Editorial
| Pages | 2-6 |
| Date | 01 March 2004 |
| DOI | https://doi.org/10.1108/17465729200400001 |
| Published date | 01 March 2004 |
| Author | Lynne Friedli |
| Subject Matter | Health & social care |
journal of mental health promotion •volume 3•issue 1 •march 2004 © Pavilion Publishing (Brighton) Ltd
Editorial
As the year 2004 gets well underway, it may be timely
to reflect on where mental health promotion has got to
in the UK, after the euphoria and optimism that
accompanied the launch of a range of favourable policy
documents in the late 90s. It is also worth considering
the different approaches adopted by England, Scotland,
Wales and Northern Ireland, and to look at what might
be learned from more opportunities for discussion and
debate across the UK.
In England, it is hard to resist the conclusion that
mental health promotion is slipping down the agenda
(Ingold & Cameron, 2003). Responsibility for mental
health promotion lies with the National Institute for
Mental Health in England (NIMHE), but in practice
NIMHE has focused on social inclusion, both in
partnership with the Social Exclusion Unit (based in
the Cabinet Office) and through an extensive
programme of initiatives designed to tackle factors that
prevent people with mental health problems
participating, notably in employment and education, as
well as projects concerned with the improvement of
mental health services (www.nimhe.org.uk). England’s
national campaign, Mind Out for Mental Health, has
also focused on the experiences of those who use
mental health services, with a strong emphasis on
challenging stigma and discrimination, although their
workplace programme does address mental well-being
more broadly (www.mindout.net). Tackling social
exclusion and addressing legislative, institutional and
other forms of discrimination experienced by people
who use mental health services are important
priorities.1However public mental health (of which
mental health promotion is one element) provides a
strategic and analytical framework for addressing the
wider determinants of mental health, reducing the
enduring inequalities in the distribution of mental
distress and improving the mental health of the whole
population.
Notwithstanding standard one of the English
national service framework for mental health and the
requirement to promote mental health for all, local
mental health promotion strategies are very low on the
performance management agenda (Department of
Health, 2001). This means that delivery of mental
health promotion is dependent on local champions,
strong commitment at a senior level within PCTs and
an existing network of colleagues with the relevant
skills and expertise across all sectors. While there are
many examples of excellent local strategies, the absence
of national leadership reinforcing standard one as a
priority may make it increasingly difficult to secure
resources, particularly in the run up to a general
election. It also means that strategic opportunities to
make the case for public mental health are lost. Current
debates about diabetes, obesity and physical activity all
lack informed input from a mental health promotion
perspective.
To some extent, this is not just a result of NIMHE
and the English Department of Health’s priorities but
also a reflection of the absence of national stakeholders
with a clear remit for public mental health. Within the
voluntary sector only one charity, mentality
(www.mentality.org.uk), is specifically dedicated to
mental health promotion, although the Mental Health
Foundation (which also has a Scottish centre) is
increasingly engaging with broader debates about
mental well-being in the workplace, in schools and in
the wider community (www.mentalhealth.org.uk). A
further factor may be ongoing conceptual confusion
about what mental health promotion is and a tendency
to view standard one solely in terms of changing public
attitudes and reducing the stigma and discrimination
experienced by people with diagnosed mental health
problems. The challenge of finding a common
language and developing a shared understanding of the
scope of the mental health and well-being agenda has
been recognised by the Scottish Executive, which has
recently commissioned a briefing to clarify terms and
definitions for colleagues working in the field.
The growing importance of the regions in England
means that NIMHE’s eight regional development
centres (RDCs) may come to exert more influence than
the centre. Certainly some RDCs, notably the North
West, the West Midlands and London, have placed a
strong emphasis on mental health promotion and
support a wide range of initiatives and networks. In the
2
Lynne Friedli
Editor
1The recommendations of the Disability Rights Commission, which aim to ensure that the Disability Discrimination Act review adequately recognises the rights
of people with mental health problems, are a case in point (Disability Rights Commission, 2003).
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