Yesterday there was a warm welcome for the launch of ‘Closing the Gap: Priorities for essential change in mental health’. launched by MPs Norman Lamb and DPM Nick Clegg, giving them both welcome respite from political party traumas. It identifies 25 aspects of mental health care and support where government – along with health and social care leaders, academics and a range of representative organisations – expect to see tangible changes in the next couple of years: changes that will directly affect millions of lives for the better.
However we have another suggestion to help make these ideas happen. When you look through the list of 21 National Clinical Directors (NCD), one thing really strikes you: there is one NCD for mental health; 20 for physical health. If we are serious about parity of esteem, then we need to signal that from the top. Mental illness is not homogenous: PTSD is not the same as post-natal depression, is not the same as clinical depression, is not the same as schizophrenia is not the same as bipolar disease etc. Just because it doesn’t usually require surgery, and just because much treatment isn’t medical either, it doesn’t mean that we shouldn’t take a focused approach.
Whilst the political direction of travel is ‘whole person care’ (and of course care should be holistic), as health guru Michael Porter says, a high value health system still needs “teams focused on specific conditions or population types”. The logical next step for mental health is to have NCDs appointed to represent the main areas of mental illness. We may not need another 19, but parity of esteem will not happen while we have only one (excellent though she is!)