Opinion: Mental health – is prevention a potential solution?

Just as public health experts develop strategies to tackle binge drinking, smoking and obesity, do we need to develop a more comprehensive approach to preventing mental ill health? With youth depression, alone, having doubled in the last 20 years, maybe it’s time to look again at ways to prevent mental health problems from taking their toll at different stages in our lives. It’s complicated, but here are just some thoughts on what might help.

Infancy

Post-natal depression is, unfortunately, relatively common, affecting up to 15% of mothers after childbirth, and infants and children affected as a result of their mothers’ ill health can go on to suffer long-term emotional complications themselves, as currently being looked at by the APPG on Conception to Age 2, the First 1001 Days. Work needs to continue to limit the harmful effects of PND on young children.

The school years

It is well-known that bullying and discrimination at school can trigger serious mental health problems such as depression and anorexia. I have seen too many real-life examples of this to know that this is not just hearsay. We must have a zero-tolerance approach to bullying in school with strategies in place to ensure that teachers really listen to students and tackle the problem – and don’t just pay lip-service to doing so. As part of the national curriculum, we also need to take a more proactive approach towards helping children become more resilient. As the WHO says:

Enhancing social skills, problem-solving skills and self-confidence can help prevent mental health problems such as conduct disorders, anxiety, depression and eating disorders..

The Workplace

On LDV’s #timetotalk day, Maria Pretzler wrote about the need to promote good mental health at work. I cannot add anything to her very good article apart from mentioning bullying. Although, hard to quantify, it is estimated that workplace bullying is costing employers £2 billion a year.

Ideally, in every workplace there would be a designated person with the necessary training to whom a person could turn if they felt they were being bullied. In practice, with shrinking HR departments, or in small companies, this is not going to happen. Therefore, by law, ACAS’ guidance on bullying and the National Bullying Helpline number should be given to everyone starting a new job.

Relationships

We know children benefit when they are brought up in a stable home and, where there are two parents in a household, couples need to understand how the way they interact can seriously affect their children. During ante-natal classes, for example, the emphasis tends to be on the physical aspects of pregnancy and early child-rearing, but prospective parents should be told about the importance of conflict resolution should things go seriously wrong to avoid an unnecessary emotional burden on their children.

Older age and retirement

The life transition towards retirement and older age can be another time when depression and anxiety come to the fore again. Some employers, such as local authorities, offer advice for those retiring, but not all workplaces have the resources to do this. Maybe local Health and Wellbeing boards should run courses to help older people negotiate the work/retirement transition and develop strategies for dealing with the potentially greater isolation they may face.

This is not easy work – and I haven’t had time to consider the impact of economic policy on health – but we cannot give up trying to tackle what makes people experience deeply upsetting psychological problems at key stages in their lives. With mental health costing the economy in excess of £100 billion a year, and causing much individual suffering, more money and thought about prevention would probably be money very well spent.

* Until recently, Judy Abel was Head of Health Policy at Policy Connect.

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19 Comments

  • As my father told me there were some in the Armed Forces during WW2 who could not take it.I don’t think it was possible to predict easily which ones could and which ones couldn’t.
    In more recent years many of those who served in Afghanistan and Iraq have mental problems arising from what they went through.

  • Jayne Mansfield 11th Feb '15 - 5:09pm

    In answer to the first question posed, ‘ ..do we need to develop a more comprehensive approach to developing mental ill health?’, my answer is a resounding yes.

  • Jayne Mansfield 11th Feb '15 - 5:12pm

    Sorry the above should have read, preventing not developing ill health. Freudian slip!

  • Of course, there were many things I couldn’t touch on in a short article. The trauma of war for armed services personnel and the effects of bereavement on mental health cannot be ignored. I suppose this was just a starting point – to consider whether we could prevent some cases of mental ill health. There is so much more I could have covered: economic hardship through a more stringent benefits system; child neglect and much more. I particularly think we need to do more for young people. I was disheartened to read just today that 1 in 10 children are estimated to suffer from a ‘low level of wellbeing’ in this country (Children’s Society).

  • Eddie Sammon 11th Feb '15 - 5:22pm

    A good article and it is also good to see there will be lots of action on mental health at Spring Conference.

    The prevention thing is important and I think might be harder to solve. We all have to be careful how our actions affect others and we can’t just tackle mental health in an isolated bubble from other policy areas and campaigns.

    Regards

  • Absolutely Eddie. We have to look at the bigger picture when it comes to mental health.

  • How about not enabling idealogical Tory policies that have done more to worsen or create mental health problems?

  • I am glad the Liberal Democrats are concerned about mental health. Mental diseases are complex health disorders that are far from understood so to talk of prevention can lead to possible undesirable outcomes one of which is a GP denying there is anything really wrong with the patient if some kind of “prevention” has happened. My niece works on a mental health ward and one comment she sometimes makes of patients on her ward is, ” that person is not mentally ill”
    In a related question how can alcoholism be prevented?( I think there is a link between between drink and drugs and mental health issues.) Easy the people in question must become teetotallers. Now how can we stop them drinking?

