By Louis Allwood and Andy Bell
The Government has announced its COVID-19 mental health and wellbeing recovery action plan for 2021-2022. The plan describes how departments across government will consider mental health within new and existing programmes, and the action that will be taken to improve population mental health and address health inequalities.
We welcome the explicit acknowledgement within the recovery action plan that activities across government, not just within the Department of Health and Social Care and the NHS, have a profound impact on our mental health and are therefore an important part of the plan. Action to prevent or mitigate poverty – while not mentioned directly in the plan – and steps to improve housing security and quality are just as important to our mental health as the expansion of mental health services.
The commitments include a new £15 million fund for the most deprived local authority areas to invest in preventing mental ill health
The plan gives further detail on the allocation of the £500 million for NHS mental health services first announced in the Spending Review 2020. Much of this is being given to speeding up the delivery of existing commitments, for example to expand talking therapy services, mental health support in schools and community services for adults. And some will be earmarked for meeting needs arising from the pandemic – for example, to support NHS staff who have experienced traumas over the last year, and for people living with Long Covid.
The plan also makes some commitments outside the NHS. They include a new £15 million fund for the most deprived local authority areas to invest in preventing mental ill health. While this welcome investment will not come close to replacing the funding lost to local authorities through the contraction of the Public Health Grant since 2015, it will provide some impetus to support better mental health in communities where the pandemic has been most devastating.
The plan also includes a pledge to “explore the development of a policy tool which allows policymakers to examine the impact of their proposals on mental health”. In the long-term, this could have a transformative impact if it resulted in a lasting change to the way policies are made across Whitehall, putting the public’s mental health at the heart of government activity.
Public Health England will dissolve and transition into new national structures for health security and health improvement
The plan will be delivered in the context of wider changes. In England, health and care reforms will bring together NHS commissioning and strategic decision-making into 42 Integrated Care Systems, which will be mandated to work collaboratively with local councils, voluntary sector organisations and community providers. The record so far of Integrated Care Systems in embracing prevention and giving equal weight to mental health has been mixed. We will need to see a lot more focus on both if the new arrangements are to bring about the necessary transformation in the way people’s health is supported.
Over the next year, meanwhile, Public Health England will dissolve and transition into new national structures for health security (tasked with protecting against future health crises and pandemics) and health improvement (enhancing public physical and mental health). The latter will be brought into the Department of Health and Social Care under the leadership of the Chief Medical Officer. We hope to see the new Office for Health Promotion demonstrate clear and effective leadership for the public’s mental health within government. Government is also expected to develop and announce proposals to deliver a sustainable social care system. This much-delayed development must consider how to fund social care support for people of all ages with mental health needs.
Government can also take action to mitigate the risks of poor population mental health, and to respond to the mental health impacts of the pandemic as they emerge.
Centre for Mental Health will soon publish an update to our most recent ‘mental health forecast’, which brought together the best available evidence to demonstrate that 10 million people are likely to need new or enhanced mental health support as a result of the pandemic. This is a forecast with a difference: meteorologists might predict a risk of rain, but we warn about the risk (metaphorically speaking) of getting wet. The difference is mitigation. We can wear a raincoat or an umbrella. We can find shelter. We can fix the leaky roof. Government can also take action to mitigate the risks of poor population mental health, and to respond to the mental health impacts of the pandemic as they emerge. The new plan goes some way to doing that. It is a step in the right direction.
However, the plan is limited, at least initially, to activities in 2021 and 2022. And, while cross-government in its ambition, most of the detail on funding and responsibilities announced within the plan are focused on health, public health and social services. To achieve the important ambition of “preventing and mitigating the root causes of poor mental health”, the cross-government ministerial group must take a longer term view and facilitate further contribution from wider government departments. At Centre for Mental Health, we will continue to work with our partners to make the case for further steps to secure better mental health for all.