Just over a year ago Prime Minister Theresa May announced that she wanted to transform approaches to mental health across society, setting the tone for 12 months of intense focus on mental health across the political spectrum and in the media. The government rolled out mental health training for school staff, set out plans to review the Mental Health Act and announced a national mental health awareness campaign. All three parties also made a commitment to parity of esteem between mental and physical health in their election manifestos, and even the Royals got in on the act, leading campaigns as part of Heads Together.
There’s no doubt that 2017 was a landmark year for mental health awareness. This year, however, our politicians need to continue to translate awareness into meaningful action to make the most of this newfound momentum. But, how well equipped are our elected representatives to do this? What structures are in place in Westminster to support the mental health agenda and continue the drive for parity of esteem?
All Party Parliamentary Groups (APPGs) are one key part of our parliamentary system that help MPs and stakeholders channel debate and policy reform. But a quick look through 2018’s list, and it’s clear that mental health lags a long way behind physical health. There are well over 40 groups on subjects specific to physical health, covering everything from physical first aid, to diabetes, to ovarian cancer. For mental health there are a paltry six - just six! These include action groups for the arts, health and wellbeing, body image, complex needs, mental health, mindfulness and suicide and self-harm prevention.
If we want to address the complexity of issues in mental health with any rigour, then a good place to start would be with this basic machinery of parliament. It seems bizarre that in 2018, we have APPGs for darts, angling and jazz appreciation (yes really), but not for depression, anxiety or psychosis. Under the current structure the APPG for mental health is left to cover everything from detention, recovery, and a wide range of mental health issues, to prevention, first aid and treatment.
Writing recently for Times Educational Supplement, the government’s former mental health champion, Natasha Devon MBE, highlights the dangers of reductionist approaches to ‘mental health’. Explaining the differences between prevention, initial support, and professional services, Natasha warns that conflating the three areas undermines the complexity of the issues, hinders political action and feeds empty rhetoric. Action on mental health should of course never be a tick-box exercise, and diversifying APPGs in this area is one way our politicians can begin to show that they are serious about parity of esteem.
Let’s take funding as one core part of achieving parity of esteem. In 2016, NHS England’s Independent Mental Health Taskforce highlighted that, although mental health makes up 23% of the health service’s activity, overall spending here – £9.2 billion – accounts for around a tenth of the total NHS budget. This figure is approaching £10bn as we head into 2018, but taken in perspective, there’s still a long way to go.
A broader set of action groups in parliament can, among other things, empower different stakeholders to advocate for properly funded services and help inform the most efficient use of budgets in different areas. They can better highlight the overall benefit to society of investing in prevention, initial support and treatment and the knock-on effects this would have on physical health and productivity. All of which could actually help to reduce the £105 billion cost to the economy associated with mental ill health.
True parity of esteem is ultimately borne out in quicker access to treatment, properly funded services and improved approaches to supporting wellbeing, from the cradle to retirement. It goes without saying that there’s more to this than the conversations that happen in the corridors of power, but those who represent us at the highest levels have a crucial part to play.
So, if Westminster’s advocacy groups can be vehicles for a mentally healthier future, isn’t it about time we gave them a mental health MOT?