  • Andrew Taylor 12th Feb '15 - 7:22am

    The National Bullying Helpline is closed due to an investigation by the Charity Commission and not a suitable organisation to be trusted on this issue. Whilst I agree prevention is the answer, that requires more education of employers and HR and less input from lawyers. Spotting the behaviour is not easy and even harder to overcome and the adversarial nature of the tribunals. A far better solution lies in true mediation with health expertise as part of the mix. This is from someone who has considered this problem for 15 years. In addition a culture of avoiding responsibility that is promoted by public bodies and departments. An institutional group think has created an atmosphere along with charging that makes going through a legal process effectively a life destroying event,

  • @Andrew Taylor
    Apologies for not checking the status if the National Bullying Helpline. I agree education of employers is important. That may work in larger organisations, but in smaller ones, unless someone has an understanding line manager or CEO, people can feel isolated if they have a sense of being bullied at work – it can be very subtle. That is why I suggested people may need an external organisation to turn to in these situations. It is interesting that yesterday the NHS announced that they would be introducing ‘whistleblower guardians’ to protect NHS staff who feel intimidated after reporting concerns about a health professional – a positive move. Maybe every local authority should have an anti-bullying officer to act in a similar capacity?

    @Manfaring
    Thanks for your comments. By prevention, I mean trying to look at the key stages in life when a child or adult is at particular risk of emotional difficulty and trying to have support mechanisms in place to avoid a problem escalating into depression or self-harm. I was thinking particularly about adolescence when patterns of thinking can be set for life. In a recent report by the think tank 2020health, it was suggested that schools should introduce a Head of Wellbeing role to help improve the mental and physical health of both pupils and staff – that was the sort of thing I was thinking about. Education in schools about the mental health risks of alcohol and drugs should also form part of the school curriculum – both can have a serious psychological impact on users.

  • Jayne Mansfield 12th Feb '15 - 9:06am

    @ Judy Abel,
    Judy, I would just like to bring to your attention that there is research demonstrating that men also suffer post natal depression. It is important that this is not overlooked, particularly by men themselves.

  • @ Jayne

    Absolutely. Thanks for mentioning that.

  • Andrew Taylor 12th Feb '15 - 10:11am

    @ Judy,

    I agree that an external view is required, however if that individual is part of the same organisation it is not able to be seen as impartial. The issue with someone bullied is fundamentally about ‘trust’ and ‘being heard’. I support however the wide use of employee assistance via third parties.

    I think that a separate body should undertake the ‘helpline’ issue with some funding. Since the Andrea Adams Trust was closed and Tim Field is no longer with us, the ability for targets to find a voice in the corridors of Westminster have been lost. I would also recommend talking to the actual survivors to better formulate policy.

    I would highly recommend two prime educational resources:-
    Bullyonline and Bully In Sight by Tim Field. This gives a glimpse of the horrendous nature of this awful behaviour.

  • I think, a lot of Mental health problems, plus a great deal of society’s problems, could be reduced massively by adding a new subject to schools curriculum.
    It should start, right from infant school. The lesson would include philosophy and empathy.
    Learning to think logically and feeling for others, can/does, stop a great many wrong, unhealthy and dangerous decisions throughout life.
    Whether it be ;committing criminal acts; taking actions that are “unhealthy”for oneself,or others; treating others badly plus all life’s events, have better outcomes if more realistic and logical thought is involved.

    “Desert Island Discs” recently had a philosopher as a guest and she said it is understood- even by five year olds.

    http://bigthink.com/experts-corner/lets-make-2015-the-year-of-living-empathically

    A recent analysis involving nearly 300,000 students, for instance, found that SEL (social and emotional learning) participants demonstrated significantly improved social and emotional skills, attitudes, behavior and academic performance that reflected an 11-percentile-point gain in test scores.(“The year of Living Empathically” JOAN COLE DUFFELL)

    Of course it is a long-term commitment, but I think it would improve society in general and of course save £billions for the NHS, Police force, Prison service and the benefits system ;as people become more responsible for their own actions.
    I think Nick should use half of his speech to “The Debate” going into detail on a theme like this- to show a clear difference from other parties; and a direction for all.
    The other parties seem to just want to educate/create workers!

    I think this may well give rise to more Lib/Dems!

    I would replace it with religion- but that is just me!

  • @Andrew and AC Trussell

    This was the kind of debate I hoped would get going after this article. I agree that the Lib Dems are well placed to develop policy in the area of developing social skills, empathy and cooperation in the classroom. I also agree it would produce savings further down the line – and quite simply make for happier people. We live in a fiercely competitive world and building self-esteem is also important so people don’t feel that success is just about status and earning money… although it goes without saying that we need equality of opportunity so everyone can fulfil their potential – which is of course Lib Dem policy!

    Thank you for adding these helpful perspectives.

  • @Andrew and AC Trussell

    This was the kind of debate I hoped would get going after this article. I agree that the Lib Dems are well placed to develop policy in the area of developing social skills, empathy and cooperation in the classroom. I also agree it would produce savings further down the line – and quite simply make for happier people. We live in a fiercely competitive world and building self-esteem is also important so people don’t feel that success is just about status and earning money… although it goes without saying that we need equality of opportunity so everyone can fulfil their potential – which is of course Lib Dem policy!

    Thank you for adding these helpful ideas.

  • Sorry, no idea how that came up twice!!

  • AC Trussell 12th Feb '15 - 1:02pm

    Judy Able – It came up twice- because it is very important! 🙂

  • Of course – I should have realised that was the reason!

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