Mental health difficulties have a major impact on people’s lives and are the largest cause of disabilities in the UK. One in four adults experience a diagnosable problem each year and 50% develop them before the age of 18. The cost of this to the economy is roughly the cost of the entire NHS - £105 billion a year. Given this widespread problem, Mental Health Services often have long waiting lists and high caseloads and despite recent government strategies, use of mental health services has continued to rise. Austerity has exacerbated these problems and suicides each year are now rising.
So, what if we were able to prevent people from developing mental health difficulties in the first place? Prevention is a concept that is often talked about and is a key part of the Government’s new Five Year Forward View for Mental Health. Three key phases of prevention have been identified: primary prevention to stop mental health problems occurring in the first place, secondary prevention to intervene at the earliest stage and prevent more severe mental health problems occurring and tertiary prevention to promote recovery when mental health problems have become established to reduce the impact of living with a mental health problem. Prevention should focus on the whole lifespan and at different system levels, for example whole community based approaches as well as individual and family based approaches. The independent report from the Mental Health Taskforce (February 2016) outlines prevention as a key area for getting the foundations of mental health care right. It calls for a specific Prevention Concordat programme and a multi-agency approach to prevention as well as developing mentally healthy communities.
So given this great need and call for prevention work how do you go about successfully preventing mental health difficulties in a specific community? In Southampton, researchers at the University and the Local Authority Mental Health Champion have drawn together a working group to look at tackling exactly this and to aim to create a ‘Mentally Healthy Southampton’. The working group consists of local organisations - the Local Authority, Clinical Commissioning Group, NHS Trusts and third sector organisations who work with the local community across the lifespan and across services for drug and alcohol, children, adult and older people’s mental health. The project is a collaboration with the Mental Health Foundation who have been developing evidence for effectiveness in this area.
The work has commenced mapping out local services, across the city and importantly across all ages. In addition to this, locally available data and measures of health and wellbeing specific to Southampton is being collated to get a population baseline and allow for tracking of changes. These two pieces of work will then be used to identify and prioritise areas for prevention initiatives based on government guidelines and current evidence. This will form a community specific prevention plan.
Outputs from this project will include a Public Policy Brief for Public Health England, Health and Wellbeing Boards, Mental Health Champions and other people responsible nationally for mental health provision, as well as the implementation plan for developing a Mentally Healthy Southampton. This work will aim to contribute to tackling the mental health challenges that exist in our community.
Prof David Kingdon, Southampton
David Kingdon is Professor of Mental Health Care Delivery at the University of Southampton, UK, and honorary consultant adult psychiatrist for Southern Health NHS Trust. He has received an award from the Public Policy|Southampton to disseminate the findings of the 'Mentally Healthy Southampton' in collaboration with the Mental Health Foundation.
