Over the past 12 months I have been working with mental health experts and the think-tank CentreForum, grappling with the challenge of how we can improve mental health care.
Today sees the publication of our final report, The pursuit of happiness: a new ambition for our mental health. It reflects the expertise of many, makes a number of recommendations to transform not just health services, but the mental health of the nation, and it has one overarching call – that the pursuit of happiness should be a priority for government.
Costing the economy over £105 billion, 1-in-6 adults and 1-in-10 children suffer a mental illness at any one time in this country. The cost in human misery is incalculable, compounded by the burden of stigma and made worse by institutional bias even in the NHS. Institutional bias leads to evidence being overlooked and ignorance of the evidence means mental health does not get its fair share of resources.
Sadly, this is not new news. In 2011, as Minister for Mental Health, I published No Health Without Mental Health, setting our ambition for parity of esteem between mental and physical health. The strategy was widely welcomed, but the evidence reflects that not enough of the policy direction we set has followed through into action on the ground.
Norman Lamb, Lib Dem health minister, has also made mental health a priority, making a commitment to access standards and negotiating the crisis care concordat to make sure that people get the support they need in a mental health crisis. But we still have a long way to go before mental health is treated in the same way as physical health.
So the Mental Health Commission has taken stock of where we are today and what a new ambition for mental health should look like. Our goal has been to identify the key changes that over the next 5 to 10 years will reduce the number of people experiencing lifelong mental illness and help those who suffer mental illness to recover. The Commission has identified five big shifts in policy and practice.
First, make wellbeing or the ‘pursuit of happiness’ matter as much as GDP. The tools are available to evaluate policy and measure its impact with wellbeing in mind. This needs leadership right from the top of government and sustained action to tackle stigma.
Second, a national wellbeing programme led by Public Health England to foster mutual support, self-care and recovery. Locally tailored by Health and Wellbeing Boards to make the best of the skills and talents in communities up and down the country, building up community capacity where necessary.
Third, prioritise investment in the mental health of children and young people right from conception. By ending the buck-passing and fragmented commissioning, and by scaling up what works, we can transform the life chances of millions of children. Good mental health will reduce the costs to society of low educational attainment, bad behaviour, worklessness, crime and antisocial behaviour.
Four, make our places of work mental health friendly. The cost to business in terms of sickness absence and lost productivity runs to £23.5 billion. There is good practice, it should become the norm, and it would save money. Government should lead in its own employment practice and set the standard in its procurement.
Five, close the treatment gap that leaves 1-in-10 people needlessly suffering depression and severe anxiety. Equip primary care to identify and support the mental and behavioural health needs of its patients. Integrating mental health and social work expertise into the primary health care teams to ensure a holistic approach.
The Commission believe that NHS England should be set the clear goal of achieving parity of funding for mental health over the next decade. We are under no illusions about the difficulties of making these changes over the next five years against a backdrop of financial constraint. However, we believe that the case for spending to be rebalanced towards mental health is overwhelming. For example, poorly managed long term mental and physical health problems cost the NHS £13 billion a year.
The cost of doing nothing or simply settling for gradual change runs to billions of pounds, but the real cost is measured in human misery, misery for want of determination to act on the evidence.
* Paul Burstow MP, was Minister for Mental Health 2010-2012. The Centre Forum Commission on Mental Health comprises Lord Victor Adebowale CBE, Professor Dame Sue Bailey, Paul Farmer, Angela Greatley OBE, Paul Jenkins OBE, and Dr Alison Rose-Quirie.
* Paul Burstow is Liberal Democrat candidate for Sutton and Cheam and was the MP until the dissolution of Parliament on 30th March.