With the nine-year war of attrition over the Mental Health Bill all but over, the mental health sector has a chance to look to the future with fresh eyes.
There are still major discussions to be had about the bill’s code of practice, on which the government intends to consult in the autumn. And campaigners will be keeping a close eye on the bill’s implementation, expected in October 2008.
But mental health organisations should now have the luxury of looking further into the future and will hope to steer the public agenda away from the more negative discussions on dangerousness often provoked by the bill.
The debate has had positive spin-offs, however most notably the formation of the Mental Health Alliance, the 77-member coalition of charities, service users and professional bodies to campaign for better legislation. The alliance has brought unprecedented unity to the mental health world. Rethink head of public affairs Paul Corry says: “In the past nine years the mental health world has really grown up, matured and got a sense of its own identity.”
Corry believes it is unlikely that the alliance will continue in its current form in the long term but suggests “loose coalitions” may form to campaign for specific issues. This view is shared by Mind chief executive Paul Farmer who warns that the sector must look at the particular issue and then decide the best way to address it: “The lessons of many campaigning groups tend to be that it’s not always easy to translate a whole lobby of organisations from one issue to another.”
One area which has already brought together a smaller alliance of campaign groups is talking therapies. The We Need to Talk campaign, which brings together five mental health charities, was launched in October last year, with the aim of making talking therapies available on the NHS to all who need them.
The Mental Health Foundation’s head of policy, Moira Fraser, says the system’s capacity to deliver therapy needs to be built up and a range of choices must be made available, not just cognitive behavioural therapy, the focus of the government’s talking therapy pilot projects. The government launched the pilots in two areas last year and in May invited primary care trusts to tender for a further 10 pathfinders.
Fraser adds: “We’ve had some fine words but we want to see some real commitment to roll out across the country rather than isolated sites.”
Fraser also believes mental health policy needs to look beyond the concept of treatment to address the well-being of all. She suggests policies need to start to “look at everyone’s emotional and psychological needs rather than pigeon-hole people as having mental health needs.”
For those who do need treatment in a hospital, improving the condition of in-patient wards is likely to continue to be an important issue, suggests Farmer, as well as the poor take-up of direct payments by people with mental health problems.
But the biggest campaigning issue for the future may well be tackling stigma. A Department of Health report published earlier this month found prejudice against people with mental health problems has grown over the past 13 years and suggests a concerted anti-stigma programme is much needed.
The government spends £1m a year on its Shift anti-stigma programme, while yesterday’s announcement of a £16m campaign run by four charities and funded by the Lottery to tackle the problem should provide a much needed boost.
Perhaps such a coalition would be a fitting legacy for the nine years of solidarity forged by the battle of the bill.
The new agenda
Possible issues for the post-Mental Health Bill agenda include:
● Improved access to talking therapies
● Better in-patient care
● Race equality in mental health
● Direct payments
● Tackling stigma
● The well-being agenda
● Service-user control