Coalition’s new mental health strategy should be supported

With very little fanfare, and very little follow up in the media, the coalition has announced how it plans to frame its strategy on an issue which affects one in four of us – not that we like to talk about it very much.

Our guest writer is Mark Davies, director of communications for Rethink, the largest voluntary sector provider of mental health services in England; Mark is a former adviser to the Rt Hon Jack Straw MP at the Ministry of Justice and the Foreign and Commonwealth Office

With very little fanfare, and very little follow up in the media, the coalition has announced how it plans to frame its strategy on an issue which affects one in four of us – not that we like to talk about it very much.

Mental health is one of the defining issues of our times. Always present, rarely talked about, people affected by mental illness represent a massive group who continue to face a degree of discrimination which would trigger street protests in any other context. Nine out of ten people with mental health problems experience prejudice.

It is estimated that 25 per cent of the population is affected by some sort of mental health problem at some point in their lives. Severe mental illness affects 1.5 million people and their families. It’s a fact that we all know someone who has experienced a mental illness.

The human cost of this is often devastating. People with severe mental illnesses like schizophrenia, for instance, die up to ten years younger than the rest of the population. And there is a massive financial cost too – according to the King’s Fund, mental illness costs us all at least £33.75 billion every year through the NHS, benefits, homelessness, substance misuse and the criminal justice system. It is probably much more – the government itself estimates the cost at £77 billion a year.

Judging by his words, the health minister Paul Burstow recognises this. In an article published in Community Care to set the scene for the government’s new mental health strategy, expected later this year, he argues that poor mental health is a key factor in a “miserable chain” which links family breakdown, worklessness, drug and alcohol abuse and crime with long term poverty and exclusion. Tackling this issue, he suggests, is critical to any attempt to reduce deprivation.

He’s right, of course. The economic arguments are obvious. The social arguments are clearer. And there is an opportunity to make progress in rectifying them  – thanks to the Time to Change campaign Rethink runs with Mind, there is evidence that the stigma which affects mental illness is falling, albeit from a disturbingly high level, and by no means far enough.

That said, we do believe that thanks to the social movement we are building – with more Facebook followers than Oxfam, for instance – the possibility of reaching a tipping point where discriminating against someone on the grounds of their mental health becomes socially unacceptable is within reach in the next few years.

The last government (for which I worked, though not in the health field) can take credit for pushing mental health up the agenda through the New Horizons strategy. The development of Improving Access to Psychological Therapies (IAPT) services, for instance, is an important step forward in terms of helping thousands of people with mild to moderate depression.

But as Mr Burstow points out, there is a need for a more fundamental change, that of a shift in culture in the NHS so that mental health has parity with physical health. It is encouraging that the new focus on patient outcomes rather than process targets is to take mental health outcomes into account, as is Mr Burstow’s desire for more emphasis on prevention and early intervention.

He’s also right, of course, that it is crucial that mental health concerns are embedded in the likes of housing, employment and children’s services: mental illness does not happen in isolation and nor does it require only a response from health professionals.

Rethink’s advice service in Plymouth magistrates court is a good example of this – by identifying problems among low level offenders which can contribute to or even cause mental illness – things like homelessness or debt, it is possible to divert them away from repeated appearances in the court room and tackle their mental health issues.

So far so good. And of course Mr Burstow is also right to point out that making changes in such a difficult area at a time of austerity is a big challenge. His belief that it will still be possible to land a “major blow against poverty and deprivation” through a new approach to mental health is therefore refreshing.

For that hope to come to fruition will, however, require a degree of innovation and a healthy dose of courage. It means supporting words with actions and committing to tackling the stigma around mental illness, extending talking therapies to people with severe mental illness, ensuring that GPs as commissioners have the tools they need to commission in the field of mental illness and being prepared to invest in early intervention to make savings down the line. Providing early intervention services in every new case of schizophrenia, for instance, could save £44m according to the King’s Fund.

Charities like Rethink, a Big Society organisation if ever there was one, are well placed to play a part in this. Through contracts with local authorities and PCTs, we already deliver more than 300 services in England, from advocacy to housing to talking therapies, costing around £50m a year. All these services play their part in reducing the human cost of mental illness as well as the economic costs.

But there is such a long way to go. Our recent report, Fair Treatment Now, highlights that when it comes to severe mental illness only 16 per cent of our service users are receiving the interventions recommended for their diagnosis. If that were the case for diabetes or asthma, for instance, it would regarded as a national scandal worthy of front page coverage in the Daily Mail.

This is the scale of the issue facing Mr Burstow. He deserves support in this endeavour from across the political divide and it would be good to see Labour’s new leader making an early commitment to working on this agenda. We wholeheartedly welcome the thrust of Mr Burstow’s commitments and will do everything we can to help him deliver real change for the millions of people affected by mental illness.

Like this article? Sign up to Left Foot Forward's weekday email for the latest progressive news and comment - and support campaigning journalism by making a donation today.