Progressing the shift to prevention

Trust leaders have stressed the importance of the sector being supported to develop and focus on implementing preventative solutions to reduce the demand for mental health urgent and emergency care services over the longer term.  

There is potential for more integrated and preventative models of care to better address the holistic needs of patients and to enable earlier intervention. However, we need to be clear on the ambitions here. For example, what is the mental health sector’s neighbourhood offer and what does this mean for the general mental health and wellbeing of the population, and for people with severe mental illness, learning disability and autism? Should integrated physical and mental health services and pathways of care extend beyond liaison psychiatry services and integrated neighbourhood health teams, and there be a greater role played by primary care and integrated neighbourhood teams to effectively support more people with mental health needs?  

From there, we can develop clear expectations on delivery, how services need to evolve and what investment is required. We can also develop better accountability with the inclusion of key metrics, such as physical health checks for people with serious mental illness, in national oversight frameworks and mechanisms to support the delivery of the shift from treatment to prevention.   

Prevention of mental ill health also needs to look more widely than NHS services. Local authorities require more funding, and the associated accountability, to fulfil the vital role they have to play in delivering prevention activity and addressing the social determinants of mental health. Despite the moderate funding boost the government has given to public health recently, the public health grant still has not recovered to 2015 levels. The sustainable delivery of coordinated, evidence-based preventative programmes that deliver a positive return on investment over the long term – such as those focused on tackling bullying in schools, providing perinatal services and supporting parents – need to be prioritised. 

A renewed focus on mental health and a strategic and systemic cross-government approach to mental health policy and delivery over the next 10 years is needed, focused on tackling the social determinants of ill health and inequalities, and prioritising the needs of children and young people. Nearly all respondents (90%) to our 2024 survey said that the health and wellbeing of children is not considered enough in national policy, and only 33% were satisfied that local plans adequately prioritise these services. Our report based on those survey findings recommended the government and trusts work together to develop and implement a cross-departmental strategy for the health and wellbeing of children and young people to support national prioritisation and a focus on early years support and prevention.   

To enable the shift to prevention in mental health care, we need to:
  

Case study 

Camden Council has invested a significant amount of money into services to support children's mental health, which trust leaders have told us has significantly helped to stem growth in demand for specialist services and crisis presentations.  Waiting times for specialist children and adolescent mental health services in Camden have continued to be low compared with other boroughs in north central London, with 82% of children seen within four weeks. All state-maintained primary and secondary schools in Camden were offered partnership with mental health supports teams in 2023/24. There is also work underway to develop a centre for prevention in Camden.