Mental health is still an area that needs improvement despite recent investments. The new government strategy, “No Health without Mental Health,” sets six objectives for improving the mental health of the population and the outcomes for those with mental health issues.
The report supports the government’s goal to achieve parity between physical and mental wellbeing. It stresses the connections between mental health, housing, and employment, as well as the criminal justice system.
The strategy is largely focused on the right areas. The system captures long-standing concerns for people with mental illness – like the pernicious effect of stigma – and reflects research evidence on, for instance, the profound interconnectedness between psychological and physical wellbeing.
“No Health without Mental Health” contains very few centrally-mandated actions. This is in line with the intention of the government to refrain from telling doctors what to do. It describes the destination and gives directions to get there. Then, it tells us how we will know if everyone gets lost.
This approach means that, if this strategy is going to have any real force, mental health, and the six objectives, in particular, need to be fully reflected within the outcome frameworks which will hold NHS, public healthcare, and social care professionals accountable for the results that they achieve. These objectives must also be incorporated into the framework for commissioning outcomes to be developed by GP consortia and any outcome measures used to monitor local contracts.
The proposed outcome frameworks only reflect a partial reflection of the objectives. One objective that more people will recover from mental health problems is meant to encompass not only the clinical recovery but also the recovery in a broader sense, which each person can define. The NHS outcome framework will only measure it in terms of the employment rates of people with mental illness.
The outcome frameworks do not include measures to reduce stigma, and therefore, the NHS or the public health sector will not be held accountable at a national level to meet this goal.
The strategy’s most eye-catching commitment is the PS400 million announced over four years to expand Improved Access to Psychological Therapies to three new groups: children and youth, people with long-term illnesses, and people with severe psychological conditions. The money cannot be ring-fenced, and it must come from existing budgets. However, the commissioners should still be encouraged to fulfill this commitment, as it will give thousands of people much-needed evidence-based treatment. This is also economically sensible. In a report from The King’s Fund & Centre for Mental Health, Mental Health, and the Productivity Challenge: Improving Quality and Value for Money, it was highlighted that improving psychological support for those with long-term illnesses, as well as addressing childhood mental health issues more effectively, could provide a return on the investment.
It is commendable that the government has such ambitious goals, but, as the strategy acknowledges, there is still much to be done to make the vision a reality. The objectives won’t be met unless the relevant organizations are held accountable for their delivery.