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Abstract
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Attributed to the Dutch humanist scholar, Desiderius Erasmus, the concept of proactive awareness and preventative interventions being more effective than later remedial action has never been more relevant in mental health. Initiatives such as the WHO Mental Health Gap Action Programme were making progress in providing services but a gap persisted and the COVID-19 pandemic has increased the global burden of common mental disorders beyond the capacity of existing services. Fortunately, governments, policy makers, and the general public have recognised the importance of mental ill health, across the lifespan and in all groups within society. This recognition now has to be matched by action. Expenditure on mental health forms a small fraction of general health care budgets, for example 2ยท4% across the Americas in 2015. However, if mental health is to play Oliver Twist and ask for more, other areas of health might have to do with less. But what is good for mental health is also often good for physical health.
In the UK, the Royal College of Psychiatrists has the prevention of mental ill health as part of its core objective, and the President, Adrian James, led a session devoted to the topic at its International Congress in Edinburgh, UK, in June, 2022. The College has established a Public Mental Health Implementation Centre to support improved implementation of evidence-based public mental health interventions to sustainably reduce disease burden from mental disorders and promote population mental wellbeing and resilience. A key phrase here is improved implementation. For example, physical activity has health benefits for minds and bodies--individuals know this and policy makers know this. The challenge is to turn knowledge into action, which requires strategic planning. Offering vouchers for gym memberships will help some people, but for many people formal exercise is inaccessible for various reasons. By contrast, walking is available to almost everyone: what is needed is somewhere safe, and preferably pleasant, to walk. More importantly, walking needs to be integrated into activities of daily living so that individuals do not consciously have to allocate time to exercise. Towns and cities need to be designed to facilitate walking, and cycling, with local shops and amenities and good public transport services. Governments should consider structural interventions to promote good health, such as no-smoking policies (where New Zealand has taken the boldest step), minimum ages and unit pricing for alcohol, taxes on high salt, sugar, or fat content in foods and drinks, restrictions on advertising for unhealthy products, and clear, simple food labelling. Structural changes to alleviate the effects of poor socioeconomic determinants of health were outlined in the WHO World Mental Health Report. The Royal College is building key partnerships, for example with Action on Smoking and Health and the Obesity Health Alliance. We encourage psychiatric associations globally to consider similar partnerships in their own countries...
Language: en |