The government’s much-anticipated mental health strategy, No Health Without Mental Health, was published earlier this month with a major, and very welcome, focus on improving services for children.
While there has been intense debate about how precisely the government’s pledge to expand psychological therapy provision will be funded, the strategy and its attendant supporting documents at last give mental health policy in England a much-needed sense of direction and purpose.
One of the key themes that emerges clearly from the strategy is that of intervening early. The evidence in almost all areas of mental health is indisputable. Mental health problems are widespread, they affect people of all ages, and the longer they remain hidden, stigmatised and untreated the worse they become and the greater the losses people experience in all areas of their lives.
Early intervention really does have to start early. Parenting support for young families, including before birth, can make a dramatic difference to the emotional health and long-term life chances of our children.
The expanded health visitor workforce as well as midwives, GPs and other health workers will have a crucial role to rebalance post-natal care to focus as much on children’s and their parents’ mental as well as physical wellbeing.
As well as early in life, early intervention can also mean acting quickly when people first become unwell.
Early intervention in psychosis teams, set up under the National Service Framework for Mental Health, have shown that not only does reaching out to young people experiencing psychosis for the first time benefit their health but it also increases their chances of getting into employment and building the lives they want for themselves.
We now need to learn from what these teams have achieved and extend this approach to other children and young adults – for example those who end up in the justice system for lack of support from other services. And of course we need also to avoid making short-sighted cuts to existing early intervention teams in the face of financial contingencies in the NHS.
Intervening early can also be applied to the 1.3 million people who work for the NHS, too. Every year, one worker in six will experiences a mental health difficulty. Only a minority either seek or receive treatment. The NHS can, and should, show leadership to other employers by promoting the mental health of its own staff and helping supervisors and line managers to respond positively when staff become unwell.
The government’s mental health strategy presents a compelling vision for promoting the mental wellbeing of the whole population and improving the lives of people who experience mental ill health. Making it happen in an environment of funding cuts across public services – and especially in local government – will not be easy.
But it is a challenge we must not neglect.
We need to foster a culture in which our mental health needs really do have ‘parity of esteem’ to our physical health, where discrimination to those with mental health problems is as unacceptable as racism and sexism, and building on these foundations where intervening early is the norm, not the exception.