Mental health: one step forward and two steps back? | Mental health

It’s very encouraging to hear the announcement about the new network of community mental health clinics in England (Editorial, 6 August). The focus on early intervention is crucial, as it means that people can access treatment as early as possible, rather than waiting for their mental health to reach a crisis point. The centres should improve access, reaching people where they are. The government should make sure that they meaningfully involve people with lived experience of mental health problems to ensure the centres are co-designed and co-led with them.

As your editorial says, parity between mental and physical healthcare became a policy goal in 2011. Mental health is an issue that unites us. According to new research, which we commissioned from More in Common, nearly three-quarters of the public believe that mental health is as important as physical health, most people are comfortable talking about it, and support for early intervention is high across the political spectrum. Three-quarters also say the government should do more to improve services.

The centres are an important step forward, but the government needs to make sure that people can access the many new and improved mental health interventions that have the potential to transform lives. New evidence-based mental health treatments must be rigorously evaluated, adopted and made available across the NHS. This will help people get the right treatment at the right time, and lead fulfilling lives.
Dr Kate Martin
Head of field building and lived experience, Wellcome Trust

While the announcement of a new initiative on early access to mental health care must be welcomed, there is a danger that without a parallel programme on mental health promotion, it could compound an already disastrous situation by uncovering massive further unmet need.

A public health approach to mental health is long overdue. I refer to one which takes its cues from the history of tuberculosis, the “captain of the men of death” that was brought under control not by pharmaceuticals alone, but by paying attention to the environmental conditions that predisposed to transmission.

The initial prescription for action was written 60 years ago by the Manchester psychiatrist Gerald Caplan, who identified how those with psychiatric training might best be deployed to build population-level mental health resilience through their support in the community, school, places of work and recreation; in Caplan’s blueprint, clinical work was only one aspect of the daily round of the psychiatrist and their team.

The forthcoming mental health strategy is an opportunity to grasp this nettle; for too long these opportunities have been missed.
Prof Dr John R Ashton
Former president, Faculty of Public Health

Your report (NHS mental health trust plans £25m in cuts to jobs and services, 3 August) is concerning. As the NHS faces yet another reconfiguration, patients and staff can only look forward to an uncertain future as not only this trust but other mental health trusts are expected to make savings to already impoverished levels of care. This is in stark contrast to the recent announcement of a major expansion of community mental health support in England.

Successive governments have insisted that mental health should be given the same priority as physical health, yet each year psychiatric services undergo ever more cuts to funding, services and beds. This has left people with minimal help and nowhere to go in times of loneliness or crisis.
Marjorie Wallace
Chief executive, Sane