It’s often said that planting trees is one of the most visionary actions you can take. When you plant a tree you will never see it in its mature state, but having done so you’ll leave a thing of beauty and utility for future generations.
Our involvement with RHS Chelsea this year, through Centre for Mental Health’s The Balance Garden, is an important reminder of the many benefits of planting trees. Even if most of those benefits won’t do much straight away, or even maybe in our lifetimes, they will be there for many decades to come.
Policymaking – national, local, even international – is often noted to be much more short-term in its vision. Agencies that ‘make’ policy, from national governments and local councils to executive agencies and health care organisations, are said to have very limited time horizons. In democracies, these are usually defined by electoral cycles. In other words, decision-makers are more interested in what their policies will do within the next four to five years (at most) than whether they will make any difference beyond that time.
At its recent summit, the Nuffield Trust’s Nigel Edwards added to the picture, noting that short-term policy fixes frequently follow a failure to understand the problem they are trying to solve. National governments, for example, so often prefer to reorganise public services (not least the NHS) despite the disruption this causes, rather than really getting to grips with what holds them back in the first place.
Whether these judgements are fair or not is for others to judge. But they raise the question: what would a genuinely long-term vision for mental health look like? What are the equivalents to planting trees that will safeguard mental health for future generations (which may, of course, include planting trees)? And how can we create the conditions for this kind of thinking and action to thrive?
There are no easy answers to this – but we have some evidence, and through our Festival of Ideas we will be generating more in the months to come. It’s clear that tackling poverty and inequality is essential to secure better mental health for future generations. Challenging racism and racial injustice, creating safer communities for women and girls, and providing sufficient good quality housing for all, are vital too. Effectively tackling the climate crisis, and mitigating the risks from its effects, will also be part of the picture. As will actions to promote and protect mental health early in life. And we still need to think much longer term about the mental health services we want for the future: to develop alternatives to coercive and institutional responses to distress, so that more people get the right support at the right time in the right place for them.
Longer term thinking is at its most difficult in the midst of a crisis. Few of us in 2020 could envision much beyond that year. It’s still difficult now to think much further ahead with the cost-of-living crisis, NHS backlogs (including for mental health treatment – not just elective care), and international conflict dominating the agenda.
But there are signs of hope. The Welsh Government’s Wellbeing of Future Generations Act has created a framework for longer-term thinking about a wide array of policies in Wales. Local councils across the country are often able to look beyond electoral cycles to take a longer view because their members are members of their communities first and foremost, and with their public health responsibilities they can be more ambitious about what they want to achieve beyond the here and now. And growing awareness of the climate crisis is (finally) creating an imperative for action to secure a decent environment for people to live in both during and after our lifetimes (ironically only after the immediacy of the phenomenon has become evident with heatwaves, floods and wildfires all around us)
So, will policymakers start to plant (mostly metaphorical) trees for our mental health? The Welsh Senedd’s recent comprehensive report on how to tackle mental health inequalities set a clear direction of travel for the Welsh Government to make a long-term difference: an approach that the other UK governments could do well to learn from. In England, the first published integrated care strategies show signs of recognising their responsibility for population health management reaches beyond the here and now. And at Centre for Mental Health, our Mentally Healthier Councils Network will bring together local authorities that want to invest in sustainable approaches to the public’s mental health.
Making and implementing policies whose benefits are predominantly long-term is notoriously difficult. It can be hard to commit funding to such plans, and staying the course can be just as difficult if an initiative doesn’t produce immediate results. Good intentions and wise words only get us so far. On top of those, we need a deep understanding of the issues at hand, an appreciation of the solutions most likely to work, and a determination to sustain progress beyond the initial wave of enthusiasm. We’ll be there to provide robust evidence, with workable and relevant solutions, for those who are prepared to make a sustainable difference to the public’s mental health.