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Blog Jon Rouse


Mental health and parity of esteem: the long road ahead

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One in four people in the UK will experience a mental health issue over their lifetime. This may be a familiar statistic to many of you – but familiar or not, it should be a cause of concern to all of us working in the health and care sectors.

More concerning is evidence that 3 in 4 people diagnosed with mental health problems are likely to receive little or no treatment for their condition. Even for psychotic disorders, around one third of people are untreated.

Treatment rates for most physical long-term conditions are much higher, in some cases over 90 percent. People diagnosed with a severe mental illness are nearly 4 times more likely to die from serious conditions such as heart disease or cancer related illnesses.

An awareness of this, set against a broader desire to see mental and physical health treated equally in all areas of the health and care system, prompted Norman Lamb, Minister of State for Care and Support, to commission a report from the Royal College of Psychiatrists.

Its findings make a strong and compelling case for promoting the parity of esteem agenda and are testimony to why mental health and well-being is a priority for the government. The overarching goal is to ensure mental health has equal priority with physical health, and everyone who needs help and support has timely access to the best available treatment.

Indeed, the Health and Social Care Act 2012 enshrines the equal importance of mental and physical health. Changing the law is just the start, of course, but it sends a clear signal, not only about the importance of mental health, but also the government’s intention to transform the treatment of mental illness and challenge stigma and discrimination. In addition, the Mandate to NHS England makes it clear that:

  • mental health is just as important as physical health
  • there is a health gap between people with mental health problems and the population as a whole which should be closed
  • everyone who needs it should have timely access to the best available mental health treatment

Much is already being done at a national level to promote parity of esteem. NHS England and Public Health England are working with national clinical directors to develop a parity of esteem work programme and national programmes for better mental health. Health Education England too has made parity a priority in its mandate and is working to ensure the mental health workforce has the right skills and values to drive service improvement. It also highlights the importance of mental health awareness in the wider health workforce.


But it is within and between local communities and organisations where we can work more effectively. Health and wellbeing boards will play a crucial role in coordinating and promoting collaboration between local authorities, clinical commissioning groups and health and social care providers. This ties in neatly to my previous blog about integration and the very welcome £3.8 billion investment in local pooled budgets to drive integration in health and social care services.

There are also some hard questions that Health and Wellbeing Boards need to be facing up to:

  • Is crisis care good enough in their area, in terms of access and response?
  • Are there sufficient independent mental health advocates?
  • Is the local IAPT programme going to achieve the national target of 15 percent access and 50 percent recovery rate by the target date in 2015?
  • Are employment support advisers embedded within the mental health service offer? 
  • Are community and acute services working seamlessly or are people falling down the gaps?
  • Are mental health services adequately supporting the police and is there an effective liaison and diversion service?

This is by no means an exhaustive list.

More broadly, while legislation and new ways of working can play their part, it’s also about challenging attitudes and perceptions, a daily battle for many in the care sector. It’s why the work of organisations like Time to Change has been so important in demonstrating how collective action can lead to significant change.

We all have a part to play. By making a few, simple changes we can all help challenge the stigma still clinging to mental health. Signing up to Time to Change is a great place to start. Regardless of where we work, in or with government, the health and social care services, or simply as concerned individuals - together we can start to change attitudes. 

This is a subject I will return to many times in my blogs. If there are particular aspects of mental health services you would like me to cover, please let me know.

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1 comment

  1. Comment by Tim posted on

    I think the modern lifestyle is not conducive to maintaining a healthy mind and body. Unless we receive better education at school on mental health I fear its trap a lot of people will fall into.