Next year, the first of the government's national service frameworks will come to an end. The adult mental health framework was published in 1999 as a 10-year plan for improving services and setting out what patients could expect from them.

The question many are now asking is: what next? Many of the services the framework promised are now in place, thanks in part to the extra funding that has come into the NHS since 2000 and the targets contained in the NHS plan that year for crisis resolution, assertive outreach and early intervention teams. Other elements of the framework, notably in primary care, have fallen short of expectations.

Nonetheless, the conclusion of the framework's 10-year life provides an important opportunity to review what has been achieved and set out the direction for the next decade. Unless we do, the risk is that the sense of urgency and purpose the document created will dissipate and we will simply drift without a clear sense of long-term, strategic direction.

In addressing this question, the Sainsbury Centre for Mental Health has worked with partners in other mental health charities, the NHS Confederation and ADASS to set out what a new vision for mental health beyond 2009 would look like. The outcome is the discussion paper A New Vision for Mental Health.

Improving lives

The document notes that people with severe and enduring mental health problems now have access to better services than they did in 1999, but that their lives continue to be constrained by communities that still do not accept them as equal citizens and by services that do not do enough to give them the same opportunities in life as everyone else.

Mental health is still seen as a minority issue, something to be avoided and ignored rather than an inevitable fact of human life.

Our starting point for the next decade, then, is to look beyond what we have achieved in building better services and to focus on helping people build better lives for themselves.

From promoting better mental health in schools and workplaces to giving people with severe and enduring mental health problems control of their own care and support (as Lord Darzi's next stage review has begun to iterate), the aim should be to demonstrate that mental health matters to all of us and that the role of public services (all public services) is to support those who experience mental ill-health to live the lives they want to live.

Universal concern

In other words, we need a new national framework, not another national service framework, for mental health. Central to this framework is leadership across government, with a Cabinet-level champion for all aspects of mental health and well-being.

Mental health is so important to all of us, as individuals and as a society, that it needs a voice where national policy gets made. It must no longer be an afterthought of government policy, stuck out on the margins of health and social care. It is so fundamental to the human condition that no policy discussion - about the NHS, law and order, welfare reform or education, for example - should take place without it.

For more on the Sainsbury Centre for Mental Health, see www.scmh.org.uk

To read the discussion paper, visit www.newvisionformentalhealth.org.uk

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