The recognition that mental health is as a complex interaction of social, environmental and relationship issues has been long-awaited
If you consider a good crowd a sign of success the launch of the new English mental health strategy on 2 February demonstrated there is a lot of interest in the No Health Without Mental Health document. To a packed room in London, health secretary Andrew Lansley and care minister Paul Burstow extolled the virtues of the strategy and the coalition’s commitment to it.
So what does this new strategy contain? It has six overarching objectives and a series of proposals as to how they will be achieved, together with measures of achievement.
The objectives are:
- More people will have good mental health, which we all have a stake in achieving and enjoying ourselves;
- More people with mental health problems will recover and resume a fulfilling role in society, rejecting the traditional low expectations that have dogged service users;
- More people with mental health problems will have good physical health, requiring a reversal of a situation where a diagnosis of schizophrenia effectively wipes 15-20 years off your life;
- More people will have a positive care and support experience. Much progress has been made but it is recognised that further development is needed in areas such as access to crisis assistance and collaborative care planning;
- Fewer people will suffer avoidable harm. This embraces not only situations where people harm themselves but also the rare occasions in which they harm others;
- Fewer people will suffer stigma and discrimination - possibly the biggest challenge we face. It will require the reversal of centuries of ill-advised and ill-informed attitudes that some consider worse than the experience of poor mental health itself.
The strategy was also accompanied by a call to action signed by many organisations, all of whom pledged to work together to achieve these aims. To that end, there will be a minister-led implementation group and a responsibility laid on the newly formed Public Health England to see mental health as central to its remit.
This recognition that mental health and wellbeing can be seen as a complex interaction of social, environmental and relationship issues, rather than a narrow focus on illness models, will present a challenge to both strategists and health professionals. Yet, to many, this is a long-awaited recognition that a purely biological illness focus is out of date.
There is the challenge that mental health nurses may enter a contested future territory, and many may ask how they can assert and evidence their place in this new future. There are implications here, not only for current nursing practice but also for the education and training of the next generation of nurses in this specialty.
There is no doubt that in common with its predecessor New Horizons, this is an ambitious strategy and one that has an eye on the significance of early intervention as well as spending now to save later. There is also a clear recognition of the huge cost of poor mental health and wellbeing, both financially and in human terms of the consequences. There is clear evidence within the strategy and associated documents to show there is a vast array of guidance, good practice examples and standards to be both met and inspected against.
The real question is whether the strategy has been launched into a financial sea that is chilling and indeed may freeze over, leaving it stuck fast rather than progressing as we all wish and hope it could.
Ian Hulatt is mental health adviser at the Royal College of Nursing.