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Putting prevention of mental ill health on the political agenda

20 February 2024
By Bethan Bottomley
Bethan Bottomley

Last September, Centre for Mental Health, alongside over 30 organisations, launched A mentally healthier nation: a 10-year cross-government plan for mental health. We now have over 60 endorsements for the document and a clear vision for parties to adopt into their manifesto work as we head towards a general election.

A mentally healthier nation focuses on three key areas – prevention, equality and support – as points of direction to be prioritised in new legislation and investment.

Despite a huge body of scientific evidence, and countless practical examples, it has long been a challenge to make the case for investment in the prevention of mental ill health. Public health grants in England have been cut by as much as 26% since 2015, with the most deprived areas subjected to even bigger cuts.

With improved investment in preventative measures, taking a public health approach, we can begin to mitigate the circumstances that increase the risk of poor mental health outcomes. By paying attention to the wider determinants of mental health, such as poverty, poor housing and access to green spaces, we can reduce the risk factors associated with mental ill health and recognise the importance of improvements to equity on overall population wellbeing.

As well as the formal preventative services overseen by national and local authority public health agencies, many of the wider determinants of health, such as child poverty, access to secure housing, safe environments and public services that keep people well (like youth, library and leisure facilities) have also been worsening. In A mentally healthier nation we examine how the deterioration of protective factors due to austerity is likely to have contributed to increased risk factors and poorer mental health outcomes.

The evidence is clear that poverty and economic inequality are extremely damaging to our mental and physical health, which is only becoming more apparent as we understand more deeply the effects of the current cost-of-living crisis. Rates of depression, severe mental illness and suicide (not to mention nearly every physical illness and injury) worsen with poverty in a clear relationship – the greater the depth and duration of the poverty, the worse the outcomes.

World leading researchers in this field are clear on the fact that economic inequality is a driver of poor mental health, and that we must work towards closing the wealth gap to improve health outcomes. Indeed, the most unequal developed economies (including the UK and the US) experience disproportionately higher levels of mental illness, stress, social problems and instability than more equal ones, such as Scandinavia, New Zealand and Japan.

In line with this research, A mentally healthier nation recognises the impact of wider determinants on our mental health and the need to improve our environments in order to lay the foundations for a healthier future. Improvements to housing will reduce stresses caused by overcrowding and physical ill health from poor ventilation and cold. Stronger regulation on alcohol, smoking and gambling licensing will reduce the risk of developing addictions that reduce people’s quality of life and place a high burden on NHS services. Improving workplace protections for the most vulnerable will help more people into meaningful work, reduce exploitation and provide stronger stability for people in financial difficulties.

Strong protective measures for our physical environment are also important factors of public health improvement. We know that access to green spaces and places for exercise can have huge benefits for our mental health, among them reducing the amount of time we spend in online environments which can be harmful and increase isolation.

All of the protective factors explored above are linked with poverty and economic inequality. For example, poor housing is often found in deprived areas where there is little access to green spaces and higher levels of air pollution. Without the right support, being out of work due to prolonged mental illness can also lead to worsening financial circumstances. This is a clear indication of the importance of alleviating poverty as a matter of priority for whoever forms the next government.

The importance of prevention is perhaps made most evident through the impact of poor mental health in childhood into our adult lives. Most (75%) mental health difficulties first occur before the age of 24, with 50% first occurring before the age of 14. And children growing up in severe poverty are four times more likely to have serious mental health difficulties by age 11 than children from wealthy households.

What happens to us as children can profoundly affect our lifetime mental health and other outcomes. By effectively addressing social determinants, like poverty and discrimination, and environmental factors, including housing and pollution, more of us can have better mental health. Investing in more powerful public health infrastructure is key to preventing illness and promoting better health for all. A mentally healthier nation sets out the framework for how to achieve these vital aims.

It is imperative, therefore, to give everyone the best start in life by boosting protections for children and young people and building in preventative infrastructure now, so that we can all grow up with the best possible chance of a healthy life protected from deprivation and other harms.

Join us in demanding a fairer and healthier future for us all

The prime minister has confirmed that 2024 will see a general election – so we’re calling on all political parties to adopt the ideas we set out in A mentally healthier nation in their manifestos and enact them if elected. You can help us to make this happen by contacting your local candidates.

If we all put mental health on our candidates’ agendas we can build the momentum needed for these ideas to be put into action. Nearer the election we will provide the means of identifying your candidates and a template to call on them to support a mentally healthier nation.

Join us in the fight for equality in mental health

We’re dedicated to eradicating mental health inequalities. But we can’t do it without your support.

Please take this journey with us – donate today.

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