Mental health is one of the most neglected aspects of public health worldwide, despite its growing importance and urgency. Public mental health – a term that includes work to promote mental wellbeing, to prevent mental ill health, and to pursue social justice – is essential to create a mentally healthier future for all. Yet it is often undervalued: on the margins of both public health (which tend to prioritise physical health) and mental health services (that focus on treatment and care for individuals).
It doesn’t have to be this way, however, and for eight years Public Health England (PHE)’s mental health team provided a focal point for national public mental health work that has given us valuable learning for future policy and practice. As members of that team, we have reflected on that experience, on what we learned from working in a national public health agency, and what policymakers now and in the future can do to boost the public’s mental health.
Our experience tells us that having public mental health capacity at a national level that is able to influence across government departments enables an integrative approach to policy development and implementation. Only then can you deliver a whole government approach to the public’s mental health, informed by the best available evidence, coordinated across departments, with clear leadership and accountability. This is enhanced by connections with organisations outside government that provide advocacy and advice that boost its momentum and sustainability.
An essential element of this work is to provide insight, monitoring, evidence and research. For example, in the early months of the Covid-19 pandemic, PHE provided valuable intelligence on the nation’s mental health. And ongoing data on suicide deaths and on the physical health of people with severe mental illness is vital to inform essential actions to save lives.
Policy and evidence are of limited value, however, without infrastructure to support implementation. This need not be heavy-handed or bureaucratic. One of the most effective mechanisms to support local public mental health activity has been the Prevention Concordat for Better Mental Health, supported by a small team of regional leads who have helped councils to put its principles into practice.
Today, public mental health activity in England is fragile. More than a decade of austerity cuts has reduced local capacity, and there is no longer a national public mental health function in the UK Government. There is no strategy, and little accountability or transparency nationally. Yet with a relatively small but wise investment this can be turned around. With a clear strategy, a small team (perhaps headed by a national mental health commissioner), and a commitment to mental health in all policies, we could start to co-ordinate action to turn around the decline in the public’s mental health.
Read more of our reflections and recommendations for future action in this published article.
Jude Stansfield is Principal Research Fellow at Centre for Health Promotion Research, Leeds Beckett University; Claire Robson is a Public Health Consultant at Trafford Council; Ian Walker is Head of Public Health at Barnsley Council.
