The new minister’s agenda

Sean's blogOriginally posted in the HSJ blog Leadership in Mental Health, 6 September, 2012

For the new minister responsible for mental health policy, there will be challenges and opportunities in equal measure. But what might (or should) his priorities be from this week onwards? And how will he achieve the ambition of putting mental health on a par with physical health?

The new minister benefits from the dedication of his predecessor, Paul Burstow, to creating and supporting a cross-government strategy, No Health Without Mental Health. The strategy sets out an ambitious agenda to improve mental health for all, tackle inequalities and radically improve the life chances of people living with mental ill health. Making it happen against a backdrop of organisational change and financial pressure, however, is another thing altogether.

So one big priority for the minister will be to see through the far-reaching change that the strategy requires: to embed mental health in the new public health system; to build the capacity of public services to intervene early; and to make Recovery the defining feature of mental health support in England. None of these will be achieved overnight but without government support the first steps to delivery will not be taken and the aspirations of the strategy will remain just that.

But the challenges (and opportunities) do not stop there. System reforms in the NHS have major implications for mental health services and the people who use them. The new commissioning system may stimulate creativity and innovation in mental health care commissioning but will all CCGs be able to demonstrate commitment to this and to work effectively with local authority partners? Ensuring that the Mandate places mental health on a par with physical health will be an important starting point, following which work is still needed to develop clear and robust outcome measures and to implement payment by results in a way that improves quality of care and promotes recovery.

Changes to public health and early years services create an ideal backdrop for enhancing mental health promotion and prevention work; but only with effective leadership from the centre to make these ‘must-do’ actions for local authorities.

Social care reform also needs to take mental health into account. The aspiration of a system that promotes independence is welcome but only if the new funding and legal arrangements encourage early intervention and support for recovery.

Finally, but perhaps most challenging of all, the minister can become a champion for mental health (and those living with mental illness) across government and in society more widely.

While public understanding of mental illness is beginning to improve, myths and misperceptions remain and discrimination continues to prevent people with mental health conditions from having a fair chance in life. National leadership to combat stigma and promote equality is as important now as it has ever been.

And as No Health Without Mental Health is a cross-government strategy, cross-government action to implement it is vital for success. This means linking with the Department for Education on schools; with the Ministry of Justice on prisons and probation; and crucially with the Department for Work and Pensions on welfare reform. The latter is causing especial concern with continued difficulties over assessments for a number of benefits and proposals to increase the use of sanctions with disabled people. These issues risk undermining efforts to improve people’s health and life chances.

The new minister for mental health will soon have a burgeoning in-tray. But it is a job that can make a difference to the lives of millions of people and address some of the starkest inequalities in health in our society.

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