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2. The national context for mental health

Mental Health and Emotional Wellbeing (MHEWB) has received a lot of attention in recent years both locally and nationally. National strategies and reviews have outlined both a preferred approach to improving MHEWB but also a number of clear areas in need of improvement.

Recent national documents are The five year forward view for mental health (2016) No health without mental health (2011) and Closing the gap (2014). Our local strategy draws from each of these documents as well as the data and stakeholder views relating specifically to South Gloucestershire.

No health without mental health was published in 2011 but its recommendations are still very relevant to mental health in 2017. The strategy set out six shared objectives for improving mental health in England:

  1. More people will have good mental health
  2. More people with mental health problem will recover
  3. More people with mental health problems will have good physical health
  4. More people will have a positive experience of care and support
  5. Fewer people will suffer avoidable harm
  6. Fewer people will experience stigma and discrimination

No health without mental health, talks at length about the wider social context of mental health linked to factors such as housing, employment, transport and community cohesion. The role of communities and the individual in promoting positive mental health is made clear. This acknowledges the fact that although health and mental health services are very important, most people’s level of mental health is an outcome relating to the context in which they live. To really improve mental health we have to help people improve the whole context in which they live and their individual ability to thrive.

However, whilst making this point about the wider context of mental health the strategy does also talk about the need for high quality mental health services for those that need them. Again this is something we agree with and is reflected in our South Gloucestershire strategy.

Another clear message from No health without mental health, was that there is a strong link between mental health and physical health. This message was confirmed by our local stakeholder engagement and it is clear that health needs must be looked at in a holistic way for long term improvements to be achieved for any individual. To that end parity of esteem between mental health and physical health is another principle we have adopted locally from the national strategy. This highlights the importance of mental health services working alongside services addressing key risk factors such as smoking, drugs and alcohol and sexual health as well as protective factors such as physical activity and healthy diet.

No health without mental health, identifies stigma as a big issue relating to mental health and again this was backed up by our local findings. One key local finding was that whilst stigma experienced from individuals was a problem, stigma experienced from institutions was seen as a bigger issue. Many employers were reported as not having a positive attitude towards mental ill health as were a number of public sector, voluntary sector and private organisations. Addressing this locally is part of our mental health action plan.

The national mental health task force published Mental health: Moving forwards – The five year plan in 2016. This plan sets out clear strategic themes centred on prevention, access, quality and integration. These themes will drive system transformation and help to establish a framework with measureable objectives. The five year forward view mental health taskforce recognises that the NHS alone cannot transform mental health services – it is ‘everyone’s business.’