Doing justice to mental health in STPs

Claire Murdoch, national director of mental health for England, argued recently that certain sustainability and transformation plans fail to do ‘justice with mental health. What would a judge look like? The answer is to make mental health a central part of new care models and the STPs’ approach to improving population health.

We estimate that in England, poor mental health increases the annual cost of long-term physical health conditions by between a data-entitysubstitution=”canonical” data entity-type=”node” data entry-uuid=”1700a584″>PS8 billion and PS13 billion/a>. We estimate that poor mental health in England increases the cost of long-term health conditions between and PS8 billion. It is not surprising that people’s physical health can deteriorate when they are struggling with social and emotional stress. This is felt in A&E, general practice, and other places. All too often, we treat these issues as if they are only of concern to mental health professionals.

Leaders are taking advantage of the STP development process to rethink their approach to mental health, well-being, and their local systems. They are also embedding mental wellness into every aspect of their work. Those who aren’t doing this yet risk missing out on a great opportunity to use STPs for better population health.

What should STP leaders focus on when it comes to mental health? In order to answer this question, we must return to the two core objectives of STPs.

STPs will be the primary vehicle for the new care models being tested at NHS England’s vanguard site to be implemented across the country. (This includes the Multispecialty Community Provider and Primary and Acute Care Systems models). These new integrated approaches are based on the creation of multidisciplinary community teams that coordinate around clusters of general practices and serve populations between 30,000 and 50,000. Leaders of STPs should make sure that mental health is integrated into these approaches right from the start. As part of their core skillset, professionals in integrated care teams and primary care teams that they work alongside need to be able to think broadly about both the physical and mental requirements of those they support.

We will draw on the lessons learned from Vanguard sites to provide recommendations for how this can be done. We will then explore the possibilities for primary care, a closely related issue that will need to be addressed in STPs.

STPs will also need to reduce future care demand by improving population health. STP leaders should be concerned about improving mental health at the population level, given the relationship between poor mental well-being and the nation’s biggest public health issues. A big part of this will be to make a significant change in the way we support and promote the mental health and wellbeing of children and youth, as per the Future In Mind report and the foresight report that came before.

The Five Year Forward View for Mental Health described service areas that were particularly in need of investment and improvement, such as liaison mental health and perinatal mental healthcare, early intervention for psychosis, and crisis resolution teams. STPs must also support local areas to act on these commitments. NHS England’s aid memoir summarizes some of the key priorities for STP leaders.

In some ways, the word justice may send the wrong message. Justice is a word that speaks to our concern for fairness and equal opportunity – both noble and important sentiments. The message I want to send is that putting mental health at the center of STPs makes clinical and financial sense.


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