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A New Horizon

The British government’s White Paper 'Healthy Lives, Healthy People’, published in 2010, was the first public health strategy to give equal weight to mental and physical health (1). Subsequently, ‘No Health Without Mental Health’, published in 2011, specified its aim to mainstream mental health in England, delivering parity of esteem for mental and physical health services (2). Furthermore, for the first time, in 2013, the Chief Medical Officer chose mental health as the subject of their annual report ‘Public Mental Health Priorities; Investing in the Evidence’ (3). These important policy documents set the scene for a growing conversation and shone a spotlight on the stark truth about the UK’s mental health in the 21st century.

We could no longer hide from the appalling reality that mental ill health represented a staggering 28% of the national disease burden and was the leading cause of sickness absence at work, costing the UK upwards of £105 billion a year, with treatment costs expected to increase by at least 50% over the next 20 years (4). The National Institute for Health and Care Excellence (NICE) also emphasised that common mental health disorders affected a significant proportion of the population (15%) at any one time with potentially long-lasting effects (5). Mental health had long been a Cinderella speciality within medicine, but such figures meant it could not be ignored anymore: policy and investment in the English NHS service needed to be aligned to address the ever-widening gap between physical and mental health.

Alongside increasing recognition and awareness from the government, the general public’s perception of mental ill health was also beginning to change. The depth of associated stigma remains a significant challenge, but the general public’s attitude towards psychological difficulties, especially young people, has noticeably improved as individuals recognise that many people they know are affected by poor mental health. High profile campaigns meant it was becoming easier to talk about mental health and its impact. Conversations online, on buses, in cafés and in homes were occurring, and important steps toward change followed as the NHS in England established the Mental Health Taskforce, which launched its ‘Five Year Forward View for Mental Health’ in February 2016 (6). The Taskforce will report in autumn 2017, setting out key recommendations to tackle mental and physical health inequalities, including its specified priorities for a seven-day crisis response, part of the seven-day NHS service; integrated mental and physical healthcare approaches; promotion and prevention initiatives; and a focus on how research and innovation must drive this change.

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Professor Kathryn Abel is National Specialty Lead for Mental Health at the NIHR Clinical Research Network (CRN). She is Professor of Psychological Medicine and Director of the Centre for Women's Mental Health at the University of Manchester, UK and an Honorar Consultant Psychiatrist at Greater Mancester Mental Health NHS Foundation Trust. Kathryn is an internationally acclaimed academic and the current holder of a prestigious European Research Council mid-career award and NIHR Senior Investigator award. Kathryn’s posts include Research Director, Senior Mentor, NICE Appraisal Committee member, Local Division 4 Lead for NIHR CRN and Royal College of Psychiatrists Academic Faculty member.
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Professor Kathryn Abel
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