Major Conditions strategy framework – MQ’s Response

Is Mental Health still the Cinderella of the Story?

Opinion by Lea Milligan, CEO of MQ Mental Health Research 

In a move that raises questions about transparency and accountability, the government has chosen to release its much-anticipated Major conditions strategy framework in the depths of the summer parliamentary recess.

This strategic timing, when parliamentary scrutiny is significantly reduced, casts doubt on the government’s commitment to addressing the pressing mental health crisis that our society faces.

For context, the mental health sector had been waiting for the government to release the much anticipated 10-year mental health strategy for a long time. This would have been the first focused strategy on mental health from the government in over 12 years, the last being ‘No health without mental health’ published in 2011 by the coalition government of the time.

However, the sector was shocked when, in January of this year, it was announced by Health Secretary Steve Barclay that this much needed strategy was to be scrapped, and would be replaced at some point in the future by a new ‘major conditions strategy’.

Whilst a holistic approach to reducing mortality is laudable, the fact remains that years of under-funding for mental health means it lags far behind the other physical conditions listed in the proposed major conditions strategy, with no apparent recognition from the government that this will need levelling up.

This lack of appreciation from the government of the unique requirements for mental health services, separate to the physical health conditions listed, brings me back to the timing of this new framework, published this week.

At a time when mental health issues are on the rise, affecting individuals across all walks of life, it is crucial that policy decisions are made with the utmost seriousness and transparency.

Mental health is not a matter that can afford to be discussed behind closed doors or rushed through without thorough examination, especially when it is the last on a list of conditions that already sit light years ahead in terms of funding, research and services.

Mental health care should not be subject to political manoeuvring or expedient timing. It is a matter that directly impacts the well-being and lives of millions, and any policies introduced should reflect a commitment to comprehensive, evidence-based solutions.

Across this new framework, one thing stands out above all else – an undue emphasis on individual responsibility and the underestimation of the systemic challenges that contribute to mental health struggles.

While certain aspects of the plan are commendable, the narrative leans heavily on a rhetoric of personal accountability. Such a narrative, while intending to promote public health awareness and participation, risks undermining the complexity of mental health issues and the urgent need for a holistic, systemic approach.

The frequent focus on “bearing down” on personal factors as a solution, risks oversimplifying the complex web of factors that contribute to mental health conditions. Mental health issues often stem from a combination of genetic predispositions, environmental triggers, and socio-economic disparities. Placing the heavy onus on individuals (and employers, who seem to get a free ride on the physical health front!) to prevent or manage mental health challenges disregards the structural barriers that many face, including unequal access to education, healthcare, and employment opportunities.

A recurring implication of individual responsibility is that those with severe mental illnesses could have taken more preventative measures. However, this narrative neglects the fact that mental illnesses like psychosis are often caused by intricate neurobiological factors beyond an individual’s control. Blaming individuals for conditions rooted in biology perpetuates stigma and creates barriers to seeking professional help, which is vital for managing these conditions.

While involving employers in supporting mental health among their workforce is important, solely relying on them to address mental health challenges overlooks broader societal factors. Placing the responsibility on employers disregards the government’s role in creating policies that ensure safe working conditions, equitable wages, and access to mental health resources for all citizens. The government’s duty extends beyond placing this burden solely on employers.

The narrative of individual responsibility can deter people from seeking help when they need it most. Those struggling with mental health issues might feel that they should have been able to prevent their condition, which can lead to self-blame and isolation. This further exacerbates the societal stigma surrounding mental health, making it harder for individuals to access the support and treatment they need.