February 2, 2011

expert reaction to publication of the mental health strategy

The Government published its new strategy to support people with mental health problems.

Professor Roz Shafran, Charlie Waller Chair in Evidence-Based Psychological Treatment, University of Reading, said:

“This new cross-government mental health outcomes strategy and four year plan for talking therapies will make a real difference to hundreds of thousands of people with mental health problems and their families. More than ever before, those with anxiety and depression will be able to quickly access high quality therapies with sound scientific support.”

Professor Dinesh Bhugra, President of the Royal College of Psychiatrists, said:

“We welcome the new strategy and the commitment the government has shown both to public mental health and to quality services for mental health patients. It is vital at a time of austerity for the NHS that mental and physical health care receive equal resources – particularly as mental health problems tend to be more widespread in times of economic hardship. If this does not happen, we are in danger of reversing the gains that have been made in the quality of care in mental health over the last decade, and the hope for recovery that has been possible for those who have benefited from them. There is still a long way to go for mental health patients to receive a satisfactory standard of care and treatment throughout England, and the challenge set out in this strategy needs to be taken up by commissioners and providers in health and social care.”

Simon Lawton-Smith, Head of Policy at the Mental Health Foundation, said:

“Overall, this strategy is to be welcomed for, amongst other issues, its emphasis on co-operation between government departments, its life-long approach to improving mental health, and the additional investment promised for early intervention and preventative approaches in younger people. However, this strategy will only prove successful if adequate funding is provided in the right areas across all relevant national and local government departments, which will be a challenge as the government looks to cut the deficit. This will necessarily include investment in mental health research, a topic on which the strategy has not placed great emphasis, which will help identify and develop the most cost-effective mental health therapies and services for the future.”

Kathryn Hill, Director of Mental Health Programmes at the Mental Health Foundation, said:

“We have been greatly encouraged by the consultation process for the strategy, which has lived up to up to the government’s pledge to be more responsive to the thoughts and concerns experts in the field.

“We are therefore hopeful for an age-inclusive strategy that will recognise mental health as a public health issue in need of coherent, cross department cooperation.

“Amongst the necessary points for inclusion, we would like to see a renewed commitment to preventative and early-intervention approaches to tackling mental health problems, which have been proven to be the most cost-effective long-term.

“We will also be looking for the coalition to back the pledge to expand the IAPT [increasing access to psychological therapies] programme made in the spending review with a genuine increase in investment.

“Finally, we need investment in mental health research to be protected, if not increased. It is through this research that we identify the most effective services and therapies of the future, so a lack of commitment in this regard would represent a very short-sighted approach.”

Professor Peter Kinderman, Chair of the British Psychological Society Division of Clinical Psychology, said:

“I anticipate this strategy will be a positive and welcome step towards the kind of mental health service that psychologist have been calling for over many years. It should stress the importance of seeing people as human beings – people who experience distress and occasionally need help as we all do from time to time, but as real people with real lives. Psychosocial approaches are increasingly recognised as ‘gold-standard’ and we welcome an emphasis on a psychological approach in Government policies. This would be particularly timely – many vulnerable people are facing severe pressures due to reduced income and retractions of a wide range of social services. All kinds of psychological difficulties are exacerbated by adverse social circumstances, so the next few years may well prove demanding. At the same time, pressures on local authority budgets will have a significant impact on services for children, people with disabilities and long term conditions, people with mental health problems and older people. Obviously, psychologists will strongly argue for sustained investment in the services that we know are vital for citizens and for well-functioning, productive and healthy societies. This includes ensuring that everyone has access to evidence-based psychological therapies. Too often, people with mental health problems are offered only drug treatment when care which included psychological therapies would produce a better outcome.”

Professor Joe Reilly, a consultant adult psychiatrist and Director of the Mental Health Research Centre at Durham University, said:

“There should be much in the Coalition’s new Mental Health Strategy to be welcomed. There has been great progress over the last ten years to provide modern and effective services for people with severe mental illness, and to increase access to talking therapies. I hope the new strategy will build on that progress.

“Mental health, physical health and social well-being are inseparable, and the strategy should focus on combating stigma and enabling people with psychiatric disorder to get back to work. This would show a serious intent to change further how our society views mental illness. Recognition of the paramount role of effective and early services in childhood and adolescence, when so much of adult psychiatric disorder begins, is also vital.

“If indeed the strategy sets out to achieve these laudable goals, there are still some serious challenges and threats which could threaten them. Promotion of better mental health and prevention of severe mental illness will need serious investment, which can only be achieved by spending less elsewhere. The cost-effectiveness of both new and established treatments needs substantial research efforts, to inform tough decisions about which evidence-based services are funded.

“For instance, can we comprehensively provide psychological therapies to help people with milder mental health problems to stay in jobs, whilst also intensively supporting those with severe illness to access work and education? Choices like this may have to be made and the NHS reforms make it increasingly likely these will be local choices, presenting powerful dilemmas of equity and fairness.

“More than ever before, it will be critical for clinical leaders, patients and carers to work together on this. A collaborative approach is needed with general practitioners as the leaders who will commission these changes.”

Steve Trenchard, Director of Nursing and Patient Experience at West London Mental Health Trust, said:

“We hope that the new Mental Health Strategy will provide an overarching framework for mental health commissioning and service delivery for the next ten years that has at its heart the principle and belief that recovery is a very real possibility for all people who experience mental health difficulties. The strategy should provide a foundation for more informed, evidence-based provision of mental health care, including:

,- The notion that the mental well-being of local communities and populations depends on models of preserving wellness and health prevention, rather than illness. This includes changing the low expectation of recovery and improving access to employment for service users.

,- The need to develop better, more sustainable partnerships between voluntary and statutory agencies, as well as local communities and individuals, to promote the public’s valuing mental well-being as much as physical health. As this improves, we’ll see the reality of strengthened service user involvement – especially to implement the government’s pledge of “no decision about me without me.

,- Taking into account that the foundations of good mental health start in childhood and continue across the whole lifespan through into older age, and, linked to this, the importance of prevention and early detection for effective treatment and recovery. This means ensuring easy and rapid access to urgent care services for people in primary care through strong relationships between services like ours and GPs, and GP education about mental health.

“As a Trust we’re already improving our services with these goals in mind and instilling in our staff the importance of promoting hope and optimism in at all levels of care delivery, in relationships between staff, in promotional materials, in service descriptions and reflected in outcome measures, and we look forward to a mental health strategy that validates the high quality, safe and recovery focused services we provide.”