poverty, debt, poor physical health and poor housing.

Recognising just how widespread poor mental health is will not in itself change attitudes, policies or spending decisions. But it should contribute to the growing realisation that marginalising mental health policy and people with mental health problems is unsustainable and unacceptable. From the first spark of life to the end of life, we need to make better mental health a common goal of all public services and a priority at every level of government.

Now we know that mental health problems will affect nearly half of us (at least) directly in our lifetimes, and 40% of us by the age of 25, we need to accept that mental health needs to be in the spotlight not just for a couple of weeks or even months but at all times.

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