In less than 12 months, two prime ministers have chosen to start their year with major speeches about mental health, committing themselves and their governments to a transformation of the mental health landscape. But as so many of the statistics and personal stories bear witness; the landscape is not changing fast enough.
In her speech earlier this month, Theresa May talked about the critical importance of relationships and the role of government to “encourage and nurture” them.
This relational approach was reflected in May’s focus on the mental health of children and young people and the welcome recognition that left untreated mental distress can “blight lives, and become entrenched”. Half of lifelong mental illness has its first signs in the teen years, yet just 70p out of every £100 the NHS spends goes towards children’s mental health services. It’s time the resources followed the rhetoric. Otherwise we will keep on missing the opportunity to reduce the burden of life long mental illness.
May said she would hold NHS leaders to account for the £1bn David Cameron promised for mental health in January 2016. But it still remains unclear what has become of the commitment made in March 2015 to invest £1.25bn to transform children and young people’s mental health services. Reports from the frontline suggest the money isn’t getting through everywhere. Getting a grip on the money is essential; it ought to be part of the Care Quality Commission/Ofsted thematic review of children and young people’s mental health services mentioned by May.
In her speech, May suggests that tackling stigma is more important than resources. I think this misses the point: underinvestment in mental health is itself a symptom of stigma at an institutional level. Of course, less stigma is a good in itself, especially if it enables more people to seek help. But if the help isn’t there because of a lack of parity, then the results are the same.
Taking a life course approach, looking beyond conventional mental illness services, emphasising the importance of addressing mental distress early: these are all to be applauded. A whole-system response is needed to make real May’s ambition. Her recognition of the role of schools is very welcome.
May also acknowledged the need to look at what “can be done to prevent mental health conditions” and “build resilience”. I believe a new paradigm is required that looks to address the causes of mental distress and illness. For example, the growing evidence of the critical importance of the first 1,001 days of a person’s life and the role of couple relationships in laying down the foundations on which so many of their life chances rest.
Plans for green paper on children and young people’s mental health to services in education and for families offer opportunities and pose threats too. But my worry is it delays or derails the implementation of Future in Mind, the review by the coalition government committed to by the Conservative government just two years ago.
May’s speech is important if only because it is the prime minister talking about mental health. She recommitted government to the goal I set in 2011 of parity of esteem between mental and physical health. While the road to parity is paved with good speeches, it needs good deeds even more.
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