Unequal risks of mental ill health need closing

The Commission for Equality in Mental Health has stressed that the government should take concerted action to address the unequal risk of mental ill health in the UK.

Chaired by Liz Sayce, the Commission for Equality in Mental Health is carrying out a two-year investigation, exploring why some groups of people have a much higher risk of mental ill health than others and what can be done to reduce the disparities.

Its first major briefing paper claims that mental health inequalities are closely linked to wider injustices in society. Inequalities in wealth, power and voice are linked to poorer mental health. Exclusion, discrimination, violence and insecurity all increase our risk of poor mental health and explain why some groups of people face markedly higher rates of mental ill health than others.

The briefing explores actions that can be taken, from communities and local services to national policies, to reduce mental health inequalities. They include action to reduce income inequality, housing insecurity and poor working conditions as well as changes to education and the provision of early years support to families.

Sayce said: “Anyone can have a mental health problem, and many of us will during our lives. But our risk of mental ill health is anything but equal. Children from the lowest income families are four times as likely as the wealthiest to have poor mental health by the time they leave primary school. Disabled people and people with physical health problems have far higher rates of mental ill health, not least because they disproportionately experience poverty, isolation and disconnection from their communities.

“The causes of mental health inequalities are complex. Women face higher risks of mental ill health for many reasons, including the far higher risk of experiencing abuse and violence at home. For LGBT+ communities, discrimination and bullying are major factors in the much higher rate of psychological distress. And for Black, Asian and minority ethnic communities in the UK, racism and oppression are at the heart of the high levels of distress that affect many. #“For too long we have accepted that inequalities in mental health are inevitable. They are not. We can take action at every level, from local communities to national policies, to reduce mental health inequalities. Our first briefing paper looks at what we can do to make a difference. Ideas shared with the Commission include action to reduce child poverty and homelessness, inclusive education as part of a ‘whole school approach’ to mental health, and the provision of early years interventions such as parenting programmes.

“The Commission will produce two further briefing papers on access to mental health support and on outcomes. In our final report later this year we will make recommendations for how to build a system designed for equality.”

Sarah Hughes, Centre for Mental Health chief executive, said: “The Commission’s first briefing paper demonstrates beyond doubt that inequality is toxic to our mental health. Deep and entrenched inequalities and stark injustices create profound and enduring risks that have and will continue to create highly vulnerable groups and communities for generations. We can start taking action now to turn this around, addressing inequality is the biggest yet most important challenge of our time.

“The government pledged in its election manifesto to take action to reduce health inequalities and to focus on preventing health problems. It is realising this promise that we believe will have the biggest and most positive impact on health. Government commitments to invest in schools, regenerate towns, level up opportunities and continue efforts to reduce poverty, including child poverty, could also make a critical difference to reducing inequalities in mental health. We very much see our role as helping move this agenda forward in ways that help achieve greater mental health equality. The Commission sets out some of the steps that will be necessary to fulfil that mandate, we know that by taking a cross-government approach to reducing inequalities we will prevent mental health difficulties which will inevitably contribute to a thriving society.”

Ian Hudspeth, chairman of the Local Government Association’s Community Wellbeing Board, said: “People’s mental health and well-being is affected by so much more than just the immediate health and care services available in their area. As this report identifies, someone’s risk of mental ill health can be increased due to their personal circumstances or the environment they find themselves in.

“Councils have a crucial role to play in issues affecting wider mental health, such as housing, skills, employment, transport and public spaces. If you live in good quality accommodation with convenient access to work, have the right skills to progress in life while being able to use your local leisure centre or public park, your chances of living a healthy and fulfilling life are much improved. We want to work with the new government and the NHS to use councils’ unique position and expertise to support people via these essential public services, to improve the mental wellbeing of all of our communities.”