Promising signs in a challenging landscape: mental health in 2016 By Alethea Cope How will you remember 2016? For many, it will be regarded as a year of unparalleled political upheaval. But how was 2016 for mental health? Certainly, mental health problems (their effect on individuals and the services required to address them) seem to be higher up on the agenda, in government policy, in the media and in society more generally. In her first speech as Prime Minister, Theresa May highlighted mental health as a priority on the steps of Downing Street. However, these advances come amid some of the greatest financial and systemic pressures facing public services. Alongside more recognition of mental health than ever before, we are also seeing more pressure on services and the people they serve. One key instance was the launch in February of the Mental Health Taskforce’s Five Year Forward View and our economic analysis which shaped the priorities of the strategy. The strategy included some important service improvements such as the development of perinatal mental health care (30,000 more women to receive specialist help) and the expansion of Individual Placement and Support employment services. However, these objectives come at a time of unprecedented financial demand on the NHS and concerns that funds earmarked for mental health will be diverted to other services. The Centre will be monitoring the situation to ensure that money is spent well to deliver effective change in people’s lives. 2016 saw further coverage of the mental health problems facing our children and young people, led by the Duke and Duchess of Cambridge and Prince Harry and the new Heads Together campaign. This year we emphasised the importance of raising mental health literacy in families by highlighting the 10-year gap between children experiencing first symptoms and experiencing support. This led to calls for concerted action to address the mental health needs of children amid concerns that funding pledged for this was not getting through to services despite the rise in awareness about the problems. For many of us, one of the key events of the year was the UK’s EU referendum. Following the referendum, we arranged a round table meeting of mental health charities to explore the implications of the result for our mental health and for services. We highlighted concerns that the financial and emotional uncertainty caused (both to individuals and as a society) could affect levels of mental wellbeing and in turn increase the pressure on services, many of which depend on staff from other EU countries. The year also saw the Centre’s new report on housing, More than shelter. We highlighted the importance of secure housing to ensure good mental wellbeing, and reviewed the evidence about supported accommodation provision in England. We also raised concerns about the impact of recent housing policy reforms on people with severe and enduring mental ill-health, creating a toxic mix of pressures which subsequently exacerbate need and service demand. Two major surveys this year created a clearer picture about the mental health of the population and our understanding about it. The British Social Attitudes survey made for sober reading, with stigma and misunderstanding still acting as major barriers to equality and help-seeking. Just 36% of respondents, for example, said that they would be willing for someone with symptoms of depression to marry into their family. And new mental health prevalence figures were released in the Adult Psychiatric Morbidity Study, which takes place every seven years. Overall levels of mental health appear to be broadly similar in 2014 compared with 2007, but there has been a dramatic growth in the number of young women reporting that they have experienced mental health problems. Both surveys also reminded us that mental health problems disproportionately affect those living in more deprived areas, people who are poorer, and people from black and minority ethnic communities. Nowhere in our society is poor mental health as endemic as in prisons, and in 2016 concerns grew as the number of suicides in prison rose to over 100 (the highest since records began in the ‘70s). The reasons behind this are, as ever, multifaceted. However, a cause noted by many was the dwindling numbers of prison staff. Our research, with the Howard League, emphasised the need to make every prison ‘psychologically informed’ and put wellbeing at the centre of the justice system to prevent further losses of life. 2016 was arguably a year of some significant advances in the face of a perpetually challenging landscape. As we look back on the year and anticipate all that lies ahead in 2017, the words of Tennyson spring to mind – Hope smiles from the threshold of the year to come, whispering ‘It will be happier’ More challenges will lie ahead in 2017. At Centre for Mental Health we will seek to ensure that mental health continues to get a high profile, and that this translates into genuine action which really transforms society and changes people’s lives.