In recent years we have made great strides in the UK, not only tackling the stigma around mental illness but have also seen the issue of mental health rise to the top of the political agenda. In June 2012, Charles Walker MP and I both spoke in parliament about our personal experiences of mental illness, something which at the time was seen as groundbreaking. I am pleased that people from all walks of life have spoken about their experiences since then, adding to the debate to ensure that mental illness is no longer seen as the taboo it once was. Campaigns such as Time for Change and the work done by mental health charities have also made a real difference in changing attitudes. So, if we are winning the battle against the stigma around mental illness, what should the next steps be?
Firstly, we need to hardwire mental health and mental wellbeing into policy-making and secondly, we need to make the economic case for good mental health.
In response to the increased debate on mental health, the government established an independent mental health task force in 2015, which was widely welcomed and resulted in the NHS Five Year Forward View for mental health. Its plans are ambitious, but success will depend on resources and the buy-in from the various actors in a fragmented National Health Service. Only time will tell if this well intentioned policy bears fruit, but a more fundamental change across government in policy-making is needed.
All new government policy, across all departments, should be road-tested against mental health and mental wellbeing objectives. There also needs to be a cabinet committee at the heart of government which has a series of mental health and mental wellbeing tests that policies need to pass before they can be adopted. This would embed mental health and mental wellbeing into the policy-making process throughout Whitehall.
Clearly this is not happening now. You only have to look at the roll out of personal independent payment to see this. Mind – the mental health charity – found that 55 per cent of those surveyed with mental health conditions lost all entitlement or had their benefits reduced, and 22 per cent felt unable to appeal against the decision. I know from speaking to my constituents that the main problem is that those assessing claimants have little or no knowledge of dealing with people with mental health conditions. The result is a system aimed at supporting some of the most vulnerable in our society, making the situation worse for them and possibly leading to increased costs for the NHS because of individuals’ mental health deteriorating. If this policy had been tested for its suitability to meet the needs of those with mental health conditions we could have avoided much of the distress and anguish caused to some of the most vulnerable people in society.
Having such a system at the centre of government would ensure that mental health and mental wellbeing would be at the heart of departmental policy-making, turning many well intentioned words into meaningful action.
At a time of austerity, why is change needed? The answer is simple – it makes economic sense too. In the debate around mental health and mental wellbeing the economic case is one which often only gets a passing reference. Dennis Stevenson and Paul Farmer’s excellent report Thriving to Work dramatically sets out the case for why good mental health is important to the UK economy. It found that the cost to UK economy of poor mental health is between £74bn and £99bn per year, with an additional cost to government of between £24bn and £27bn per year. The report was commissioned by the government and has several recommendations both for the private and public sector. It recommends the establishment of a mental health employers’ leadership council to drive the implementation of mental health work plans for employers. It also argues for using public procurement as a way of incentivising the adoption of such plans. The public sector employs 5.4m people and provides an opportunity to start the implementation of the report’s recommendations.
Though these proposals are ambitious, with enough political will they can make a real difference. Some will argue that they will be an added burden on business, but if you look at some of those companies already implementing such policies like BT, the economic benefits can already be demonstrated.
With the continued debate about Britain’s future following Brexit there are those who would argue that concentrating on the nation’s mental health is not a priority. But I would argue it is not just the right thing to do for the wellbeing of our citizens, but it is vital for the future of the UK’s economy.
Now is the time to turn all of the well intentioned words on mental health into action.
This first appeared on the Fabian Society’s health network blog