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Improving the lives of people with mental health problems

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Last month I blogged about the independent Mental Health Taskforce’s Five Year Forward View for Mental Health. Public Health England is now working with NHS England and other partners across the health and wider systems to implement the Taskforce’s recommendations.

In this blog I wanted to share some of the work we are doing with others to help improve the lives of people with mental health problems.

This includes helping people to improve and maintain good physical health, have access to good quality housing, employment, social networks, support and advice, and crucially, helping to ensure that people with mental health conditions are understood and not discriminated against.

Dealing with these and other wider social issues and determinants of good health and wellbeing will help improve lives.

For example, we are working with the Department of Work and Pensions and the Joint Unit in the Department of Health to help people with mental health problems gain employment, and we continue to work with the National Housing Forum to raise the profile of the impact of housing and homelessness on mental health.

A public health priority

People with mental illness die 15-20 years earlier on average and also experience more risks to their physical health.

Smoking rates are about twice as high as the general population and alcohol misuse and obesity rates are around 50% higher.

People with mental health issues also experience higher levels of unemployment and often live in poor quality accommodation, and experience higher rates of diseases such as cancer and heart disease, and also longer term condition such as diabetes.

Many people with poor long-term physical health also have a higher risk and incidence of mental health problems, meaning the resultant NHS costs can be substantial. It is conservatively estimated that £1 in every £8 spent in England on long-term conditions is linked to poor mental health.

Our aim, as part of our mission to protect and improve the nation’s health and address inequalities, is to help the public health system achieve ‘public health parity’ for mental health.

This includes ensuring that people living with and recovering from mental health difficulties are encouraged, supported and enabled to improve their physical health, wellbeing and quality of life and  to help address the shocking disparities in life expectancy experienced by people with mental illness.

Helping mental health trusts to go smokefree

In improving physical health, initially, our focus has been on supporting NHS Trusts and other organisations in becoming smoke free and compliant with NICE recommendations, and addressing the issue of equal access to community smoking cessation programmes for people living with mental health problems.

We have also been advocating for equal access to population healthcare for people living with mental health conditions. The Mental Health Taskforce has made it a clear priority that people with mental health problems get access to prevention and screening programmes including screening, NHS Health Checks and smoking cessation services and that all NHS Mental Health Trusts should be smoke free by 2018.

People with mental health problems smoke significantly more on average and have higher levels of nicotine dependence than the population as a whole. While the last 20 years have seen large reductions in smoking rates in the general population, the same cannot be said for people with mental health problems.

Today we have published new implementation guidance on smokefree mental health services in England, to complement our guidance for commissioners on smoking cessation in secure mental health settings.

In 2013, there were no completely smokefree NHS Mental Health Trusts. Now, 16 Trusts are completely smokefree and 24 have committed to becoming smokefree by 2018.

Supporting practitioners

We are also currently working with the Royal Colleges of Psychiatry, Physicians, GPs and Nursing to produce recommendations to help practitioners address the physical health needs of people with mental health issues.

This follows our work with NHS England in 2014 to revise the Lester tool – a decision support tool that guides health care professionals working with people with mental health problems through the assessment of a person’s smoking history, lifestyle, body mass index, blood pressure, glucose regulation and blood lipids, offering appropriate interventions and targets to improve that person’s physical health.

We are also working with lead mental health nurses to produce a support document for mental health nurses to address the physical health of people with mental health problems, which will be launched in April this year.

Listening to people with mental health problems

Perhaps most importantly, we are listening to the views of people living with mental health difficulties through our project A Day in the Life, with social enterprise Social Spider, which will publish its findings soon.

These first-hand accounts and experiences add significantly to our knowledge of what matters most to people, and is an invaluable source of intelligence and learning for now and the future.

The Five Year Forward View for Mental Health is part of a growing focus on the nation’s mental health and on addressing the health inequalities associated with mental ill health. It follows previous pledges as part of the Government’s 2011 mental health strategy to ensure that more people with mental health problems have good physical health and that fewer die prematurely.

The commitment to improving the lives of people with mental health problems has been made. Our work continues to focus on making it happen.

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