Preventing people from developing mental health problems and promoting good mental health
One in eight young people has a diagnosable mental health problem. However, only one in four of them accessed specialist services last year. This leaves too many young people with no support at all1. Mental Health Support Teams based in schools can help increase access to services. They can also identify young people showing early signs of mental health problems who may not be identified by their GP or mental health services.
1 NHS Digital (2018), ‘Mental Health of Children and Young People in England, 2017’
It’s vital that services include young people not in school. This includes young people who are home-schooled, have been off-rolled (removing a pupil from the school roll without using a permanent exclusion, when the removal is primarily in the best interests of the school, rather than the best interests of the pupil), or don’t attend school due to special educational needs.
NHS services must link up with local authorities to ensure that more vulnerable groups, such as young people in care or those on child protection plans, are supported and safeguarded. Joined up working and a shared understanding of local needs between Clinical Commissioning Groups, local authorities and schools is crucial to ensure young people are supported by the right service at the right time.
Around one in five women will experience a mental health problem during pregnancy or in the year after giving birth. These problems cause distress to the mother and her family. They can also adversely impact the child’s mental health, development and educational outcomes for many years.
The long-term economic and social costs of untreated perinatal mental health problems are £8.1 billion for each one-year cohort of births in the UK2. It’s crucial that both mothers and children get the right support.
Specialist perinatal mental health services have expanded as part of the Five Year Forward View for Mental Health. However, the full range of services are still not available everywhere. Around one in ten new fathers also experience mental health problems, so support must be available for them too.
2 Centre for Mental Health, Costs of perinatal mental health problems, 2015
The majority of suicides are related to mental health. We know that in many cases people have struggled in silence, feeling unable to ask for help. A more coherent and consistent approach to suicide prevention is needed, building on existing local multi-agency suicide plans to significantly reduce suicides among people in contact with mental health services, and those who aren’t.
The NHS has a critical role in shaping local plans and delivering effective interventions, including within primary care, focusing on the most at-risk groups. These include people who self-harm, middle aged men, people in detention, in custody, in contact with the criminal justice system and people who have been bereaved by suicide.
Currently more than 300,000 people living with long-term mental health problems lose their jobs each year. The Stevenson/Farmer Thriving at Work review of mental health and employers identified steps the NHS, government and employers need to take to transform the mental health of our nation’s workforce.
There’s currently a high number of vacant posts and high levels of stress among the NHS workforce. Attrition rates are also high. So local NHS plans need to show how they’re going to support the mental health and wellbeing of their own staff to improve recruitment and retention.
Local areas must ensure that they partner with local authorities to develop local long-term plans. This is to make sure NHS activity aligns with public mental health and mental health prevention initiatives, building on existing activity around the Prevention Concordat.
Mind wants to see more funding for public health to help stem the flow of people becoming unwell in the first place. Mental health needs to be central to areas as diverse as housing, parks and green spaces, leisure facilities and libraries. The NHS can encourage local government to take action on this. Increased investment in, and access to, public mental health services, parenting programmes, drug and alcohol services, smoking cessation and physical activity programmes is also critical.
Mental Health Support Teams will be introduced in schools and colleges in a fifth to a quarter of the country by the end of 2023. NHS England will test approaches to support children and young people outside of education settings. They’ll also provide more upstream preventative support such as information sharing and digital interventions to reduce need for specialist Child and Adolescent Mental Health Services.
Perinatal care will be available from preconception to 24 months after birth, extended from 12 months. Plus, people will get more access to evidence-based psychological therapies in specialist perinatal mental health services, including parent-infant, couple, co-parenting and family interventions.
The NHS will also offer greater access to evidence-based care for women with moderate to severe perinatal mental health problems and a personality disorder diagnosis and increased access to psychological support and therapy, including digital options, in a maternity setting. There will be more support for partners of women accessing specialist perinatal mental health services and maternity outreach clinics.
NHS England will provide full coverage across the country of the existing suicide reduction programme and design a new Mental Health Safety Improvement Programme for mental health inpatients focused on suicide prevention and reduction.
Suicide bereavement support for families and staff working in mental health crisis services will be made available all over the country. Building on the work of the Global Digital Exemplar (GDE) programme, NHS England will use decision-support tools and machine learning to improve personalised care and predict future behaviour, such as risk of self-harm or suicide.
The Long-Term Plan (LTP) commits to improving the wellbeing of NHS staff, building on the NHS Health and Wellbeing Framework that includes recommendations from the Stevenson/Farmer review of mental health and employers, and support improved staff health and wellbeing and sickness absence management.
Is your area taking action to support children and young people in schools and outside of schools?
Does the plan set out how it will improve access to specialist perinatal mental health services for women and support for partners?
Does the plan align with the priorities set out in the local multi-agency suicide prevention plan, including targeting at-risk groups? What support will be provided for people bereaved by suicide?
What action will your area take to support the mental health and wellbeing of NHS staff?
Does the plan complement local authority-led public mental health programmes, including those happening under the Prevention Concordat? Is the local authority involved in conversations about mental health prevention and promotion within the plan?
Does the plan include targeted measures to ensure the NHS is helping people with mental health problems to stop smoking, be physically active and manage their weight?