DHSC 10-year mental health and wellbeing strategy - consultation response

In July 2022 we responded to the Department of Health and Social Care’s call for evidence to inform a new 10-year Mental Health and Wellbeing Strategy for England.

The page has a summary, with the full response available to download.

You can find the Department of Health and Social Care’s call for evidence on the GOV.UK website. 

The DHSC’s strategy will cover six themes relating to mental health and wellbeing:

  • Promoting positive wellbeing 
  • Preventing the onset of mental ill health 
  • Early intervention to support mental health 
  • Quality and effectiveness of treatment for mental health conditions
  • Supporting people with mental health conditions to live well
  • Improving crisis support

These themes touch on many aspects of paediatrics and child health, and we responded with evidence from members, from RCPCH &Us and by drawing on our public statements around the need to support children and young people’s mental health, including State of Child Health. These all emphasise the need to take a holistic and inclusive approach to strategies that promote good mental health and wellbeing and seek to support and treat mental ill health through multidisciplinary working and collaboration that ensures early intervention. 

In summary, in our view, a successful government strategy would be both broad and deep; broad so that mental health issues are considered wherever policy is developed, deep so that where specific needs arising from mental health issues are seen they can be tackled swiftly and appropriately.

In particular it should prioritise early intervention, integration and multidisciplinary working, and take a broad view on manage risks to mental health and well-being. 

1)    Early Intervention and support for mental ill health and mental health conditions

The strategy must address the delay that children and young people experience in securing help with their mental health and wellbeing. For example, we can see delays arising through lack of access to preventative schemes (the Mental Health Support Team programme is not available in all schools), and delays in assessment and support for emotional and behavioural difficulties (as seen in the NHSE sitrep data for community paediatrics published in April 2022). 

Half of adult mental health problems start before the age of 14 and 75% start before the age of 24. Improving children and young people’s mental health should be everyone’s responsibility, both individually and as a society, and this should be prioritised in the strategy.

Well-resourced and high quality specialist mental health services are part of the solution, but in our view it is essential that these are complemented by equal attention and support for contributions made by multidisciplinary teams of health and care professionals across the six themes encompassed by the strategy, together with an acknowledgement and plan for tackling the impact that wider determinants have on mental health.

Local Authorities should have the resources to invest in a preventative, multi-agency approach to mental health across all ages (incorporating education for children, young people and families, long term conditions, social determinants and health promotion). The approach should focus on early intervention, including minimising the need for admission and effective crisis services to ensure that children and young people can be effectively supported and their treatment managed in their communities as much as possible. 

2) More support for collaboration, integration and multidisciplinary working 

More widespread multidisciplinary and integrated working is essential to deliver a step change in how mental ill health and mental health conditions are prevented and treated. The Government’s strategy should support and enable delivery of multidisciplinary services early in care pathways, and bring together health, social care and education to support those in the early stages of mental ill health to get the help they need. It should also ensure that:

  • there is sufficient trained workforce available to deliver multidisciplinary care, including paediatric liaison services and paediatric crisis services. 
  • children and young people have timely access to a range of mental health and psychosocial services that are integrated with children’s health services and that all healthcare staff have sufficient competences to support the psychological needs of children and recognise when involvement of mental health services is required.
  • joint commissioning arrangements that allow cooperation and collaboration between health, social care, education and the VCSE sectors are supported to endure.

3) The strategy should consider impact on mental health and wellbeing in wider policy development, particularly around programmes to address health inequalities and social determinants of health.  

We would like to see the strategy uphold and embed the understanding that managing the risks associated with mental ill health demands action across health services, public health, social care, education and wider society.  This includes taking action to address health disparities and inequalities. The influence of poverty on children’s health and wellbeing is undeniable. Children living in poverty are more likely to have poorer health outcomes including low birth weight, poor physical health, and mental health problems. The health impacts of growing up in poverty are significant and follow children across their life. The current cost of living crisis will only exacerbate this by pushing more families into poverty. It is essential that health inequalities driven by poverty are addressed to improve child mental health outcomes, as well as reduce costs to the NHS in the long term.

We respond to a wide range of consultations to ensure that the College’s position, and ultimately children’s health, is represented. Members can get involved in current consultations by contacting the Health Policy team: health.policy@rcpch.ac.uk.