mental health

Bringing together physical and mental health
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Priority 1: Incorporating mental health into public health programmes
The problem
Poor mental health is a major risk factor implicated in the development of
cardiovascular disease, diabetes, chronic lung diseases and a range of other
conditions. It is also a major public health issue in its own right, accounting for
23 per cent of the burden of disease in the United Kingdom (UK) (World Health
Organization 2004). There is increasing evidence that at least part of this burden is
preventable (Knapp et al 2011). Despite this, prevention of mental health problems
and promotion of positive mental wellbeing often receives limited attention in
health improvement work, and is not well integrated with action on other priority
public health issues such as tobacco, alcohol or obesity. Mental health prevention
and promotion activities account for less than 0.03 per cent of NHS spending on
mental health (Mental Health Strategies 2012), and the majority of joint strategic
needs assessments (JSNAs) have little or no coverage of mental health and wellbeing
(Campion, forthcoming).
Impact on people
Poor mental health is associated with higher rates of smoking, alcohol and drug
abuse, lower educational outcomes, poorer employment prospects, lower resilience,
decreased social participation and weaker social relationships – all of which leave
people at increased risk of developing a range of physical health problems (Health
and Social Care Information Centre 2012; Keyes et al 2010; Foresight 2008). For most
people, mental health problems begin in childhood or adolescence (Jones 2013).
This can have lifelong effects, and is a major route through which health and social
inequalities are transmitted across generations (NICE 2013; Colman et al 2009).
Impact on the health system
Poor mental health is associated with greater resource use within the health system
and adds to the burden created by smoking, alcohol and other behavioural risk
factors (Joint Commissioning Panel for Mental Health 2013e). The wider impact of
mental health on public services and the economy is significant; the Organisation
for Economic Co-operation and Development (OECD) estimates that mental health
The case for change: 10 areas where integration is needed most 22