On the right track to a mentally healthier nation?

6 October 2023
By Andy Bell
Andy Bell

Last week, Centre for Mental Health and thirty other organisations published A Mentally Healthier Nation. In it, we set out what a cross-government long-term mental health plan could look like. By bringing together research evidence and expertise from people living with mental health difficulties and working in the sector, we showed that a whole-of-government approach to the nation’s mental health could make a major impact on the whole of our society.

Since that time, we’ve seen a number of developments that have underlined why such an approach is urgently needed. At the Conservative Party conference, we heard some deeply worrying assertions and announcements that put many thousands of people’s mental health at risk. From the Home Secretary’s inflammatory rhetoric about immigration and asylum to the Chancellor pointing to greater use of benefit sanctions against people who are out of work, many people will feel more anxious about their place in society and chances of a decent quality of life after this week.

Suggestions that prison overcrowding could be solved by buying places in foreign prisons are deeply worrying in the context of rising rates of self-harm and suicide deaths in prison. And statements about the treatment of trans people in NHS hospitals will cause major concern for people who already struggle to get fair treatment from the health service and experience discrimination and the risk of violence and abuse every day.

Many of the groups of people singled out in these statements face higher rates of mental ill health than the rest of the population already. This is not inevitable. Too often, poorer mental health is a product of social injustice. We know that poverty, racism and transphobia are all toxic to mental health. Exclusion, discrimination, isolation and violence harm people’s wellbeing, both immediately and in the long term. Rising levels of hate crime against trans people are a painful reminder of the consequences of demonising groups of people in society.

Putting people’s mental health at the heart of government would help to create policy solutions that are stronger, fairer and more sustainable. A more equitable social security system that gives people a stronger safety net against poverty; a more effective justice system (with less reliance on imprisonment and an end to the continued incarceration of people given Imprisonment for Public Protection sentences more than a decade ago); and an asylum system that recognises the rights, needs and potential of refugees, would create a mentally healthier nation for everyone.

Against that backdrop, and in contrast, the Prime Minister’s proposed progressive age ban on the sales of tobacco products offers real hope of a change that would benefit people’s mental health as much as their physical wellbeing. Smoking is a major contributor to the 20-year life expectancy gap for people with a severe mental illness – a gap that is currently getting bigger. Shifting the dial on smoking will save lives and boost the nation’s health long-term.

For such a measure to succeed in extending and equalising people’s life expectancy, it’s vital that the Government and the NHS invests now in effective support for people with a mental illness to quit smoking. This must be done with, not to, people, with evidence-based interventions and coproduced approaches to helping people to stop smoking. It cannot be left to chance. For too long, people with mental health difficulties have been denied effective help to quit.

A mentally healthier nation is possible. Decisions made in every government department affect our mental health: for good or for ill. If government was to centre policy on the nation’s mental health, it could bring about dramatic improvements in people’s quality of life nationwide. If government was to bring the commitment it has shown this week to creating a smokefree future, it could also help to tackle poverty, racial injustice, discrimination, climate change and the consequent rise in mental ill health that we see today.

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