The ten-year national service framework for mental health, which has stood as the government’s guiding light for standards in mental health since 1999, expires next year. Ministers are deciding what should replace it, and a coalition of seven leading mental health organisations have published a discussion paper outlining their vision for future services.

 Experts from those organisations say the future direction of policy should be towards:

• Self-determination, shifting the balance of power towards individuals, families and communities
• Mental health promotion, aimed at improving the mental well-being of the whole population
• Prevention and early intervention
• And away from a solely medical model of care

The paper is supposed to kick-start a debate about the future of mental health and the coalition is urging professionals to send in their views as part of a consultation this summer.

What do you think the future priorities should be? Should we move towards a more preventive and promotion-based approach, and attempt to improve the mental health of the whole population? Or should the emphasis be on clinical treatments? Have community orders proved too punitive?

Would be interested to hear your views. Cheers

Interestingly the government has just trumpeted the success of some of the key measures in the national service framework with big increases in the number of people using crisis resolution, early intervention and assertive outreach teams. (Though I guess these kind of "output" figures don't really tell you anything about "outcomes" - to use a word that's now banned (probably rightly) by the Local Government Association).

However, at the same time the Mental Health Foundation has pointed out that spending on mental health promotion has fallen dramatically over the last few years, and that spending on prevention and promotion is 0.1% of total spending on mental health for adults.

On paper, this suggests that the treatment model is still massively dominant. However, I think given how the culture of public services and care services in particular has changed over the last 10 years - with the increasing emphasis on choice, integration across agencies, prevention etc - any replacement to the NSF will have to be along the lines suggested by the seven organisations.

You can see the government wanting to place a big emphasis on getting people into work which remains as controversial an area as ever.