Unlike most documents produced by government, the framework is a genuine ‘co-production’ between it and a range of independent organisations, including Centre for Mental Health. As a result, it brings together a range of perspectives and understandings about what needs to be done to bring about change in people’s lives. It aims, ultimately, to leave no one in any doubt about their responsibility for the strategy as well as offering very practical suggestions for how to make a difference in their localities.
Achieving the strategy’s six objectives remains, of course, a major challenge. To take just one objective, improving the physical health of people with a mental illness and vice versa, we are only at the beginning of a long journey towards integration and better outcomes for the half a million people with a severe mental illness whose life expectancy is dramatically reduced and the four million with long-term conditions alongside depression and dementia.
Nonetheless, there are signs of a shift in understanding and expectation. The draft NHS Mandate now places a clear obligation on the Commissioning Board to place mental health on a par with physical health. Both Sir David Nicholson and Duncan Selbie have pledged the Board and Public Health England respectively to do their part to implement the mental health strategy at national level.
Many localities are also taking the initiative. Dorset County Council has a member ‘champion’ for mental health who works across the council and with local health services and employers to promote equality. Some clinical commissioning groups are making plans to improve local mental health services while local authorities are investing in parenting programmes despite the spending pressures they are facing.
Successful application of the mental health strategy will depend on both national and local action, with a range of services cohering and supporting one another to achieve more than any could do in isolation. The framework offers ideas about practical steps that can help to trigger bigger changes over time. In practice, though, what will make it work is people: coming together, championing change, building relationships and doing things differently.