Closing the Gap in mental health – four observations

Four quick observations on the publication of Closing the Gap: Priorities for essential change in mental health (pdf).

1. It’s good to see it published and it’ll be a useful document to refer to.

2. The significant changes needed will come about only through an alliance of everybody affected by the mental health system, from both the top down and the bottom up. The target audiences explicitly identified in the document miss one half of this equation by not including people with mental health problems, their (representative) organisations or families/carers.

3. As @shaunlintern over at HSJ highlighted, the focus on parity in mental health is a sham when NHS England and Monitor have cut the 2014/15 tariff price for mental health (and community) services by a fifth more than the reduction proposed for acute providers

4. The signatories to the policy are Nick Clegg and Norman Lamb. No Jeremy Hunt, in his role as Secretary of State for Health, or (perhaps more noteworthily) as a Conservative. Are the Lib Dems looking to claim mental health as their own ahead of 2015?

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Mental health: on our minds?

Parity of esteem in mental health is something we hear a lot about: it essentially means putting mental health on a par with physical health.

Underneath this, though, it feels to me that there isn’t a parity of attention when it comes to mental health – it doesn’t feel to be discussed or debated anywhere near as much as other topics.

This feeling is borne out by two excellent reports published on the topic of Joint Strategic Needs Assessments (JSNAs) and Joint Health & Wellbeing Strategies (JHSWs) by the Children & Young People’s Mental Health Coalition and the Centre for Mental Health respectively.

The Children & Young People’s Mental Health Coalition found two-thirds of JSNAs didn’t have a section specifically on children and young people’s mental health. They also found that risk factors were highlighted which put children and young people at greater likelihood of having mental health problems, but the links between these factors and mental health weren’t made.

The Centre for Mental Health found 91% of JHSWs aimed to tackle at least one mental health issue, or 9% didn’t mention mental health at all. They too found that the majority of JHSWs highlighted health risk factors (such as drinking or smoking) but didn’t make the relevant links between these factors and mental health.

More encouragingly, though, where mental health was a priority in JHSWs that priority tended to be children and young people’s mental health – somewhere between 55-67% of JHSWs made it a priority.

Nevertheless, we have a situation where around one-third of JHSWs make no reference to children and young people’s mental health, and 10% make no reference to mental health in general.

Is mental health on our minds? These figures would suggest it isn’t as much as it should be. We also need parity of attention on mental health.