mental health



Bringing together physical and mental health

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problems cost the UK around 4.5 per cent of gross domestic product (GDP) –

£80 billion – in 2015. Most of this is in the form of lost employment and reduced

productivity (OECD 2014). Within the NHS, the annual cost of staff absence and

reduced productivity as a result of poor mental health is estimated to be more than

£1 billion (Parsonage 2007).

What would a more integrated approach look like?

A more integrated approach to population health would tackle the determinants

of poor physical and mental health in a co-ordinated way, using ‘place-based’

approaches to combine resources from different sectors. Mental health and

wellbeing would form a core part of JSNAs, with health and wellbeing strategies

giving particular priority to interventions capable of improving mental and physical

health together. These might include: promotion of outdoor physical activity

(Institute of Health Equity 2014; Rosenbaum et al 2014); prevention of hazardous

alcohol use; and interventions that enhance social interaction, facilitate social

cohesion and combat isolation (Economic and Social Research Council 2013; Jenkinson

et al 2013).

Childhood health would be a particular priority, with a focus on intervening early

to prevent the development of more significant problems later in life. This would

include investment in evidence-based parenting interventions (Hutchings et al

2007), nurse–family partnerships or Sure Start (Melhuish et al 2008; Olds et al

2007), and schools-based programmes to promote social and emotional learning

(Durlak et al 2011; NICE 2009b). Targeted public mental health initiatives would be

developed for population groups at greatest risk, such as black and minority ethnic

groups (Kirkbride et al 2012). Strengthening the evidence base on public mental

health would be a high priority (Davies 2014).

Further guidance


Guidance for commissioning public mental health services (Joint Commissioning

Panel for Mental Health 2013e)

• • Annual report of the Chief Medical Officer 2013. Public mental health priorities:

investing in the evidence (Davies 2014)

The case for change: 10 areas where integration is needed most 23

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