Gregor Henderson, Director of Wellbeing and Mental Health at Public Health England, discusses the challenges of promoting good mental health across the population.
If you look back, and I’m looking back now on a 30 year career, the NHS has been both our saviour and also the thing that we need to grow up from. Because accessing the population’s awareness and education is where we have to put efforts.
So let’s just step a little bit more boldly into the next stage and use the opportunities we have not to try and argue for more money for mental illness treatment services which would be great, we have to embark on a prevention revolution by doing no more money projects. This has to be about using the resources we have to better effect. But I would certainly much rather be young and facing a mental health problem and challenge in this country today than 20, 30 years ago when I started my career.
So there are some opportunities. The five year forward view that talks about prevention but it also talks equally about changing the way in which we deliver and design services, and I think what we have to do is make sure we’re doing both of those together. We have this independent task force that has a once in a lifetime opportunity to really shape a new narrative around mental health, that embraces both mental health and mental illness and in Public Health England we have created a new national prevention alliance because there hasn’t been the opportunity to do that before we’ve invited people to lots of things but now they want to play, they want to play because the cards are on the table.
If you’re going to go into prevention how much money are you going to take out of downstream mental illness treatment services? This is about the prevention revolution happening with employers, happening with schools, happening in early years, happening in criminal justice. The leadership for this agenda needs to go beyond the narrow leaderships that we’ve defined and allowed mental health to be defined in relation to mental healthcare. It is very clear that the next five, perhaps beyond years is going to be one of shrinking public resources not more.
So in times of shrinking resources we need to collaborate more, we need to integrate budgets more, the narrative for mental health all too often defaults to mental illness and more money for services which is fine but it’s only one part of the narrative. We need a community narrative about the strength of communities. We have to have the engagement of other sectors and I would like to see at every single conference about mental health that we have people from employment, we have people from housing, we have leaders from all of those different sectors.
And there are five areas that think are good for focus. One is what Geraldine talked about which is this area of public literacy and awareness but we need to understand mental health alongside physical health. Wouldn’t it be great if we had a prime ministerial challenge of mental health, where our prime minister or someone else stood up and said, “We as people need to know as much about our good mental health as we do our physical health”? That would be a start.
And then we need to know more about mental illness. There are fantastic evidence based programmes and support for recovery so the conversation moves from understanding good mental health to understanding good mental illness to understanding that you, we and us can provide support for recovery because no-one recovers on their own.
The second issue is continuing its scale the things that we’ve got really good policies for in this country, the suicide prevention strategy, improving the physical health of people living with mental illnesses and we talk about comorbidity. We need to improve mental health access to everyone across the life course, the best investment would be in the early years but we know all this in terms of early year schools, employers and older age, we know what the evidence based interventions are, we need to now scale them and of course I’ve said it before, and it’s about addressing all those social determinants whereby those working in these sectors understand exactly what they have to do to improve the lives of those living with mental illness to enable recovery to happen and to make sure that we understand what the impact of all of these different social determinants has. And we need greater knowledge, capacity and evidence. We have begun to start using the information we have more wisely, we have in Public Health England and NHS England the Mental Health Intelligence Network, building workforce capacity to understand exactly what I said earlier, and making sure that we’re developing investing in research and evidence.
So what next? Well look out for the taskforce publication, it’s an independent report that will be published, the latest date we have is 10th October which is a Saturday but it’s World Mental Health Day, all the arms-length bodies will respond as will many other people to the recommendations. Then it’s into the usual phase of implementation, planning and delivery. We have to underpin what happens next by better intelligence, better data, better workforce capacity, but we also have to underpin it by a way in which we look at the things that you’re going to look at today, by understanding the benefits of what we get when we prevent early and understanding that it’s not within the gift of the NHS to tell education what to do. I’d love to see and so would others love to see the work going forward in the NHS, making sure it’s doing the things it can do better for access and quality but making sure we and others have a conversation with many people outside of this room of the contribution they can play to really making sure that a prevention revolution is about to happen or it’s not going to be another missed opportunity when we talk a good game but can't deliver.