A new report summarising the latest evidence around public mental health has been published today. It summarises the latest evidence for the: 

  • Impact of mental disorder – accounting for at least a quarter of UK disease burden
  • Impact of mental wellbeing
  • Risk factors for mental disorder and protective factors for mental wellbeing 
  • Groups at higher risk of mental disorder and poor mental wellbeing 
  • Effective interventions to treat mental disorder, prevent associated impacts, prevent mental disorder from arising and promote mental wellbeing 
  • Economic savings of different public mental health interventions 

The report, produced by Dr Jonathan Campion (Director of Public Mental Health at South London and Maudsley NHS Foundation Trust) and hosted on the RSPH website, has been endorsed by the Association of Directors of Public Health, Faculty of Public Health, Health Education England, Local Government Association, Royal College of General Practitioners, Royal College of Psychiatrists and RSPH.

Despite the existence of cost-effective public mental health interventions, only a minority of those with a mental disorder in England receive any treatment, far fewer receive interventions to prevent associated impacts and even fewer receive intervention to prevent mental disorder or promote mental wellbeing. The report highlights how this results in large scale human suffering and lost potential. It also represents a breach of the 2010 Equality Act and the right to health. The report summarises the reasons for the implementation gap including lack of:

  • Knowledge about size of the intervention gap at national or local level
  • Public mental health knowledge and training in public health, primary care, secondary mental health care, social care and commissioning to reflect the impact of mental disorder and wellbeing and evidence base for public mental health interventions 
  • Appropriate policy targets 
  • Appropriate resource allocated to mental health: In England, this amounted to 12.0% of the NHS budget (NHSE, 2018) and 1.6% of the public health budget (DCLG, 2018) despite at least 23.8% of UK disease burden due to mental disorder (WHO, 2018). Furthermore, local authority expenditure reduced by 28.6% in real terms between 2010/11 and 2017/18 (NAO, 2018) 

The report sets out a number of actions necessary to improve coverage of evidence based interventions to reduce the population impact of mental disorder and promote population mental wellbeing which include: 

  • Mental health needs assessment to inform JSNA, mental health strategy and policy development followed by implementation and evaluation of coverage and outcomes 
  • National assessment of the size, impact and cost of the public mental health intervention gap as well as impact and associated economic savings of improved coverage in order to inform transparent agreement about nationally acceptable standards for minimum level of coverage of different public mental health interventions and required resource 
  • Improved population understanding about public mental health 
  • Public mental health training for public health, primary care, secondary mental health care, social care, commissioners and policy makers to reflect impact of mental disorder and wellbeing and evidence based for public mental health interventions  
  • Settings based approaches such as schools, workplaces and neighbourhoods

Professor Sir Michael Marmot, Professor of Epidemiology, University College London welcomed the report: “I must confess to a frisson of excitement as I went through this report. More than a frisson. Two clear messages stand out. Half of lifetime mental illness, except dementia, arises by age 14; and there is a great deal that can be done in early childhood to prevent it. Taking the action laid out here has great potential to reduce inequalities in health.” 

Professor Helen Herrman, President of World Psychiatric Association said: “We are indebted to Jonathan Campion for conceiving and publishing this authoritative report. It makes a compelling case for including mental health in the public health agenda in the UK and elsewhere. It confronts us with the extensive evidence base for the prevention of mental illness and the promotion of mental health. It invites reflection and action on the need for policies and practice in health and other sectors that protect and promote mental health across the life span. This report is an accessible goldmine of evidence and inspiration for those seeking to design public health action suitable for the places they serve, those advocating for more action on improving mental health, and those striving to extend the evidence base.” 

Professor Jim McManus, Vice-President for the Association of Directors of Public Health said: “The Association of Directors of Public Health welcomes this public mental health report which outlines key actions to sustainably reduce population impact of mental disorder and promote population mental wellbeing.” 

Professor Wendy Burn, President of the Royal College of Psychiatrists said: “The Royal College of Psychiatrists welcomes this report. Public mental health is an increasingly important area for us and we know that our patients suffer many inequalities. This report highlights where improvements are urgently needed and gives helpful guidance about how these improvements can be achieved.”

Professor Lisa Bayliss Pratt, Health Education England’s Chief Nurse said: “The publication of this report is very welcome. It brings together the latest evidence for preventing mental ill-health and promoting mental wellbeing – and also strengthens the case for training, development and upskilling the workforce in these crucial areas of public health.”