Closing the Gap: great ideas for mental health need backing with power

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!)


About Julia Manning

Julia Manning is a social pioneer, writer, campaigner and commentator. Formerly a clinical optometrist specialising in diabetes and visual impairment, she is the founder and Director of 2020health, an independent, social enterprise Think Tank whose aim is to Make Health Personal and Social. 2020health has through research, events and campaigning influenced opinion and action in fields as diverse as bioethics, alcohol, emerging technologies, fraud, education, consumer technology and vaccination. In 2014, 2020health were founding partners of the Health Tech and You Awards with Axa PPP and the Design Museum. Since 2016, 2020health has increasingly focused on digital health and public health in the community. Julia is a Fellow of the RSA and now also a part-time PhD student at the UCL Interaction Centre, studying the use of digital technology for stress management in the workplace. Julia has shared 2020health's research widely in the media (BBC News, ITV, Channel 5 News, BBC 1′s The Big Questions & Victoria Derbyshire, BBC Radio 4 Today, PM and Woman's Hour, LBC) and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week.
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