A voice for Mental Health in London
London is a special place. One of the world’s great world’s cities and central to the economy of the UK, Europe and, in some respects, the world. It is also a city with its own very specific issues in relation to mental health.
At the end of February the 10 Mental Health Trusts in London came together to launch the Cavendish Square Group as a new voice for mental health in capital. In doing so we believe there much more we could do, collectively, to raise the profile of mental health as priority in London, advocate on behalf of people who need help and services and celebrate some of the important activities which, whether in the fields of research, clinical services or training and education, are based in the capital.
A city as large, diverse and pressured as London undoubtedly is, will always face specific challenges in relation to mental health. The risk factors for various forms of mental illness are higher than in other parts of the country. Research is clear, for instance, that rates of psychosis will be higher in urban areas, in areas large with BME communities which may be experiencing discrimination and poverty or where risk factors such as the consumption of cannabis are particularly prevalent. London has all these features in spades and this is reflected in the level of demand experienced by London’s mental health services.
The issue of mental health has a wider relevance however for a city such as London. Mental health and emotional difficulties are crucial barriers to the successful development of the capital’s young people. Around 1 in 10 of young people in London , or something like 110,000 individuals, are thought to have a clinically significant mental health problem and the impact of childhood psychiatric disorders cost London’s education system around £200 million each year, in addition to the impact such issues have on the lives and lifetime prospects of the individuals concerned.
Mental health problems are also the biggest single reason for lost productivity in London’s labour force. This is something which good employers are becoming increasingly aware of and beginning to tackle but there is much still to do both in terms of providing effective support for people with mental health problems in the workplace and also in reducing the stigma which prevents employees from being willing to disclose problems in the first place.
Finally good mental health is fundamental to the physical health of the capital. The burdens on the city’s hospitals are significantly increased by the impact of co-morbid mental health issues, whether in terms of the 65,000 Londoners living with dementia or the even greater numbers suffering from depression or anxiety.
All of this makes a strong case for putting mental health and wellbeing at the very centre of the agenda for London’s decision makers, whether the Mayor, local authorities, major employers or health care commissioners and providers. Our view, however, is that, with some honourable exceptions, there is insufficient priority or interest given to the crucial importance of improving the capital’s mental health. That’s why as a group of mental health providers we believe we need to work together to champion this issue and help mental health in London have a bigger voice.
As a group, we have set out three ambitions. First to press for a reduction in the treatment gap for Londoners with mental health problems. Over 900,000 Londoners of working age are likely to experience depression or anxiety yet as many as three quarters of those individuals will fail to get any treatment at all. The equivalent figure for diabetes is 8%. Similar stories can be told for many other groups with mental health problems. Despite the rhetoric and some growing political commitment we have an enormous way still to go to deliver anything approximating to parity of esteem between physical and mental health.
Our second ambition is to help make London the most mental health friendly workplace in the world. Many London employers, including those such as Legal and General operating in the pressured environment of the City, are already recognising this and taking positive initiatives to support employees with mental health problems. Such employers see mental health friendly policies as offering a competitive advantage in the labour market and many others would benefit by following their example. There is a role for the Mayor to champion this issue on behalf of London and to work with us and other organisations in London to promote good practice across employers including the public sector and small and medium sized employers.
Our third ambition relates to support the mental health and wellbeing of young people. 50% of adult mental health problems present before the age of 14 and childhood difficulties. There are many good examples of services children and young peoples’ services in London but there is more to be done to ensure consistency of outcomes across the capital and to ensure a completely integrated approach between the NHS, social services and education. There is no better investment in the future health and wellbeing of Londoners.
Our final in setting up the group is to stress the opportunity to build on what is already good in London’s mental health provision. There are gaps to address but the story of London’s mental health is not solely one of deficits. London already has many outstanding and innovative services and is one of the leading centres for research and education on mental health with organisations such as my own and others which are recognised across the world.
At times mental health has seen itself as Cinderella, the poor relation never invited to the party. The Cavendish Square Group believes that those times need to change and that London has much to benefit from putting mental health and wellbeing at the centre of its agenda. Furthermore if the time to come to the ball has come, a decent frock would also help.