27 / 01 / 2015
The mentally healthy society
Taskforce on Mental Health in Society, January 2015
This report is the output of a taskforce established by Ed Miliband in late 2012, and forms a submission to the Labour Party. The Taskforce on Mental Health in Society aimed to “set out a roadmap for how society needs to change to prevent mental health problems and promote good mental health.” In particular it addresses mental health as a population public health issue, looks at the untapped potential of early intervention services and shows how wider society can provide better support and opportunities for those with mental health problems.
The report begins by setting the scene around mental health in the UK. Mental ill health is the “single largest cause of disability,” accounting for 23 per cent of total disease burden. It notes the broad impact of mental ill health on wider life outcomes and its economic impact. The report observes that positive steps forward in recent years, such as the acknowledgement of the importance of parity of esteem between mental and physical health and the development of the Crisis Care Concordat, have happened alongside cuts in funding and increasing bed shortages.
Population mental health is then addressed, with the report arguing that the “well-established building blocks” of public health interventions for physical health have had a massive impact on life expectancy, but that no equivalent set of interventions for mental health has been developed at this scale. A number of resilience factors have a role in preventing mental ill health. For example, an individual’s social networks can play a key part in preserving good mental health. Equally, those experiencing problems often find forming and maintaining social networks more difficult. Support from these networks can range from that provided by friends and family, through to formal public services. Various initiatives can help in removing barriers to social activity and the report recommends that the government develops a social infrastructure plan “to help catalyse public and private investment in social infrastructure.” It also endorses a new national campaign to increase physical activity due to its role in preventing mental ill health, as well as the incorporation of social and emotional development into PHSE education.
The report then discusses risk factors which could increase people’s vulnerability to mental health problems. It notes the devastating effects of violence and abuse, as well as the impact of bullying on both children and adults. The taskforce recommends strong action to tackle these issues, with a zero-tolerance approach across society backed up with policies. The specific issue of cyber-bullying should also be addressed through the school curriculum. Looking at work-related illness, the reports states that work-related stress, depression and anxiety resulted in 11.3 million working days lost in 2013/14. It is recommended that all line managers have training in the specific skills needed to ensure “a mentally healthy workplace” and support staff who are unwell. This should be reflected in professional management standards and employer accreditation schemes. Social isolation is another clear risk factor for mental illness and the taskforce recommends that Health and Wellbeing Boards (HWBs) assess the need for social support as part of their joint strategic needs assessments. Health inequalities should also be addressed and “major government policies should undergo a Mental Health Impact Assessment”.
The document goes on to consider the key role of early detection and intervention to prevent and lessen the impact of mental ill-health. It observes that health visitors, who have contact with every family in their home, are in a unique position to detect issues early. It recommends that health visitors have additional training and support to identify and respond to issues relevant to mental health. Greater access to parenting programmes for those who need them is also encouraged, as is strengthening training on mental health issues for teachers. The taskforce recommends that contact with healthcare professionals at 13/14 for vaccinations should be developed into a “universal health check”, incorporating questions on wider wellbeing. In addition, funding for Child and Adolescent Mental Health Services (CAMHS) should be restored at minimum, with a named CAMHS worker in every school. Children should also be able to access counselling services at school or college. An extension of the IAPT programme and the introduction of waiting time standards for psychological therapies would extend access, particularly important for those on sickness absence or out of work benefits. Early intervention psychosis services should be expanded to meet demand.
Finally, the taskforce looks to support and opportunities for those with mental health problems. The increased housing difficulties experienced by those with mental health conditions are raised and it is recommended that HWBs include a housing or planning representative. CCGs and local authorities should also include housing organisations in designing their care pathways. As regards employment, the report recommends that any provider bidding to deliver government employment programmes must demonstrate specialist knowledge of mental health. Personal care plans and a personal care coordinator should be available to everyone with a serious or comorbid mental health problem. Finally the report recommends that the Time to Change campaign is funded beyond 2016 to help counteract negative attitudes and discrimination.