By Ed Davie
As integrated care systems become statutory bodies, the need for a focus on prevention and health promotion as well as excellent clinical care has never been clearer.
Over the next three to five years, Centre for Mental Health has estimated that mental health services in England will need additional capacity for 8.5 million adults and 1.5 million children and young people; a total of 10 million people. This investment in staffing, facilities and treatment should be made, but we also need to do much more to improve wellbeing and prevent mental illness from occurring in the first place.
Our aim is to support England’s 42 integrated care systems to use all their power, influence and budgets to improve the social determinants of mental health, like poverty and discrimination, and environmental factors like access to decent housing and green space, as well as providing parity for high quality clinical mental health services and social care as soon as needed.
We are asking integrated care systems to take this wider approach because even with additional resources, the demand for mental health services is far outstripping capacity with referrals to children’s mental health services alone up 134% in a year.
The size and nature of the challenge means that treatment alone cannot manage this crisis
The demand for mental health services is being driven by the worsening circumstances of many people’s lives with a decade of austerity cuts, especially to the incomes of the poorest and their services, being followed by the hardships of the Covid-19 pandemic and the cost of living crisis.
Whilst high quality clinical services are vital, research suggests that health care accounts for about 20% of health outcomes. The size and nature of the challenge means that treatment alone cannot manage this crisis – we also must address the factors that make up the other 80%. Principal among these factors is poverty, which is associated with more years of lost life than smoking and obesity combined.
It is vital that central government, which holds many of the levers that can alleviate poverty such as welfare, tax credit, childcare, insulation and minimum wage policies, does much more to alleviate poverty, as we have called for in our submission to the cross-government mental health strategy consultation.
But integrated care systems can also play their part, for example by supporting all constituent members to become Living Wage Foundation accredited, using social value procurement to hire, train and buy more locally (especially from vulnerable groups), and supporting environmental improvements like active travel and access to decent housing and green space.
Centre for Mental Health is already working with integrated care systems in Greater Manchester and the West Midlands and would welcome the opportunity to support others in becoming mentally healthier.
If you’d like to be in touch about this work, please email ed.davie@centreformentalhealth.org.uk
