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 entrepreneur, writer, campaigner and commentator. She is based in London and is the founder and Chief Executive of 2020health, an independent, social enterprise Think Tank whose aim is to Make Health Personal. Through networking, technology, research, relationships and campaigning 2020health has influenced opinion and action in fields as diverse as bioethics, alcohol, emerging technologies, fraud, education, consumer technology and vaccination. Julia studied visual science at City University and became a member of the College of Optometrists in 1991. Her career has included being a visiting lecturer at City University, a visiting clinician at the Royal Free Hospital, working with south London Primary Care Trusts and as a Director of the UK Institute of Optometry. She specialised in diabetes (University of Warwick Certificate in Diabetic Care) and founded Julia Manning Eyecare in 2004, a home and prison visiting practice for people with mental and physical disabilities using the latest digital technology, which she sold to Healthcall (now part of Specsavers) in 2009. Experiences of working in the NHS, contributing to policy development, raising two children in the inner-city and standing in the General Election in Bristol in 2005 led to Julia forming 2020health at the end of 2006. Julia is a regular guest on TV and radio shows such as BBC News, ITV’s Daybreak/ GMB, Channel 5 News, BBC 1′s The Big Questions, BBC Radio, LBC and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week. She is mum to a rugby-mad son, a daughter passionate about Shakespeare, and wife of a comprehensive school assistant head-teacher. She loves gardening, ballet, Zimbabwe, her Westies Skye and Angus, is an honorary research associate at UCL and a Fellow of the RSA.
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