Editorial
| Published date | 01 September 2004 |
| DOI | https://doi.org/10.1108/17465729200400013 |
| Pages | 2-4 |
| Date | 01 September 2004 |
| Author | Lynne Friedli |
| Subject Matter | Health & social care |
journal of mental health promotion •volume 3•issue 3 •september 2004 © Pavilion Publishing (Brighton) Ltd
Editorial
A consensus appears to be emerging within the UK
mental health promotion community that the way
forward lies with public health. Increasingly those
seeking to influence the policy agenda, at local, regional
and national levels, are looking to public health for
allies and strategic opportunities.
Public mental health has been slowly gaining
ground over the past five years as a conceptual
framework for thinking about mental health promotion
(Friedli, 1999; Scottish Development Centre for
Mental Health Services, 1999; Stewart-Brown, 1998).
It informs the work of a number of organisations
explicitly concerned with a population-wide approach
to mental well-being: for example, mentality
(www.mentality.org.uk), the Mental Health Foundation
(www.mentalhealth.org) and the Scottish Development
Centre for Mental Health (www.sdcmh.org.uk). It is
also a significant influence in the direction of Scotland’s
National Programme for Mental Health and Well-
being (www.wellontheweb.net), in Community
Planning Partnerships across Scotland and in the
regional development centres (RDCs) of the National
Institute for Mental Health (England): notably
London, the West Midlands and the North West.
Funding has now been secured for posts with a specific
public mental health remit across all RDCs
(www.nimhe.org). These developments may help to
resolve historic tensions between mental health
promotion and mental health services, between a
population-wide approach and initiatives that focus on
the needs of service users.
More recently public mental health has begun to
make small but significant inroads into thinking about
how public health might be transformed (McCulloch,
2004) and the alliances that will be necessary to secure
resources and political leverage (see, for example, the
London-wide public health mental health network
described on page 45). In addition to the forthcoming
debate on public mental health hosted by this journal
and sponsored by the Scottish Executive, the Mental
Health Foundation is holding an online conference,
Mental Health for All, in January 2005, which aims to
consider what research, policy and action is needed to
put mental well-being at the heart of the public health
agenda (www.mentalhealth.org).
To some extent, this trend is a reflection of the
uncertain position of health promotion, long the
natural home of mental health promotion activity, and
its relocation, locally, within primary care. Both
Scotland and England have seen a major reorganisation
of their national health promotion agencies. In
Scotland the Health Education Board for Scotland
(HEBS) and the Public Health Information Service
(PHIS) have merged to form NHS Health Scotland,
and in England the abolition of the Health
Development Agency (formerly the Health Education
Authority) has been announced.
It may also reflect growing frustration with a mental
health agenda that continues to be dominated by
mental illness, notably at a local level where resources
are consistently swallowed up by treatment services
struggling to meet performance targets. In England it
took the Social Exclusion Unit, based in the Office of
the Deputy Prime Minister, to come up with a holistic
framework and robust recommendations for addressing
the needs of people with mental health problems –
needs that lie way beyond treatment (Social Exclusion
Unit, 2004). But the Social Exclusion Unit’s remit is
not to consider how the mental health needs of the
whole population might be addressed.
This might reasonably be considered the domain of
the Department of Health, but mental health
promotion continues to occupy an ambiguous and
uneasy position within England’s national health policy.
Following the Wanless reports, (Wanless, 2002; 2003),
both the NHS Improvement Plan (Department of
Health, 2004a) and the Choosing Health consultation
(Department of Health, 2004b) place a strong
emphasis on promotion and prevention. Wanless
estimated that failure to give priority to prevention
could cost an additional £30bn a year by 2020: a
warning apparently heeded by secretary of state for
health John Reid when he announced an intention to
make the NHS ‘a health service, not a sickness service’.
The scale and scope of the Choosing Health
consultations were ambitious by any standard. The
2
Lynne Friedli
Editor
To continue reading
Request your trial