Mental Health for all: Responding to the urgent need for systems designed for equality

The coronavirus pandemic is a physical health emergency on a global scale, such as we have never seen in our lifetimes. But it is also a mental health emergency. Both the coronavirus illness itself and the measures governments have had to take to contain it are placing enormous stress on people’s emotional health and wellbeing.

We have estimated that ten million people in the UK will require mental health support as a direct consequence of the pandemic. But the mental health impacts will not be felt evenly across society. We know that our chances of having good or bad mental health are unequal. Social and economic inequalities – poverty, racism, discrimination, and exclusion – create and perpetuate mental health inequalities. And just as some groups of people are more at risk from the virus, many of the same people will also feel the worst effects on their mental health.

In November 2020, Centre for Mental Health published the final report of the Commission for Equality in Mental Health, Mental health for all? The report concluded two years’ work exploring what causes mental health inequalities, why they have become so entrenched and what can be done to reverse them. Our report showed that mental health is made in communities, and so action to reduce inequality needs to begin at the local level, within communities, supported by local systems, services, and civil society. This is what we want to stimulate: to move from words to actions.

To build a system designed for equality. Across the country, groups of people are working to change this picture: to find new and innovative ways to meet people’s mental health needs and to create wellbeing in their own communities. But many of these approaches are isolated, often small scale and short term. As we recover from the significant impact of a pandemic on society, we have an opportunity to make mental health equality a real focus for ‘building back better’. But it will not happen unless we act now to change the systems that hold people and communities back.

We have developed an approach that will start the ball rolling in a small number of local areas where people are willing to work alongside us on a pilot programme to begin their journey to achieving mental health equality. We want to create a ‘proof of concept’ pilot, to find out whether the approach we have designed can take root in a community and spark the system change we know is needed. We have discussed this with community and system leaders in a number of local areas that are interested in being involved in fixing this problem. We want to build local coalitions to join together to establish the building blocks of a system designed for mental health equality.

We would work alongside each of the pilot areas to identify early actions they can take towards mental health equality and to agree some specific ambitions and goals for their local system. We would do this through a series of workshops and one-to-one discussions with stakeholders in each local area, supported by our research and evaluation team who will provide evidence about good practice, economic analysis, and critical appraisal of proposed actions. We would work to support each of the local areas to draw up a shared ‘mental health equality action plan’.

We would encourage the pilot areas to build a broad coalition including community organisations, experts by experience, civil society, business, and public services. We would also want to ensure that insights and learning from the pilot sites are shared widely and freely. To embed this, we would build alongside this targeted pilot our existing network of elected member champions for mental health and a new network of local mental health equality leaders, with whom we will share the results of the pilots as they emerge. We would publish a series of blogs, videos, and briefings during the pilot phase. We would plan to conclude the pilot programme with a brief report describing progress and exploring the potential for wider uptake. And with these we will make the case nationally for a system designed for equality, advocating for policies that support and enable local action and that reverse the inequalities that drive so much poor mental health. In the wake of a pandemic, the time has come to achieve ‘mental health for all’ by redesigning services that embed equality.




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