Prevention is the best cure – mental health equality matters Edward Davie, Councillor in Lambeth, South London Recently I had the privilege of speaking at the Local Government Association’s annual public health conference in support of the Local Authority Mental Health Challenge. Fellow Lambeth councillor Jacqui Dyer and I were introduced by the Centre for Mental Health’s Andy Bell who has worked so hard to support councillors like us. It was great to have a receptive audience because trying to convince sceptics of the value of investing time, energy and money in mental health can be a real struggle. I get the impression that, even now, a lot of people think all mental illness is inevitable, untreatable and just not worth the effort. Whilst they can grasp the link between helping people to stop smoking and thereby reducing the risk of lung cancer they cannot conceive of things we can all do to help people stay mentally healthy. So it was heartening to be reminded of Andy’s new four-point, mental health mantra based on the evidence: ‘Prevention is possible; early intervention works; recovery is achievable; equality matters.’ Those were the tenets behind our work in Lambeth to improve mental health with our black residents which Jacqui and I talked about at the LGA conference. ‘Equality matters’ does not mean everyone is the same, or that the same things work equally well for everyone. It means recognising that, for many reasons, not everyone starts in the same place or needs the same kind of support in order to get an equal chance to succeed. What could be a starker illustration of this than the fact that African and black Caribbean people make up 25% of Lambeth’s general population but 70% of our residents in secure psychiatric settings? Our commission to address this inequality focused on working with residents to improve prevention, ensuring appropriate early intervention and supporting recovery through better patient experience. We found that prevention really is the best cure and it is also the most humane and cost effective action any of us can take. To that end we recommended parenting programmes to give children the best start in life; ensuring all of our schools teach their pupils resilience and an intensification of efforts to tackle poverty, abuse and neglect. Parenting programmes have been shown to save up to £200 per £1 invested and social and emotional education saves £84 per £1 spent on it. No accountant has been able to show me a better investment as councils face the ‘graph of doom’ showing rising demand and falling revenue. It is coming up to six months since we launched our commission report last World Mental Health Day and whilst it is relatively easy to come up with a glossy report it is much, much harder to implement the recommendations. We have been helped by a committed health and wellbeing board who commissioned the original work and who have accepted all of our findings. Public health colleagues are drawing up a list of actions that have been taken or that are outstanding and national charitable trust funds are showing great interest in supporting implementation and evaluation of the changes we are making. In our borough and nationally there is now a real chance to influence the way mental health is thought about. We have to work together to support all of our residents get the chance to enjoy better mental health enabling them to fulfil their potential and take a full part in our communities.