Preventing mental illness: our manifesto for the 2024 UK General Election

We are faced with a public mental health emergency that is devastating the lives of thousands of people, while psychiatrists and mental health services are over-stretched and under-resourced amidst the ongoing impacts of the cost-of-living crisis, wars and displacements, the climate and ecological crisis, and the Covid-19 pandemic.

Simply put, significantly more people require mental healthcare in the UK than the number receiving it. We also know there are many people with mental illness who are not known to or accessing services at all, particularly in minoritised ethnic groups and underserved populations, with stigma and discrimination often acting as barriers.

People not accessing the mental health treatment they need exacerbates their ill-health, which only widens major health inequalities in the population. Those who are referred to mental health services are often faced with long delays in receiving care and too many are ending up in crisis, at the Emergency Department, at which point the system is not well set up to respond. Not only do these delays add to our patients’ distress, but they impact other parts of the health system and hurt the economy.

But many mental health conditions are avoidable and can be cured if treated early. Globally, an estimated one in five children aged between one and seven years has a mental health condition¹. We also know that half of mental illnesses in adults start before the age of 14 and three quarters before the age of 24². In fact, children from the poorest 20% of households in England are four times as likely to have serious mental health difficulties by the age of 11 than those from the wealthiest 20%³. Furthermore, 30% of children in Scotland live with a parent with a possible mental disorder⁴.

Pressures caused by increases in the cost of living are a threat to good mental health and must be addressed to prevent a stark increase in mental illness and severe mental illness as well as a further widening of inequalities. Of the more than 2.5 million adults currently out of work across the UK due to long-term sickness, 1.35 million are experiencing mental ill-health. Mental health conditions cost the UK economy an estimated £118 billion annually, equivalent to 5% of GDP. Preventing relapse and treating people early is key to keeping them in work and maintaining their relationships. And, even for those mental illnesses with strong genetic roots, high-quality treatment that is safe, timely and therapeutic can reduce the duration of episodes and minimise relapses, meaning that people are far more likely to achieve their potential.

The public mental health emergency is real. There is a clear need for cross-government prioritisation, with ministerial support, to prevent mental illness. We need investment in high-impact, evidence-based public mental health interventions to catch behaviours indicating a developing mental health condition at the earliest possible stage, preventing them from persisting and impacting people for the rest of their lives.

This is why we are calling on all political parties to prioritise the prevention of mental illness in their manifestos.

Dr Lade Smith CBE
President of the Royal College of Psychiatrists

References

1. Vasileva M, Graf RK, Reinelt T, Petermann, U and Petermann F (2021) Research review: A meta‐analysis of the international prevalence and comorbidity  of mental disorders in children between 1 and 7 years. Journal of Child Psychology and Psychiatry, 62(4): 372–81. 10.1111/jcpp.13261
2. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the  National Comorbidity Survey Replication. Arch Gen Psychiatry. 62(6): 593-602. 10.1001/archpsyc.62.6.593
3. NHS Digital, Mental Health of Children and Young People in England 2022 - wave 3 follow up to the 2017 survey, 29 November 2022
4. Scottish Government, Scottish Health Survey 2022 Main Report, Volume 1