It’s a mark of how much our perceptions have changed about mental health over the last few years that Theresa May made it a feature of her prime ministerial swan song on Monday.
A decade ago mental health didn’t have anything like the profile it has now, but there has been a seismic shift in recent years. During the 2015 general election mental health was on the agenda of every political party for the first time, and in 2017 it was mentioned more times in general election manifestos than any other condition (according to an analysis of elections since 1945). It has, undeniably, taken its rightful place on the agenda and we hope that it will stay there well into the future.
It needs this level of priority because it’s going to take a long time and the leadership of several successive prime ministers to get mental health services and support to where they need to be. It is seven years since the Health and Social Care Act said the NHS would give mental health ‘parity of esteem’ with physical health and while we have had an overwhelming number of policy changes, pilot programmes, plans and pots of money, we are still miles from equal priority.
There is a plan – a good plan – that will start to move NHS mental health services closer to where they need to be. The devil is in the delivery, and the focus now is on making sure local areas are developing their own individual plans with, crucially, the input of people with direct experience of mental health problems. And NHS leaders already need to be thinking further ahead, to what comes next. Only a third of the people who need it actually access any kind of support and those who do don’t always get what they need – there is a very long way to go.
Keeping up the momentum around mental health is key, and not just for the NHS. We are pleased to see a commitment from government today to publish a white paper on the Mental Health Act before the end of the year. Having promised a complete overhaul of this important and outdated legislation in her manifesto, Theresa May commissioned a review, but progress stalled because of Brexit and we feared it might never happen. Reforming this area of the law is essential if we are to make sure we treat people with dignity when they are at their most unwell, and address the inequalities faced by some groups when in statutory care. It’s good to see a fresh promise to take this forward.
It’s encouraging too to see such a focus on young people’s mental health. Most mental health problems start in childhood and if we can teach our young people to understand their mental health, to look after it and to speak up as early as possible when they need help, we could do a lot to reduce the impact on the NHS and other services in the future. But the NHS and schools aren’t currently able to cope with the increasing numbers of young people needing support so, while training teachers to spot the signs is undoubtedly a good idea, we also need to make sure that the right services and support are in place.
Finally, it’s good to see the government acknowledge the impact that difficult life circumstances can have on mental health. Buried in the raft of announcements today is a renewed commitment to a ‘breathing space’ scheme that will protect people in financial difficulty from debt collection action if they need support for their mental health. This growing acceptance that mental health is about more than health services is critical. All government departments should have one eye on wellbeing when making decisions. There’s little point throwing money at the NHS to help people when they are unwell, if at the same time you are actively making people unwell through the benefits system, or not working hard enough to make sure everyone has a safe place to call home, or letting employers get away with not doing the right thing by their employees’ mental health.
The job for the next prime minister will be to bring together the good work being done in different bits of government and formulate a cross-governmental strategy for mental health. Only when we truly accept that all areas of our lives are impacted by and can affect our mental health, and start looking at all of this as part of one picture, will we really get to grips with one of the most pressing issues of our time.
Paul Farmer is chief executive of Mind
Useful websites and helplines:
- Mind, open Monday to Friday, 9am-6pm on 0300 123 3393
- Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI - this number is FREE to call and will not appear on your phone bill.)
- The Mix is a free support service for people under 25. Call 0808 808 4994 or email: firstname.lastname@example.org
- Rethink Mental Illness offers practical help through its advice line which can be reached on 0300 5000 927 (open Monday to Friday 10am-4pm). More info can be found on www.rethink.org.