Chief Medical Officer’s report urges reinvestment in better mental health


by Andy Bell

Today’s report of the Chief Medical Officer, Dame Sally Davies, sends out a clear message that mental health can no longer be sidelined or ignored either by the NHS or by public health services.

Mental ill health affects almost a quarter of us at any one time and, as the Centre calculated in 2010, costs more than £100 billion a year. Three-quarters of children and adults with mental health problems get no treatment at all. Yet effective early intervention can dramatically improve people’s lives and prevent future distress.

The report, Public Mental Health Priorities: Investing in the evidence, makes a clear call for a greater focus on children’s mental health. Children with behavioural problems face a lifetime of ill health and disadvantage. This can be prevented or mitigated through evidence-based parenting programmes. Yet few parents get the help them need to manage their children’s behaviour when they seek it. Local authorities that invest in evidence-based parenting programmes can address one of the biggest public health problems their communities face and dramatically improve the health and wellbeing of some of their most vulnerable children.

The report also has a major focus on work. Too many people with mental health problems are given inadequate help to get or keep work. Yet employment can be an integral part of recovery for many people. Better help for people to retain employment and to get timely access to psychological therapy when they become unwell is crucial.

Many of the building blocks of better health and work support are already in place. A growing proportion of mental health services provide an Individual Placement and Support service that gets the best results in supported employment – but it is still not offered everywhere. The Access to Work scheme offers financial support for reasonable adjustments at work – yet just 3% of funding is used to support people with mental health problems. And more employers are waking up to the importance of supporting the mental health of their staff – but many more are yet to recognise and act on this.

The report recognises the importance of linking mental and physical health. Some 4.6 million people in England today have a long-term physical condition and a mental health condition. Improving support to people with physical and mental health needs is vital both to improve their health and to cut the £10 billion extra cost to the NHS. Developing effective collaborative care arrangements that offer people with long-term conditions effective and engaging mental health support could improve quality of life considerably and may help to reduce premature mortality.

Last week’s Barker Commission report for The King’s Fund advocated ‘equal support for equal need’. Today’s report identifies that this is still far from being a reality for people with mental health problems. Access to evidence-based treatment remains patchy. Waiting times are variable. The Chief Medical Officer’s report reinforces the case for parity of funding for mental health support as part of the answer to this longstanding inequality.

Today’s report once again demonstrates once again that there is a compelling case for reinvesting in effective mental health support for people of all ages. The task now is to convince more than 200 clinical commissioning groups, 150 local authorities and a range of other key agencies, from schools to employment services, to make mental health the priority it clearly should become.

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