Bringing about change in communities: putting the Prevention Concordat for Better Mental Health into action By Andy Bell The Prevention Concordat for Better Mental Health was published by Public Health England in August 2017 to help to guide, support and encourage local action to improve mental health and prevent mental health difficulties in communities across the country. Between January and March, Centre for Mental Health has been working alongside PHE, Kaleidoscope Health and Care and The King’s Fund to run a series of learning events in every English region about the Concordat. In ten separate events, from Plymouth to Durham, we have met people working in local authorities, clinical commissioning groups, voluntary sector organisations and other public and private bodies, all with diverse interests and expertise but all united in their determination to improve public mental health and reduce inequalities. The leadership role of local councils in addressing the determinants of good or poor mental health was evident from start to finish in these events. Local public health teams have a vital role in building and sharing an understanding of the mental health of the communities they serve, the challenges and inequalities they face, and the assets they have to bring about improvements. Many are now developing or already implementing mental health and wellbeing strategies, as well as suicide prevention plans and changes to mental health services for both adults and children. Those supported by elected members, for example as mental health champions, have extra impetus to bring about change and crucial political support for investing scarce resources in prevention. In ten separate events, from Plymouth to Durham, we met people... all with diverse interests and expertise but all united in their determination to improve public mental health and reduce inequalities. It was also clear from all of these events that local councils face enormous pressures. Many have faced numerous budget cuts in recent years which have reduced their ability to spend on prevention activity – in social care, in public health, in youth work and in early years services. While our understanding and appreciation of the importance of public mental health has never been higher, the capacity of public services to invest in it is extremely limited. But that has not stopped many from taking action and finding creative ways of making a difference: for example through ‘social prescribing’ initiatives to prevent loneliness. Every event also had representatives from NHS clinical commissioning groups locally and voluntary and community organisations. These are both crucial partners for local authorities. At many of the events we held discussions about the links between mental and physical health and the work many are doing to integrate support across this traditional divide. Through these we heard about initiatives to improve access to cancer screening and dental care for people with mental health problems, for example, and efforts to improve the mental health of people with long-term physical conditions. Yet there was very little engagement from Sustainability and Transformation Partnerships, despite their importance within the NHS and their avowed role in shifting resources and attention towards prevention and mental health. Many councils have faced numerous budget cuts in recent years which have reduced their ability to spend on prevention activity – in social care, in public health, in youth work and in early years services. A consistent message throughout these events was the relationship between mental health and the broader economic, social and cultural influences on our lives. Poverty, ethnicity, gender and class have a big impact on our chances of having good mental health and our experiences of mental health support. So attention is needed to the inequalities and adversities we face at every stage of our lives: every choice made by local and national government affects people’s wellbeing and therefore its implications need to be considered in that light. Challenges aside, it is clear that there are people working across the country, in many different ways, to give everyone a better chance of good mental health and to bring about change in communities. It is vital that they get ongoing support to do that, that we keep learning about what works and what doesn’t, and that we hold policymakers to account for the decisions they make that have an impact on our mental health. There is a lot more to do. Missed the prevention concordat events? You can still catch the webinars here. Explore how NHS organisations, local authorities, the voluntary sector and others can work together to prevent mental ill health in local communities, through The Kings Fund event on 6 June.