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The Royal College of Psychiatrists Improving the lives of people with mental illness

Food for thought

Wednesday, 29 February

On Wednesday night I attended, along with other Royal College Presidents, a very interesting dinner with Sir David Nicholson and Sir Bruce Keogh, on the role the Royal Colleges could play in taking forward commissioning and the delivery of quality service. It was held under Chatham House rules, but gave me great food for thought which I’ll reflect back in future blogs.

What did give me considerable food for thought was the article published online yesterday evening: Why does mental health not get the attention it deserves? An application of the Shiffman and Smith framework, by Mark Tomlinson and Crick Lund. Mark works at the Centre for Public Mental Health in Stellenbosch University, South Africa, and Crick works in the Centre for Public Mental Health, Department of Psychiatry and Mental Health at the University of Cape Town. What they recommend in terms of increasing attention to global mental health would equally apply to increasing attention to mental health in the UK. So for those of you that don’t want to look at the whole article, their recommendations to increasing attention to global (UK) mental health are:

1)  Greater community cohesion and international government structures need to be developed to contribute to a more unified voice regarding global mental health.

2)  A common framework of integrated innovation is needed to ensure that global mental health speaks in the language of national and international policy makers.

3)  For global mental health to gain significant attention, a coherent evidence base for scalable interventions that can be shown to have an impact at the structural level – on economic development and human well-being – is central.

4)  A social justice and human rights approach is important.

5)  Current innovative strategies for addressing stigma need to be evaluated and expanded.

I would really like to get a debate and dialogue going on this. I am going to a medical conference in South Africa in April, and hope to bring back ideas on how to harness all the work that is being done under the umbrella of the International Advisory Committee to enrich the global mental health agenda.

We have been in discussions with the Royal Society of Medicine, about organising a conference in spring 2013 that focuses on global mental health. I hope this would be an exciting and challenging conference, that is not afraid to ask some difficult questions and take us out of our comfort zone with regard to this topic. I’m excited by the proposal, because I’m sure it would be a very popular conference, and will keep you posted on developments.

Another paper that came to my attention yesterday was one published in the Lancet, and covered by a number of media outlets including BBC News. The headline reported was that people with mental illness are four times more likely to be a victim of violence. The research team from John Moores University in Liverpool and the World Health Organisation in Geneva found that, in general, people with any sort of disability were at greater risk of violence, with 3% experiencing violence in the previous 12 months. However, those with learning difficulties were more vulnerable, with more than 6% reporting violence against them, and adults with mental illnesses were even more so. The study found that more than 24% said they had been the victim of some form of violence in the preceding year. Professor Mark Bellis, who led the study, said the results suggested a wider problem. He said: "Lifetime exposure to violence, and the proportions of individuals with disability who are directly threatened with violence or otherwise live in fear of becoming a victim, are likely to be substantially higher than our estimate."



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