Gael Scott, Policy Officer at the Centre for Mental Health
On Monday the Government published its Social Justice Strategy, Social Justice: Transforming Lives, aimed at coordinating work to support people facing multiple disadvantages. Although the strategy doesn’t give detailed attention to mental ill-health, it touches on many of the areas where mental ill health impacts on people with complex and multiple needs.
What the strategy does recognise is that there is a group of people experiencing multiple problems who continue to fall through the gaps in services. Importantly, the strategy gives specific attention to the group of individual adults who we know experience entrenched difficulties (rather than just the 120,000 ‘troubled families’ that the Government has targeted in other ways). The strategy recognises that a large number of adults experience multiple disadvantages, referring to household survey data showing that 11% of adults in the UK (5.3million) experience three or more areas of disadvantage at any one time (out of 6 areas: education, health, employment, income, social support, housing and local environment) and it is reiterated throughout that these problems are not only interlinked, but compound each other.
The strategy calls for new approaches to delivery for people experiencing multiple problems, including better preventative services, multi-agency approaches, and the provision of key workers to provide long-term tailored support. In line with the ‘localism’ agenda, it is clear that it will be up to local areas and ‘grassroots’ movements to design and deliver new and innovative solutions. At the central government level, the Social Justice Cabinet Committee will provide political leadership and facilitate cross-government working, and also advocate any innovative evaluation techniques and delivery mechanisms.
The strategy is based on two overarching principles:
1. Prevention – in particular the role of families at an early stage in a child’s life. Attention is also given to the role of schools, the youth justice system and the welfare system later on in a young person’s life.
2. A “second chance society” – whereby people who do get into trouble and experience problems are given a second chance and the support and tools they need to change.
The strategy is based on what it calls a ‘life cycle’: beginning with family; then looking at children and young adults, particularly the role of schools; then working age adults, with a focus on benefits, welfare reform and getting people into work; and finally looking at those adults who are most disadvantaged and already experiencing entrenched problems such as homelessness, mental illness and repeat offending.
Working with children and families and in schools
In relation to families, the strategy sets out two themes: firstly, the relationship between parents, keeping parents together and reducing the number of divorces; secondly, on supporting parents in their child’s early years. Although the early intervention measures proposed by Graham Allen MP are supported, the main thrust of the section on families focuses on relationships between parents.
In schools the rhetoric is still largely around “bad behaviour”- giving schools more “authority” to enforce “order and discipline”, although when the strategy goes on to consider mental health it does point out that poor mental health can be at the root of some disruptive behaviour, and also states that guidance on exclusions will be revised to stress the importance of early intervention to identify and address the causes of disruptive behaviour. The strategy also highlights recent changes which make schools accountable for a pupil it excludes to ensure access to alternative provision.
We know that behavioural or conduct problems which emerge early in childhood are very likely to persist into later life. They are associated with a wide range of adverse outcomes, including not only continuing mental health difficulties but also poor educational and labour market performance, poor health, disrupted personal relationships, criminality, substance misuse and reduced life expectancy. Particularly for the one in 20 young children whose problems are sufficiently severe to merit a clinical diagnosis of conduct disorder, life chances are seriously compromised, however, an increasingly strong body of evidence shows that parenting programmes and schools based interventions can prevent conduct disorder entirely or prevent the condition lasting into adulthood.
Does the strategy mention specific provisions to support people with mental health problems back into work?
No. In relation to work, most of what is said in the strategy simply details the various welfare reforms and current approaches to supporting people back into work (mainly the Work Programme). There is some discussion about what is being done to support those with disabilities back into work, and the strategy highlights that work is good for both physical and mental health, with reference to the outcomes on employment in the Public Health Outcomes Framework.
On the section for the most disadvantaged adults – people who need to be given a “second chance” – the strategy stresses that these people have a range of needs which can compound each other and lead to social exclusion and isolation from the services they need to change their lives. There is a commitment to sharing data more effectively across government in order to build up a better picture of the number of adults with multiple needs.
Overall, while the strategy adds little to what we already know about the changes taking place across different departments, it does help to bring these threads together, and the official recognition that more needs to be done to support both individuals and families with multiple needs is to be strongly welcomed.