The Joint Commissioning Panel for Mental Health (JCPMH) has published guidance on public mental health commissioning.
In summary, the document outlines that mental disorder:
- Is responsible for 23% of burden of disease in the UK compared to 16% for cancer and 16% for cardiovascular disease
- Affects 1 in 4 of the population at any one time
- Results in broad range of impacts across health, education, work and criminal justice as well as health risk behaviour and associated premature mortality. As an example, 42% of adult tobacco consumption in England is by those with mental disorder while 43% of smokers under 17 have either emotional or conduct disorder
- Costs England £105 billion each year
However, only a minority of people with mental disorder get any treatment despite cost effective interventions. This is in contrast to cancer where almost everyone gets treatment. This inequity in action has a broad range of associated public health impacts and costs.
Mental wellbeing also has a broad range of impacts with considerable economic consequences. National mental health and public health policy highlights effective interventions to both promote wellbeing and prevent mental disorder and commits to action on these areas. The Public Health White Paper signals a new approach which places mental health and wellbeing 'at the heart' of the new system and highlights the key role of Directors of Public Mental Health in public mental health. However, an even smaller minority who benefit from such interventions receive them.
Treatment, prevention and promotion result in a broad set of improved outcomes including in public health. Therefore public mental health interventions can play a key part in improving public health. Furthermore, evidence from the LSE in last year’s mental health strategy highlights such interventions also result in considerable economic savings even in the short term (DH, 2011). For instance, LSE estimated that promotion of mental health at work results in net savings of £10 for each £ after one year while early intervention for depression at work results in net savings of £5 for each £ spent.
The public mental health guidance highlights that levels of mental disorder and poor wellbeing vary according to the area people live in and in particular deprivation. It enables local estimation of:
- Numbers with mental disorder and poor wellbeing including from higher risk groups
- Risk and protective factors
- Numbers from particular groups at higher risk of mental disorder and poor wellbeing
- Proportion of people getting treatment, prevention or mental health promotion and thereby unmet need
- Impacts on public health, NHS and social care outcomes
- Savings from investment in treatment, prevention and promotion and which arise in a broad range of area
Such information enables information about mental disorder and wellbeing to be included in the Joint Strategic Needs Assessment which informs the Health and Wellbeing Boards strategy and commissioners about level of unmet need. The board and commissioners can then make transparent decisions about what proportion of people who require such interventions should receive them. The guidance also highlights the broad impacts of a range of evidence based interventions to address this unmet need.
