Mental health strategy prioritises offenders and recognises multiple needs

The mental health strategy No health without mental health launched today recognises that distinct approaches to mental health treatment are needed for “adults with complex multiple needs”. It promises to address the unequal access to mental health services experienced by groups such as homeless people, people with personality disorder and offenders.

A key area for action is “to ensure equity of access for all groups, including the most disadvantaged and excluded (for example people who are sleeping rough) to high-quality, appropriate, comprehensive services”.

The strategy identifies mental health as a priority across government, and promises that “the Cabinet Committee on Social Justice will also help to ensure that there is effective cross-government action to address many of the social causes of mental health problems. “Critical priority areas” for cross-government work on mental health include talking therapies, reducing drug misuse, homelessness and the mental health of offenders.

The strategy recognises that people using drug and alcohol services and homeless people are particularly likely to experience multiple problems and highlights the need for joint-working in these areas.

The cross-government project to turn around the lives of families experiencing multiple problems such as mental health, substance misuse or involvement in offending is also highlighted in the document.

There is a strong focus on preventing poor mental health and improving mental health support for children and young people. There is also recognition of the need to pay particular attention to young people’s mental health as they make the transition to adulthood, and move from children’s to adult mental health services.

The theme of greater choice and control outlined in the health white paper is continued in the mental health strategy, where it is recognised as being “just as important for ex-offenders, drug users and other socially excluded groups".

There are close links with the Ministry of Justice green paper Breaking the Cycle. Recommendations from Lord Bradley’s report on the mental health of offenders are endorsed, particularly the need for offenders to have equal access to health care as those in the community, and to the rolling out of liaison and diversion services. Furthermore, the strategy announces that the Department of Health will support the “development of mainstream service capacity to treat those referred by diversion services.”

Within the context of the proposed restructure of the health service, the strategy outlines plans to work with professional bodies to support GP consortia to commission “effective mental health services that are accessible to all, including the most disadvantaged and excluded”.

The role of local Health Watch, the “independent voice for patients, service users and carers of all ages throughout the commissioning cycle” includes providing “advocacy services on behalf of service users, including those seldom heard, such as offenders”.

Health and wellbeing boards will have a crucial role in ensuring that the needs of all, including disadvantaged or excluded groups, are met in the local area.

The strategy proposes that the policy of “any willing provider” where patients and service users can choose which provider to receive support from on the basis of quality is “of particular relevance in the area of mental health, where the needs of individuals are very diverse and where different and innovative approaches may be necessary for ensuring that even the most excluded can be helped to get the care and support they need”.

There are also links with the Big Society agenda. A role for the voluntary and community sector is identified in working with the most excluded, promoting and facilitating user involvement, and involving communities.

The strategy picks up many of the messages that we included in our response to the Liberating the NHS health white paper in autumn 2010 and to the earlier New Horizons consultation.