A focus on mental health is everywhere… Can we afford to avoid it in the world of diabetes?

It cannot have escaped your notice that mental health has been everywhere in the media over the last few months. Whether it was the publication of the NHS England’s taskforce report, The Five Year Forward View for Mental Health (NHS England, 2016) or the launch of Young Minds Matter by the Duchess of Cambridge (Bailey, 2016). It is clear from all of this recent media coverage how far reaching mental health problems are and how mental health has a significant impact on every aspect of a person’s life.

As we motor towards spring and look towards the plans and developments in diabetes for 2016, we have to recognise yet again that we can only do that if we look to the person with a holistic view, rather than focusing just on the diabetes.

In the 6 years since I have worked in mental health, public attitudes towards mental health have improved, in part due to the Time to Change campaign (www.time-to-change.org.uk). In turn, this increased awareness has heightened understanding of an urgent need to act on improving the experiences of people with mental health problems, both within and beyond the NHS. However, there is now a need to re-energise and improve mental healthcare across the NHS to meet increased demand and improve outcomes.

The Five Year Forward View for Mental Health
This exciting new report, although 82 pages long, is a very clear and informative report on the plans for mental health until 2020. The direction is clear, stating that people with mental health difficulties need us to have a greater focus and should have their physical health (including diabetes) treated equally, preventing long-term health problems. People with mental health difficulties have also said that a decent place to live, a job and good quality relationships in their local communities were crucial in their ability to stay well.

It was good to see that this report also has the backing of the Secretary of State for Health, the Rt Hon Jeremy Hunt MP, and of the Prime Minister, the Rt Hon David Cameron MP, who said:

“For too long there hasn’t been enough focus on mental health care in this country meaning too many have had to suffer in silence. The Taskforce has set out how we can work towards putting mental and physical healthcare on an equal footing and I am committed to making sure that happens. This means that if you are struggling with a mental health condition you will get the help and support you need.” (Prime Minister’s Office, 2016)

Mental health is certainly on the radar now, but I am not 100% sure that practitioners who work in other fields (like diabetes) feel they have the expertise, skills or time to devote to people with mental health difficulties.

There remain serious unanswered questions about how these services can be delivered when the number of mental health nurses is still declining, with almost 5000 posts being lost since 2010 (Campbell, 2016). These nurses are the quiet heroes of mental health services, helping people in crisis and keeping people as well as possible. The Royal College of Nursing has said:

“While more training places are being created, there remains a large gap between the level of demand and the number of staff available. An increase of 100 places a year will never catch up with years of under investment. Our research has shown how bad the shortage is and the effects on patients if treatment is delayed until, or beyond, crisis point. Without a marked increase in the staff and resources available, then the reality of mental health care is simply not going to be matched by the rhetoric.” (Royal College of Nursing, 2016)

It is clear to me that all healthcare professionals need to effectively work together to have this vision or the notion of “parity of esteem”. To make parity of esteem between mental and physical health a reality we have a long way to go in supporting healthcare professionals to signpost people to appropriate treatments, instead of brushing mental health issues under the carpet. We must continue to lose the “revolving door” of NHS provisions and support all to provide excellent and holistic care.

We are very fortunate to have some wonderful articles in the month’s mental health section, including a commentary from Jacqueline Fosbury and Clare Shaban on a research paper that looked at depression in diabetes and the problem of over-diagnosis. The article, written by Emma Shuttlewood and Jen Nash, discusses a solution-focused approach to diabetes distress.

Expanding our knowledge of the mental health issues associated with diabetes will help us to deliver a more multidisciplinary approach and help us focus moving forward into this next year.