The nation’s wellbeing can be improved. Mental health conditions can be prevented, and we can halt the escalation of poor mental health being experienced by so many and so unfairly. We can all learn how to better look after our mental wellbeing and influence the conditions that give rise to better mental health. That is the belief of the field of public mental health. But this doesn’t just happen automatically, or easily. It needs the organised efforts of the whole of society and systems leadership. In England, national leadership in Government to drive this agenda has dwindled over the last 5 years, and now no longer exists.
The World Health Organization sees mental health as one of the most neglected areas of public health. In the UK we have been at the leading edge globally, with great progress over recent decades. However, the current void in national policy and programmes in England leaves a gap in leadership, advocacy and infrastructure to support delivery. We are at risk of going backwards.
Despite the rising prevalence of mental health inequalities post the COVID-19 pandemic, and an increase in societal awareness that good mental health is an essential building block for living life well, England’s lack of policy and programme means it is out of step with the rest of the UK (see Scotland, Wales and Northern Ireland) and is in danger of not fulfilling WHO recommendations to national governments.
Authors had the privilege of working on Public Health England’s Public Mental Health programme (2012-2021). We have undertaken a reflective review with others to capture our learning from the national programme and consider what the future direction should be. Our findings have been published in a journal paper.
The paper provides a record of the goals and mechanisms of the national PMH programme which we hope will lessen the loss of organisational memory during change. It also provides a call for urgent action:
1. Cross-government policy and high-level leadership to address the determinants of mental health through a whole government approach. Public health expertise in health in all policy approaches is needed here and is relevant at local levels also.
2. Multi-disciplinary coalitions and collaborations across sectors and civil society will help strengthen the field of PMH and provide advocacy and sustainability. We can all seek to embrace this within our PMH SIG and day-to-day work.
3. Mental health data, including insight gathered with and by communities, is needed to continue understanding mental health inequalities and the changing patterns of need, threats and resources that strengthen mental health.
4. Prevention research needs to be strengthened and valued. A strategic approach will help build capacity of public health staff and academics to generate and synthesise evidence of effective interventions.
5. PMH infrastructure within national public health institutions can help align policy, practice and research and co-ordinate action across the system. This should build on the effective local-regional-national networks that were in place previously and recognise and invest in the role that public health professionals play in system leadership.
6. Community involvement in public mental health decision-making is essential at national and local levels. Community voice can strengthen all public health, alongside equal partnerships with the voluntary and community sector.
7. Public health and mental health strategy should provide clear goals for mental health promotion, prevention and reducing mental health inequalities. This should include workforce development across sectors, especially for early years, children and young people, and an integrative framework for fostering whole systems working between local government, the voluntary and community sector and the NHS.
Public mental health is at a critical juncture in England. National public mental health leadership and programmes are essential aspects of any mature national public health or mental health strategy and policy. We hope FPH members will support our call for Public Mental Health.
Read more here.
The authors acknowledge the contribution of the late Gregor Henderson to the leadership of national Public Mental Health programmes in England and Scotland.
