Improving the mental health of the nation

Written By Dr Jed Boardman

Last week’s election brought a welcome change of government after 14 years of policies that have resulted in increases in poverty and inequality and devastation of our public services. Perhaps now we might have some hope that we will see some changes to create an enriched quality of life for people in the United Kingdom.

But what might we want from our new administration which is set up to go and has already shown signs of decisive activity? As a starter – an increase in the trust and faith in our leaders. The last British attitudes survey revealed a “Damaged Politics”, showing public trust and confidence in government to have fallen to a historic low. This must change.

Combatting the Five Giants

We might also wish to look backwards and take another look at the Five Giants of Beveridge: Want, Ignorance, Squalor, Idleness and Disease. Combating all these matters to the health of the population – we need to see that people have sufficient finances to live, improved standards of education, adequate and secure housing, access to stable jobs, and high-quality health and personal social services.

The Centre for Mental Health has already set out a plan to address this and build a mentally healthier nation, which Careif are supporting. Along with Britain’s health and social services, mental health services have deteriorated over the past 14 years. The UK is a sicker place, health has stopped improving and health inequalities are increasing. People living in the most deprived areas have been hit the hardest.

The social safety net has been eroded and many people with disabilities, long-term conditions and mental health conditions are falling through the cracks. The provision of services to combat the Five Giants form the key pillars of a strong welfare state and not all of them are directed specifically at health and health services, but nevertheless they are integral to the facilitation of the nation’s health. They have all been devastated by the combined effects of austerity, COVID-19, rising inflation and the increasing cost of living. Now, for many people, the food bank has become part of their social security safety net.

Taking a ‘whole-of-government’ approach

The continuing struggles to reduce Want, Ignorance, Squalor, Idleness and Disease as a means of improving population health outcomes will require us to modify our strategies and to develop a greater emphasis on a Public Health approach to prevention. This approach must incorporate policies to reduce poverty, improve the quality of education, create better housing provision and support a labour market with better working environments.

This needs to be done across the whole life-course, albeit with an emphasis on early life and early intervention. If this is to be achieved, then questions arise as to how policies designed to do this might be fashioned. Government departments work in silos which results in a lack of a coordinated vision, lack of partnership and poor collaboration, and lack of flexible funding. This means that we do not have an integrated approach across government departments to confront many of the broader determinants of health. 

Nevertheless, there are ways in which these obstacles can be tackled. For example, the NHS Confederation has recently called for a whole-of-government approach to improving the nation’s health. Their approach has been specifically designed to tackle the causes of long-term sickness and economic inactivity but could readily be applied more widely. In addition, the Centre for Mental Health has made a persuasive case for a cross-government mental health policy test, that aims to ensure an overall positive impact of all policies, including transport, housing and social security, on mental health.

Our new Prime Minister has boldly offered change, to do politics differently, to set standards and for a return of politics to public service. One way in which all these can be achieved is through improving the health of the nation by changing the ways in which we approach health policy. The health of the population is a measure of the state of the nation. Improving health over the next five years will be the acid test for the new government.

References

Dr Jed Boardman

Dr Jed Boardman is visiting Senior Lecturer in Social Psychiatry at the Institute of Psychiatry and Senior Policy Adviser at the Centre for Mental Health. Throughout his career; he has worked mainly in social and community psychiatry and was Consultant Psychiatrist at South London and Maudsley Trust until 2016.

https://www.careif.org/jed-boardman
Previous

South Asian Heritage Month 2024
Next

A mentally healthier nation