The second day of the 2016 Cumberland Lodge conference on mental health and well-being featured contributions from a wide range of leading mental health specialists from a variety of backgrounds including academia, clinical practice and public health. A number of salient points and themes emerged from the day’s discussion, some of which were highly positive. The most significant of these was growing acknowledgment from policy makers, health professionals and the public of the importance of mental health and its close relation with physical health. Traditionally disregarded as less dangerous than so called “killer diseases” such as cancer or diabetes, several presentations highlighted increased recognition of the drastic impact of poor mental health on both mortality and morbidity. A striking and oft repeated example of this was the statistic that individuals with serious mental health issues typically live 15-20 years less than individuals with good mental health. Perhaps surprisingly, the leading causes of early death amongst the mentally ill are cardio-pulmonary issues, not suicide as some might presume.
Multiple presenters also highlighted encouraging results from attempts to increase the use of traditional and emerging communication technologies in treating mental health issues. In one trial of providing triage services by telephone, for example, it was possible to triage around 40% of service users without them needing a face-to-face assessment. In addition to the obvious cost saving, providing services by phone is also far more convenient and potentially less stressful for service users. Smartphone apps have also been shown to provide an effective mechanism for individuals with mental health problems to self-manage their illness, empowering them to take greater control of their own care while also reducing the strain on stretched services.
Unfortunately, a range of substantial present and future challenges were also raised, including continuing stigma, uneven quality of service provision, a lack of high quality statistical data and shrinking budgets. Perhaps most striking, however, is the very large number of people with mental health issues who receive no diagnosis – estimated to represent around 75% of people with mental health issues in the UK. Of the 25% whose conditions are recognised, it is estimated that only around 25% actually receive treatment. As a concrete example of this, it is estimated that around 40,000 women require perinatal mental health treatment each year but only around 12,000 receive such treatment. A number of reasons were given for this enormous gap: continuing stigma around mental health issues, a shortage of staff in all areas of mental health treatment apart from clinical psychology and, most importantly of all, massive and chronic underfunding. The latter of these continues to represent a major barrier to providing people suffering from poor mental health with the treatment they need, yet the situation appears highly unlikely to improve in the short to medium term due to ongoing austerity and cuts to service provision.