Public health and its role in mental heath

We know that many of the public health risks that affect the population such as smoking, alcohol misuse and obesity disproportionately and negatively affect those with mental health disorders. This is particularly true of those with Severe Mental Illness.

The effects of poverty and inequalities on these three factors are most starkly demonstrated by the fact that those with Severe Mental Illness are likely to die on average 20 years earlier than the wider population.

This is totally unacceptable and if the promise of parity of esteem is ever to be achieved between physical and mental health, urgent and rapid action is needed to reduce and eventually eliminate this gap.

College activity on Public Mental Health

RCPsych has for a long period promoted the importance of public mental health and the contribution it can make to better health outcomes for those group of patients that our members seek to serve. All our efforts as psychiatrists focus on Treatment and Recovery / Inclusion / Citizenship for our patients. Public mental health is also about the third, neglected area – the Prevention of mental disorders.

A signal of this was its appointment of an Associate Registrar for Public Health (currently Peter Byrne). It has also developed a number of publications on this topic to both influence policy makers and support psychiatrists in understanding how best to offer public health interventions.

However, it has recognised the best opportunities for securing the progress that needs to happen is through collaborative working with organisations at an individual level and as part of alliances. Action on Smoking and Health (ASH), the Alcohol Alliance (AHA) and Obesity Health Alliance (OHA) are excellent examples of this.

Current College Priorities on Public Health

The College is excited and proud in 2018 to be one of the early signatories to the Equally Well initiative. Supporting its influencing and informing function will be the College’s key priority on Public Mental Health for the forthcoming period.

Based on a similar scheme running in New Zealand, this major new initiative seeks to tackle one of the biggest health inequalities in society, the life expectancy of those with Severe Mental Illness compared to the rest of the population.

Equally Well UK is a new collaborative to bring together organisations with a part to play in reducing the 15-20 year life expectancy gap facing people with a severe mental illness in Britain today. Equally Well UK is already supported by major national bodies including NHS England, Health Education England, the Royal College of GPs, Public Health England, Mind, the National Survivor and User Network and NHS Improvement.

Organisations joining Equally Well UK will be asked to make a pledge for how they will do their part to reduce the health gap. The College has pledged that it will:

' Use all its influence and do all in its power to reduce the lost years for those with mental illness and to improve physical health outcomes for all those with mental ill health '

We are starting this collaboration in England and will work to make similar alliances in the other three home countries.

Further details can be found on the Equally Well website.

Useful Resources

No Health Without Mental Health: The Case for Action (PS04/2010)

The prescribing of varenicline and vaping (electronic cigarettes) to patients with severe mental illness (PS05/2018)

Physical Health in Psychiatric Patients

Pharmacy guidance smoking and mental health 2017 update

Primary Care Guidance on Smoking and Mental Disorders 2014 update

Oversight of Public Mental Health in the College

The Associate Registrar is supported in its role by a Public Mental Health Executive. This meets 2-3 times a year and considers what progress the College has made in its ambitions to improve the physical health of those with severe Mental Illness and also agrees how best it should contribute to this agenda in the future.

If you want any further details on this topic, please contact the Policy and standards Manager at the College in the first instance via:

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