Choosing mental health: a response to the government white paper
| Published date | 01 March 2005 |
| Date | 01 March 2005 |
| DOI | https://doi.org/10.1108/17465729200500009 |
| Pages | 35-43 |
| Author | Lynne Friedli,Andrew McCulloch |
| Subject Matter | Health & social care |
Choosing Health is the first government public health white paper since Saving Lives:Our Healthier
Nation, published in 1999.It aims to make the NHS ‘a health service, not a sickness service,’and is
strongly influenced by the Wanless reports.This paper presents a critical review of the main elements
of the white paper that relate to mental health, and sets out the actions that policy makersand service
delivery organisations need to take to build genuinely mental health promoting public services within
amentally healthy society.
Choosing mental health: a
response to the government
white paper
Lynne Friedli
Independent consultant
Andrew McCulloch
Chief executive
Mental Health Foundation
POLICY
35
Choosing Health (Department of Health,
2004a) is the first government public
health white paper since Saving Lives:
Our Healthier Nation, published in 1999
(Department of Health, 1999a). It follows
an extensive consultation exercise, including specific
consultation on physical activity and diet, as well as an
independent survey on public attitudes to health carried
out by the King’sFund (King’sFund, 2004). Choosing
Health sets out the agenda for public health over the
next three to five years and will have a significant
influence on investment and delivery priorities, notably
for primary care trusts, but also for a wider range of
stakeholders in local government, the voluntary sector,
and in some parts of the private sector.
Choosing Health is strongly influenced by the
Wanless reports, commissioned by the Treasury, and is
part of a growing acknowledgement of both the
economic and public health case for a greater focus on
promotion and prevention (Wanless, 2002; 2004).
Wanless emphasises that health promotion policy must
address ‘individual behaviour and lifestyle risk factors,
as well as wider determinants of health, such as poverty
and education’. He argues that population health
cannot be assessed solely in terms of morbidity and
mortality data, but also requires measures of positive
physical and mental health. ‘A health service, not a
sickness service’ has become an increasingly significant
catch phrase for the direction of NHS policy.
Wanless has calculated that the cost benefit of
better mental health care would be a net saving across
government as a whole of some £3.1 billion a year
(Wanless, 2002). This does not take into account the
savings from promoting mental health and preventing
problems in the first place. The Sainsbury Centre for
Mental Health has calculated that the total cost of
mental ill health to the English economy is £77 billion
ayear (SCMH, 2003). So the potential for savings is
obviously much greater than Wanless’ more modest
estimate, but as yet we lack the health economic data to
predict the total savings to the national economy that a
public mental health strategy could yield (see, for
example, Office of Health Economics, 2005).
Like its predecessors Our Healthier Nation
(Department of Health, 1999a) and The Health of the
Nation (Department of Health, 1992), Choosing
Health also identifies mental health as a priority issue
and exemplifies an important trend in health policy
within the UK and Europe over the past decade: an
increasing shift from a predominant focus on mental
illness to a recognition of the importance of mental
health and well-being to overall health.
Standard one
That Choosing Health specifically commits public
services to the delivery of standard one of the national
service framework for mental health in England
(Department of Health, 1999b) is to be welcomed:
journal of public mental health
vol 4 • issue 1
©Pavilion Publishing (Brighton) Ltd
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