Back in July, our Government committed to a £1.3 billion expansion of mental health services and the creation of 21,000 new posts to support the NHS's Five Year Forward View for Mental Health. As this process continues, questions from many quarters of the mental health community continue to be asked around the issue of funding - and rightly so.
It's important that we call attention to areas in need of further funding, ensure money pledged is getting through, and look at ways we can invest more wisely to make the resources we have go further. There is however, another conversation that lies in the shadow of the funding debate - the question of the mental health of our whole society.
The last decade has seen the beginning of a revolution in public understanding of 'mental health', from a term synonymous with mental 'ill' health, to a term also relating to everyday mental wellbeing. Indeed, mental health is a continuum on which we all sit and in 2017, it doesn't take much Googling to find a whole host of statistics and reports shouting out to us that poor mental wellbeing is something millions of people experience and live with from day-to-day. We also know that this can have a wide-ranging economic, social, and emotional impact, from academic achievement, to career progression, to friendships and relationships.
Questions about funding and access to services are crucial, but are often concerned with managing our mental health at the point at which it's too late - at the point of crisis, or when the ability to function has become severely impaired. Today as we celebrate World Mental Health Day, I want to ask what is it about the world we have created that might be conducive to poor mental wellbeing and what we can do to better support early intervention to make treatment at the point of crisis a thing of the past.
To my mind (and many others), the answer to both lies in part in a lack of, and need for, preventative approaches. By this I mean practices at an individual, organisational, structural and civic level that reach into and permeate every area of social life in support of better mental wellbeing. On an immediate level this means campaigning to break stigma, end discrimination and raise mental health literacy so individuals are better at talking about and recognising signs and symptoms and knowing how to navigate services to access support. In organisations it means weaving workplace wellbeing approaches into policies and communicating these effectively to employees.
At a structural level it means thinking about how we can create schools, universities and syllabuses that confront wellbeing and equip young people for those difficult periods of transition that we know increase vulnerability to mental ill health. At the civic level, town planners and architects also need to (as many already are) think about how buildings and cityscapes can be designed to better support our wellbeing. In truth, these examples barely scratch the surface of the potential a holistic preventative agenda has to support mental wellbeing and resilience.
In many areas it is, however, an agenda that is still being written. Its full realisation requires better information on what works and what doesn't, which in turn requires a deeper understanding of the psychosocial determinants of good mental wellbeing and the root causes of poor mental health. What is it, for example, about the structures and systems in which we're raised, work and live that might be contributing to the emergence of symptoms of stress, depression and anxiety? Low mood, irritability, and patterns of poor sleep, even if not always clinically significant, are something we're all familiar with at one time or another. But why is it that these patches of poor wellbeing are becoming an accepted part of our lives? What are the underlying factors and what we can do to change this?
I don't claim to have all the solutions; however the preventative agenda, at once protective and proactive, is part of the answer, and one we can all engage with. Intensifying research into what makes for good and bad mental wellbeing is crucial to this endeavour in the long-term, but for individuals and policy makers alike, thinking about how we support good mental wellbeing in all areas of social life is key to helping us all live mentally healthier lives, now and in the future.
With this approach, my hope is that we can eventually create a world without intervention at the point of crisis, where good mental wellbeing is woven into the fabric of our society and where we all lead healthier, happier lives as a result.
To find out more about MHFA England and its training visit mhfaengland.org