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The government has pledged to address the needs of people with mental health problems, prisoners and older people in its white paper on public health published this week, writes Clare Jerrom.

The Department of Health also promised to strengthen services to improve sexual health and deliver better services to prevent and treat alcohol problems.

Health secretary John Reid said that having defeated many deadly infectious diseases, the government faced the challenge of avoidable ill-health caused by poor diet, a lack of exercise and smoking.

“These are challenges for all of us to address in our lifestyles – making our own choices about what to eat, how often to exercise and whether we smoke, drink too much, take drugs or engage in risky sexual activity,” he added.

Mental health

The report says that increasing social support, inclusion and participation helps to protect mental wellbeing. It stresses that tackling stigma associated with mental health is crucial to promoting this participation.

The DoH will work through the National Institute for Mental Health in England to ensure day services for people with severe mental health problems develop to provide support for employment, occupation and mainstream social contact beyond the mental health system.

This will include:-

• person centred provision that caters for the needs of individuals, including those with severe mental health problems
• providing befriending, advocacy or support to enable people to access local services (including childcare services)
• a focus on social exclusion and employment outcomes

“We will develop new approaches to helping people with mental illness manage their own care and make available information for them on all aspects of health, both mental and physical wellbeing,” the report says.

Health of prisoners

The report highlights that people in prison have poorer health than the rest of the population and the white paper suggests prisoners are given information about health services as well as support aimed at influencing their drug and alcohol and tobacco usage.

Older people

The right kind of support can markedly improve the ability of older people to take ownership of planning and follow through a healthy lifestyle. People with chronic diseases and disabilities are also able to manage their condition themselves with support from others. With help to develop their skills, they can take greater control of their own health and their lives.

The white paper pledges that by 2008, 3,000 community matrons will be introduced to take the lead to provide personalised care and health advice for patients with complex health problems.

Sexual health

The government also pledges to commit new capital and revenue funding to tackle the high rate of sexually transmitted infections in England.

The document promises to:-

• support modernisation of the NHS sexual health services
• communicate better with people about the risk
• offer more accessible services
• accelerate the implementation pf a national screening programme for chlamydia
• carry out an audit of contraceptive service provision in early 2005 and invest to meet gaps in local services

Alcohol

The DoH will build on the commitments in the Alcohol Harm Reduction Strategy for England through:-

• guidance and training to ensure health professionals are able to identify alcohol problems early
• piloting approaches to targeted screening in primary care and hospital settings
• similar initiatives in criminal justice settings in a bid to reduce re-offending
• developing a programme for improvement for alcohol treatment services

The report also highlights that the health needs of adults who access social care will be the subject of further consultation in the work for the proposed Green Paper on adult social care.

Choosing Health from www.dh.gov.uk