By 2020 one in three teenagers will have access to cancer treatment in England. Think about that: only one in three. There would be an outcry. It would be scandalous, horrifying, unacceptable.
It is not true, however. Unless you delete the word “cancer” and insert “mental health”, and then it is.
In medical terms, there is a treatment gap. The number of children and young people living with a diagnosable mental illness far exceeds the number who get any help. One in 10 children suffer a diagnosable mental illness, yet just one in four of them receive treatment. By 2020 the gap may close, a little, if plans in NHS England’s Five Year Forward View for Mental Health [pdf] are realised, but only a little.
Over half of lifelong mental illness and distress shows its first signs in adolescence. We have an opportunity to do something to change people’s lives for the better and dramatically reduce the number of adults living with entrenched mental health problems. This is a great prize.
In her first major speech of 2017, Theresa May stressed the importance of prevention. Green papers on social justice, family and the role of schools in monitoring mental health and wellbeing are in the pipeline.
But can the treatment gap be closed by scaling up access to treatment and providing more digital options alone? Where will the workforce come from to provide the extra services and sessions required?
What if we could reduce the number of people getting ill in the first place? What are the underlying causes of rising levels of mental distress in children and can we put in place measures that increase resilience and reduce risk? If so, what are the most promising approaches?
Our ambition is to look beyond treatment and containment towards prevention and early intervention.
These are some of the questions Birmingham University is setting out to explore in its new policy commission. I will be chairing the commission, working with a range of experts, and together we are calling for evidence from non-governmental organisations, academics, public agencies, thinktanks, and people with lived experience of mental health issues across the UK and internationally.
I first outlined the ambitions of the university’s mental health commission in my inaugural lecture last autumn. Our ambition is to put together a new approach that looks beyond treatment and containment towards prevention and early intervention.
There is already some good evidence of what works in mental health promotion and illness prevention. As minister for mental health I commissioned the London School of Economics to review the evidence [pdf] and rates of return on investment. Among the findings was that school-based social and emotional learning programmes return £84 for every £1 invested. However, often the “saving” does not land in the budget of those who must make the investment. Siloed budgets and misaligned institutional objectives get in the way.
Last year I wrote about my visit to New York to learn about Mayor Blasio’s mental health programme: NYC Thrive. Thrive is a city-wide action plan devised from a population health perspective. It is trying to break down some of the silos. It involves schools and colleges, housing providers, the police and businesses. Prevention and early intervention are at its heart.
The West Midlands has set out its ambitions in its own Thrive strategy and the mayor of London is also working on plans.
Over the next 12 months the commission will be taking evidence, looking at the most promising ideas and setting out the actions that government and other agencies can take to make the shift to an ethos of prevention.
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What can be done to tackle the youth mental health treatment gap? | Paul Burstow
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