Earlier this year, the Government announced the development of a new Major Conditions Strategy covering mental health as well as a range of physical health conditions. Centre for Mental Health has submitted ideas to the strategy’s call for evidence.
Now we’re asking you to take part in the consultation and share our ideas below – the brief survey closes on 27 June.
Prevention, and a recognition that health risks do not fall evenly across the population, should be at the heart of any strategy to improve health outcomes.
By focusing on the prevention of illness and health equalities we can ensure that fewer people struggle with poor mental health, and that those who do get more timely and efficient support.
To deliver this prevention and inequalities focus, structural change is necessary, including:
- A Mental Health Policy Test to ensure decision-makers properly consider the mental health implications of proposed changes to government policy
- At a minimum, a reversal of the 26% cut to local public health budgets
- A properly resourced and empowered Office of Health Improvement and Disparities (OHID) to conduct effective public mental health work
- Integrated care systems, local authorities and NHS trusts being supported and held accountable for public mental health work
- Extending the Better Mental Health Fund for another five years: continuing to work with the most deprived areas and extending to others, especially inner-city, rural, and coastal areas with high levels of localised poverty and deprivation, at a minimal cost of £100m over that period.
Deprived, racialised and LGBTQ+ communities, as well as girls and young women, all face higher risks of poor mental health and disproportionately poor outcomes. Systemic discrimination and disadvantage, rather than genetic predisposition or ‘lifestyle’ choices, lie at the heart of these health inequalities. Only by tackling them can we hope to make substantial improvements including better support to people with mental ill health.
This could be advanced by reducing the risks and boosting protective factors:
- Poverty – increase the minimum wage and social security while more generously subsidising housing, insulation, child care, active travel and public transport
- Discrimination – recognise the toxicity of racism and other discrimination and take meaningful action to address it
- Child abuse, neglect, bullying – introduce a new Child Poverty Act to eliminate the conditions in which these risks thrive, while also ensuring all parents and carers get the training and support they need to give children the best start in life.
Another major health inequality is that the life expectancy of people with a severe mental illness is 15-20 years shorter than those without. Government should set an ambitious target to tackle premature mortality among people with a mental illness, with a commitment to measure and publish results annually and to take action across the system to close the gap.
We must also improve mental health support for people with physical health conditions, adopting a stepped care approach as set out in our recent report on kidney care.
Finally, people should be supported to make healthier choices:
- Implement the Khan Review to get us back on track to be smoke-free by 2030
- Adopt the Alcohol Health Alliance’s recommendations to reduce harmful drinking
- Invest much more in enabling people to walk, cycle and access electric public transport
- Legislate to improve the quality of food and protect vulnerable people from unhealthy adverts and offers.
The Major Conditions Strategy is a critical opportunity for the Government to address mental health inequalities and re-focus efforts on prevention. Truly addressing mental ill-health means tackling the poverty, discrimination and exploitation that causes and worsens so many health outcomes. After scrapping the ten-year plan for mental health earlier this year, it is even more vital that the Government takes urgent steps to improve mental health in the UK.