Call for evidence outcome

Mental health and wellbeing plan: discussion paper and call for evidence - results

Updated 17 May 2023

Executive summary

In April 2022 the Department of Health and Social Care (DHSC) launched a call for evidence seeking the public’s views on what we can do to improve everybody’s mental health and wellbeing and prevent suicide. Upon publication of the call for evidence it was originally intended that responses would inform 2 individual plans:

• a mental health and wellbeing plan
• a separate suicide prevention strategy

While we will publish a new suicide prevention strategy for England, the decision has since been taken to incorporate tackling mental ill health into a major conditions strategy, as announced on 24 January. This will ensure that mental ill health is considered alongside other physical health conditions and that the interactions between them are reflected in any resulting commitments. All responses received via the mental health and wellbeing call for evidence are being considered to inform the development of these 2 strategies.

All references to a mental health plan as they appeared in the original call for evidence have been retained and presented in this document for clarity.

We would encourage commissioners, local authorities, the voluntary community and social enterprise (VCSE) sector and employers to review the themes that have emerged from this call for evidence and look to take action where they can.

We wanted to ensure that hearing from people with lived experience was at the heart of this call for evidence as well as the broader policy work surrounding it. In addition to the responses received via the online call for evidence, DHSC also received a significant number of responses from stakeholders who submitted papers via email and post. DHSC also commissioned Mind to undertake additional engagement with young people and adults who have lived experience of a mental health problem, with a particular focus on groups who are at higher risk of experiencing mental health problems and disparities, to ensure we heard their views directly. Many of the organisations who submitted responses did so following, and on behalf of, groups of people with lived experience.

DHSC also undertook engagement with a range of charities, academics, clinicians and individuals to explore emerging themes in more depth. This engagement will continue as work around both strategies progresses.

The results highlight priority areas for consideration as well as further research. It was encouraging to see that many respondents emphasised the relationship between physical and mental health, which will be an important consideration for the major conditions strategy. Access to services was another theme that came out of the call for evidence, and we remain committed to investing at least £2.3 billion of additional funding a year by the 2023 to 2024 financial year, to expand and transform mental health services in England so that an additional 2 million people will be able to get the mental health support they need.

Respondents also underlined the importance of education settings as well as early intervention. Significant progress has been made in the rollout of Mental Health Support Teams (MHSTs) to 4,700 schools and colleges and MHSTs will cover 3 million children and young people (35% of pupils and learners in further education) by April 2023. Building on measures that we have already taken forward through the NHS Long Term Plan, the themes identified through the call for evidence will inform both the major conditions strategy and the suicide prevention strategy, as well as ongoing policy work more broadly.

This document provides a summary of the main insights gathered across all channels. We would like to thank everybody who has contributed their views and thoughts throughout this process - each and every view is valued as part of the government’s ongoing work to improve mental health and prevent suicide.

Major conditions strategy

The major conditions strategy will address conditions that contribute most to morbidity and mortality across the population in England:

• cancers
• cardiovascular disease, including stroke and diabetes
• chronic respiratory diseases
• dementia
• mental ill health
• musculoskeletal conditions

Tackling health disparities will also be a key element of the major conditions strategy as health disparities across a wide variety of conditions, including mental health, contribute to a variation in life expectancy.

Increasing multimorbidity and complexity of conditions means it is important to ensure strategies are joined up, with care and support centred around people. A joined-up major conditions strategy instead of a stand-alone mental health strategy will enable us to work with colleagues across government to ensure that mental ill health is considered alongside other physical health conditions, meaning the interactions between them are reflected in the resulting plans.

Interventions set out in the strategy will aim to support the government’s objective to increase healthy life expectancy, alleviate pressure on the health system, as well as improve labour market participation where ill health is a barrier.

