The “pursuit of happiness” must become an explicit and measurable goal of government if the £105 billion annual cost of mental illness in England is to be reduced, according to a group of mental health experts.
Chaired by former minister for mental health Paul Burstow MP, the CentreForum Mental Health Commission has concluded its 12-month study on the state of wellbeing in England by identifying five key priorities which need to be addressed between now and 2020.
Its report, titled The Pursuit of Happiness, calls on policymakers to:
• Establish the mental wellbeing of the nation or the “pursuit of happiness” as a clear and measurable goal of government
• Roll out a National Wellbeing Programme to promote mutual support, self-care and recovery, and reduce the crippling stigma that too often goes hand in hand with mental ill health
• Prioritise investment in the mental health of children and young people right from conception
• Make places of work mental health friendly with government leading the way as an employer
• Better equip primary care to identify and treat mental health problems, closing the treatment gap that leaves one in four of the adult population needlessly suffering from depression and anxiety and 1-2% experiencing a severe mental illness such as schizophrenia.
The Commission also calls for parity of funding for mental health, which currently receives 13% of NHS spend in England but accounts for 23% of demand. It is estimated that £13 billion is overspent every year on dealing with the physical health consequences of this unmet need.
Promoting good mental health
“Failure to promote good mental health not only ruins lives, it costs the economy £105 billion every year,” said Burstow. “There is no single simple change that will deliver better mental health. But making governments measure and value wellbeing as much as GDP would be an important step in the right direction. We then need bold action across the board so that we can see national wellbeing improving. We know what works in the workplace, in schools, in health services. Starving mental health services of investment is a massive false economy, building up more costs to the NHS, to social care, to welfare, to businesses and the economy.
“The first signs of life long mental illness can be traced back to childhood for half of those with mental health problems. This is simply not good enough. We would not tolerate a hospital turning away a child with a broken leg or cancer, but that is the experience of children with mental health problems every day. We need to promote good mental health from the earliest opportunity, and make sure that schools, workplaces and the communities that we all live in are supporting us to be mentally well. The cost of doing nothing or simply settling for gradual change runs to billions of pounds, but the real cost is measured in human misery, misery for want of determination to act on the evidence.”
Norman Lamb MP, Care and Support Minister, welcomed the report: “I want to build a fairer society where mental health care is valued as much as physical health care, he said. “That's why we've invested over £450 million in improving access to psychological therapies and we've launched a national agreement to improve crisis care.
“This report highlights crucial principles that we need to adopt at a local and national level to improve mental health care and we will consider all its recommendations carefully.”
Professor Sir Simon Wessely, president of the Royal College of Psychiatrists – who has a background in public mental health – also welcomed the report, especially its focus on advocacy for closing the treatment gap, prioritising the good mental health of children and adolescents and securing parity of funding for mental health services.
“This report recognises that the status quo of undertreatment and underfunding is unsustainable both in terms of the economic costs and more importantly the human misery that it perpetuates, and makes powerful recommendations for cross governmental action to reduce the health inequalities suffered by people with mental illness,” he said. “I hope that the government, CCGs [clinical commissioning groups] and health and wellbeing boards give it careful consideration, as befitting the thorough work that clearly went into it.”
Meanwhile, Professor Sue Bailey, chair of the Children and Young People's Mental Health Coalition and outgoing president of the Royal College of Psychiatrists, was glad to see the focus on children’s mental health.
“I am delighted that this report points out the current stark reality of lack of resourcing for the wellbeing, resilience and mental health of all children and young people from conception to adulthood,” she said. “But more importantly the report offers practical steps that move from the rhetoric to the reality of how to best invest in the wellbeing and mental health of young people. How to deliver effective early identification, assessment, timely support and treatment because our children simply deserve better.”
Dr Alison Rose-Quirie, chair of the Independent Mental Health Services Alliance, said that the group also supports the report’s recommendations. “To achieve equality between physical and mental health we must set tangible goals and drive momentum to create real change in the system. Closing the funding gap for mental health and investing in our children and young people has real potential to change lives. We now look forward to working with partners across the sector to deliver the report's recommendations and make parity of esteem a reality.”