2.2 Evaluate a local, national or international strategy to promote mental wellbeing and mental health

This guide will help you answer 2.2 Evaluate a local, national or international strategy to promote mental wellbeing and mental health.

Mental health and wellbeing are essential aspects of overall health. Mental wellbeing refers to a person’s ability to manage stress, build and maintain relationships, and function well in day-to-day life. Mental health is broader and covers emotional, psychological, and social wellbeing, including challenging mental health conditions like depression or anxiety. Governments and organisations develop strategies to improve mental wellbeing and support mental health on local, national, and international levels. This evaluation looks at the UK’s national strategy, No Health Without Mental Health, introduced by the government in 2011.

No Health Without Mental Health – An Overview

The UK government introduced No Health Without Mental Health as a cross-government strategy. It aimed to improve mental health services and tackle stigma. The strategy recognised that mental health is as important as physical health and outlined plans to treat it with equal priority.

The primary objectives of the strategy were to:

• Improve the mental wellbeing of the population.
• Deliver better services for people with mental health challenges.
• Reduce stigma and discrimination related to mental health.
• Offer early intervention to prevent serious mental health conditions.
• Support community-based solutions for mental health care.

The plan had a wide scope, involving government departments, the NHS, charities, schools, workplaces, and local authorities.

Key Features of the Strategy

1. Public Education and Awareness: Public campaigns aimed to reduce stigma and improve understanding of mental health. For example, Time to Change offered education and media campaigns. It encouraged open conversations about mental health and addressed misconceptions.
2. Early Intervention: The strategy focused on identifying mental health issues early. This included enhancing access to psychological therapies (e.g., talking therapies) through programmes like Improving Access to Psychological Therapies (IAPT). Speedy diagnosis and support aimed to prevent conditions from worsening.
3. Integration into Physical Health Care: Mental health services were linked to physical health services. For example, patients with chronic conditions like diabetes or heart disease were offered mental health assessments. This highlighted that mental and physical health are interconnected.
4. Targeted Support for Vulnerable Groups: The initiative recognised increased risks of mental health challenges in specific groups. Vulnerable groups included ethnic minorities, people with disabilities, and offenders. Tailored support was provided for these populations.
5. Community-Based Care: The strategy aimed to reduce reliance on inpatient treatment. Patients were supported in their local communities through schemes like community mental health teams (CMHTs). This promoted independence and reduced stigma.
6. Child and Adolescent Mental Health: Children’s mental health was prioritised. The strategy pushed for improved services in schools, early identification of issues, and better coordination between schools, healthcare, and social care.
7. Workplace Mental Health: Recognising the link between employment and wellbeing, the strategy worked with employers to improve mental health in the workplace. Initiatives such as Mindful Employer and mental health first aid programmes were rolled out.

Successes of the Strategy

The No Health Without Mental Health strategy achieved several successes:

• Awareness: Public campaigns like Time to Change significantly increased awareness. Stigma related to mental health reduced as conversations about these issues became more common.
• Improved Access: The IAPT greatly increased availability of talking therapies. People with mild to moderate mental health challenges, such as anxiety and depression, benefited from quicker and more accessible support.
• Integration: Physical and mental health services became more synchronised. For example, GP surgeries began including mental health professionals in multidisciplinary teams.
• Community Focus: Community-based mental health teams reduced inpatient admissions. This meant people were treated closer to home, which maintained social connections and normality.
• Schools and Workplaces: Mental health support in schools and workplaces improved significantly. More employers engaged with schemes like mental health awareness training and flexible working policies. Mental health first aid courses became common in workplaces.

Challenges and Criticism

Despite its successes, the strategy faced challenges:

• Funding Issues: Mental health services have been underfunded for years despite promises of parity with physical health funding. Many services struggled to meet demands.
• Waiting Times: High demand for services led to long waiting times, especially for therapies provided by IAPT. Some patients waited months or years, worsening their conditions.
• Unequal Access: Services varied across different regions. Rural areas and deprived areas often had less access compared to cities.
• Ongoing Stigma: While campaigns reduced stigma, many people still felt judged or misunderstood when seeking support for mental health issues.
• Support for Severe Conditions: The focus primarily supported mild and moderate conditions. People with severe or complex mental health needs, such as psychosis, sometimes felt neglected by the strategy.

Final Thoughts

The No Health Without Mental Health strategy marked a significant step forward in recognising and addressing mental health issues in the UK. It raised awareness, improved access to therapies, and reduced stigma. However, challenges with funding, waiting times, and access persist. Adjustments and increased investment would strengthen services further and ensure quality, accessible support is available to all in need.

This evaluation shows the importance of continuous improvement within mental health strategies to meet the growing and varying needs of the population.