Building Parity for Mental Health in the new Parliament

There is thus a lot to do if we are to put mental health on a par with physical health. It will take some fundamental changes to the way resources are allocated and used in the NHS and public services more broadly. But by using and building on the evidence of what is needed and what works, we can use scarce resources more effectively to enhance the nation's mental health and to improve the lives of people with mental health problems.

Mental ill health affects one in four of us every year. Depression, anxiety and other mental health problems affect people of all ages, from childhood to later life, and carry an economic cost of more than £100 billion every year. Yet mental health care has often been relegated to the sidelines of the NHS - viewed as a marginal matter compared with other health services. It has traditionally been an after-thought for policy-makers both nationally and locally across the country: chronically under-funded, under-valued and under the radar.

In recent years we have seen signs of this changing. The creation of the national Improving Access to Psychological Therapies (IAPT) programme in 2007, which continues to this day, brought about concerted efforts to increase the availability of proven talking treatments for depression and anxiety, first for adults and then for children, throughout England. Alongside this, the Time to Change campaign has begun to make notable progress in changing public perceptions of people mental health problems, while the five years since the Bradley Report was published in 2009 have seen significant progress in extending mental health support to people in police custody and the courts.

As we begin a new Parliament, it is crucial that the progress made under previous administrations is not just sustained but stepped up. For the first time this year we will have national waiting time standards for adult IAPT services and for Early Intervention in Psychosis services for young people experiencing their first episode of severe mental illness. Thanks to the Crisis Care Concordat we also have local agreements in every part of England for this first time about how different services will work together to support people in a mental health emergency. And more general hospitals now have liaison psychiatry teams that offer mental health support to patients admitted for physical illnesses.

These are all important developments in their own right, but even when taken together do not yet put mental health on an equal footing with physical health. And they are only the beginning of the journey to create a fair chance in society for people with mental health problems.

To achieve that, we need action on many fronts. Starting early in life, we must ensure that all women experiencing mental health problems during pregnancy or afterwards are offered prompt, effective care and support. The costs of failing to do this are huge, affecting not just the mother's health but that of her child. We need to offer timely and helpful support to parents struggling to manage their children's behaviour. And we must ensure that all schools have the right support to promote and protect the emotional wellbeing of children: putting it on the curriculum, supporting children early when they become distressed, and tackling bullying. Implementing in full the recent government report, Future in Mind, is essential for the health of our children today and the wellbeing of future generations.

For people of working age, we need to offer much better support into employment for those who want to work. The use of benefit conditions and sanctions on people with mental health problems has yet to be shown to confer any benefits, and may in fact put people at high risk, yet effective supported employment schemes are still only offered to a minority of those who would like to work with the right help. Extending access to effective employment programmes is vital, alongside support with housing, debt and other welfare issues, to help people to recover their lives.

And while progress has been made in reducing the use of police cells as a 'place of safety', access to care in a crisis is still a cause for concern for people mental health problems. A CQC report published this month has shown wide variations across the country in the quality of care people experience in a mental health emergency, with particular concerns about the way people are treated in Accident and Emergency units. If 'parity' is to have any meaning for people with mental health problems, first and foremost we must ensure that wherever and whenever a person seeks help in a crisis, they get prompt, effective and respectful treatment. We would expect nothing less for a life-threatening physical injury or illness.

There is thus a lot to do if we are to put mental health on a par with physical health. It will take some fundamental changes to the way resources are allocated and used in the NHS and public services more broadly. But by using and building on the evidence of what is needed and what works, we can use scarce resources more effectively to enhance the nation's mental health and to improve the lives of people with mental health problems.

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