After a year of political and policy change in 2010, the New Year will bring major challenges and opportunities for mental health services.
Like all public services, the NHS faces a big challenge in being able to cope with leaner times than it has enjoyed for many years. Mental health services will not be immune to that challenge, and nor should they be. While we must not see a repeat of recent years when mental health services were especially hard-hit by NHS spending pressures, there is much that mental health can do to improve its own productivity and to contribute to the efficiency and effectiveness of the NHS as a whole.
The time has come for real progress in taking forward the international evidence on recovery. We should see commissioners and providers placing experts by experience at the centre of local mental health service delivery and a real shift in the balance of power towards the people who use services and their families.
We should also see more progress on offering evidence based interventions for people with mental health problems to gain employment and keep it. Implementation of Individual Placement and Support (IPS) and building closer relationships between the NHS and the new Work Programme are vital to achieve this goal.
Diversion teams should be available to all police stations and courts to identify people with mental health needs and ensure they get the support they need from whatever services are required. This should always take into account the very different and emerging mental health needs of children and young adults.
Alongside these major changes to mental health practice, the NHS can do much more next year to improve its response to people with mental health difficulties. Effort is still needed to reduce unnecessary psychiatric bed use (in secure as well as general inpatient services) and out-of-area placements. Extending the availability of psychological therapies to people with long-term physical conditions and medically unexplained symptoms could massively improve many people’s quality of life, while improving physical healthcare for people with mental health problems could help to close a gap in life expectancy that remains unacceptably wide.
As well as looking at how we can improve mental healthcare now, we must think long term and put more investment into children’s mental health and wellbeing. Simple, cost effective parenting interventions for children with early behavioural difficulties result in better mental health and wellbeing and enhance the wellbeing of communities.
To give leadership and direction to meeting these challenges, I hope that 2011 will bring a high impact government mental health strategy that will set an agenda of promoting mental wellbeing for all, improving the lives of people with mental health problems, and tackling stigma and discrimination wherever they stand in the way of equality.
Making this real will require sophisticated commissioning and disinvestment in services with poor outcomes to focus on what matters most to the people who use services in a public spending downturn. This may be difficult against a background of changing commissioning structures but remains vital to meet the challenge of making mental healthcare more productive and effective in the years to come.