What does MQ want to see included in the 10-Year Health Plan and why?
Almost 23% of the total burden of disease in the UK is attributable to mental disorders, compared to 16.2% for cardiovascular disease and 15.9% for cancer. For this reason, it is vital that improving mental health is a priority for the 10-Year Health Plan.
We have identified four priorities we would like to see incorporated into the 10-Year Health Plan for England. These are evidence-based and will help to create a whole-person, mind-body-brain approach to healthcare.
These are:
- Reduce the risk factors to improve prevention of mental illnesses;
- Reduce silos between services, including early intervention services;
- Make embedding research within the NHS a central component of the 10-Year Health Plan;
- Make routinely collected data accessible for research.
Reducing the risk factors
By improving people’s economic, social and environmental circumstances, we can reduce mental and physical illnesses in the future.
There are significant drivers of mental illness which must be addressed:
Poverty
Poverty is more than just an economic issue. It is a pressing public health problem with far-reaching societal impact. It can be both a cause, and a consequence, of mental illness.
In 2023, MQ published the Cost-Of-Living Report which reviewed the existing evidence about time impact of poverty and past economic crises on mental health.
The report found that rates of poverty in the UK is high, with around a fifth of people in the UK classed as living in poverty. This cohort is more than twice as likely to develop a mental health problem than those on an average income.
The prevalence of psychotic disorders among the lowest fifth of household income is 9 times higher than in the highest, and double the level of common mental health problems between the same groups.
As well as a cause of mental illnesses and distress, poverty can also be a consequence of mental health problems. Having a mental health condition, while not an excuse, can be a reason why it’s harder to manage money than for others. Many with mental illness report that spending patterns and financial decisions change notably during periods of poor mental health. In fact, a survey found 93% of those who took part spent more when mentally unwell and 92% found it harder to make decisions related to money.
Discrimination
Racism, sexism, ableism and other forms of discrimination can be overt or implicit. They can include reduced access to opportunities or even spaces, micro-aggressions and outright verbal or physical abuse.
Discrimination in all its forms can be detrimental to mental health. In a paper published by MQ Science Council member Professor Kam Bhui and GALENOS Director Andrea Cipriani, it was found that not only were people from Black and other minority ethnic groups experiencing significant mental health inequalities, but that these were exacerbated by the COVID-19 pandemic.
Poverty and discrimination are intrinsically entwined. Households which are classed as living in poverty are more likely to include someone living with a disability, to have 3 or more children, to be social renters and to include someone from a Bangladeshi, Pakistani or from the Black community.
Pollution
A 25-year study of young adults living in the United Kingdom has found higher rates of mental illness symptoms among those exposed to greater levels of traffic-related air pollutants, particularly nitrogen oxides, during childhood and adolescence.
Long term exposure to air-pollutants increases the risk of anxiety disorders and depression.
Air pollution isn’t the only environmental concern when it comes to mental health. Access to green spaces has been proven to be beneficial for mental wellbeing, for increasing physical activity and reducing stress.
According to the Lancet, the climate crisis is an unprecedented threat to human health and tackling this must be a long-term aim if we are to properly address the most significant risk factors for both physical and mental illness in the future.
Trauma and Adverse Childhood Experiences (ACEs)
Adverse Childhood Experiences, or ACEs, are highly stressful and potentially traumatic events or situations that occur in childhood. There is a strong correlation between ACEs and a range of significant negative outcomes that can impact people for their entire lives.
A national strategy to reduce ACEs and better treat Post-Traumatic Stress Disorders (PTSD) could better prevent the mental health problems too often faced by those who have experienced trauma.
Addressing these risk factors to improve mental health would require a whole-government approach, with different government departments and structures all working together to improve outcomes for people over the long term.