The government is today (17 May 2023) launching a new call for evidence to inform the major conditions strategy. This new call for evidence complements and will build upon the 2 calls for evidence on mental health and cancer. While this call for evidence therefore focuses on the other condition groups we are seeking to address in the strategy, as well as how to improve the outcomes for those living with multiple conditions, anyone who has responded to the mental health call for evidence and cancer call for evidence is welcome to provide further insights and suggestions if they wish. However, there is no obligation to do so as the insights previously gathered on mental health and cancer will be used in the development of the major conditions strategy.

DHSC intends to publish an interim report on the major conditions strategy in the summer of 2023.

Suicide prevention strategy

The new suicide prevention strategy for England will update the previous strategy published in 2012. The new strategy will reflect new evidence and national priorities for preventing suicides across England including actions to tackle known risk factors and targeted actions for groups of concern. The strategy will be collaborative, and importantly, cross-government in scope to fully reflect a range of preventative activity. While a national strategy, it will also seek to support the broader sector, and local areas, in shaping and embedding activity to prevent self-harm and suicide.

This call for evidence has been used to inform priorities and actions to capture within any refreshed strategy. We have also been engaging, and will continue to as the strategy develops, with experts across the sector, including NHS England, our national advisory group, VCSE partners, people with lived experience, clinicians, academics and local authorities to ensure the new strategy is based on up-to-date evidence and reflects existing and emerging issues and priorities.

The suicide prevention strategy will be published this year.

Methodology and demographics

In this section, we provide an overview of the ways in which individuals could respond to the online call for evidence, how we analysed the data and points to consider when interpreting the results.

Format

The online survey was launched on 12 April 2022 and remained open for 12 weeks, closing on 7 July 2022. There were 2 versions of the survey hosted on GOV.UK:

• a standard survey, which was completed by 4,401 individuals and 565 organisations
• an easy read survey, which contained a smaller sub-set of questions in the ‘standard’ survey and was completed by 158 individuals and 8 organisations

Respondent type

Over 5,000 people got in touch to share their views and experiences through the online surveys. This included 4,559 individuals and 573 organisations - many of which, as set out in the executive summary, were collated responses following group discussions with people with lived experience. The majority of respondents to the standard survey were individuals sharing their own views and experiences (see table 1).

Table 1: in what capacity are you responding to this survey?

Respondent type	Proportion
An individual sharing my personal views and experiences	62%
An individual sharing my professional views	24%
On behalf of an organisation (in an official capacity)	11%
On behalf of someone else (because they do not have the capacity to do so)	3%

Generalisability

While we received a large volume of responses, the results still only represent the views of those who completed the survey. Where we refer to the views of respondents, this cannot be taken to be representative of the views of all people in England.

Analysis

The online surveys contained a combination of ‘closed’ tick-box questions (where respondents could ‘select all that apply’ from pre-determined choices) and ‘open-ended’ questions (where respondents were free to enter any text). The surveys contained mostly open-ended questions, therefore qualitative analysis was mainly used to analyse the responses to understand the broad range of views and experiences and public priorities.

The analysis is subjective and reflects personal interpretation. However, 2 independent reviewers compared the analysis to help minimise individual differences. The analysis is based on non-numerical data. As such, quantitative values are not assigned to any of the results to open-ended questions. Instead, a summary of the overarching themes raised has been provided.

The standard survey contained 3 closed and 69 ‘open-ended’ questions. Responses to the open-ended questions in the standard survey were analysed using a topic modelling and tagging system. This identified and labelled emerging themes and topics in the responses for every question and allowed responses to be tagged with multiple themes. To enable analysis to be carried out in this way, responses to questions on infants, children and young people were combined, as were responses to questions on adults and older adults.

The easy read survey was produced as a shorter, accessible version of the main survey and included 24 open-ended and 3 closed questions. Responses were analysed using a process of manually reading responses to identify topics and themes raised. These topics were then collated into overarching themes.

Individual and organisational responses have been analysed together. Insights to the standard survey and easy read survey are reported together in this report.

See the mental health and wellbeing plan: discussion paper and easy read version for the full list of survey questions.

Respondent demographics

Information about the demographics of respondents was collected for individual respondents to the standard survey (4,401 responses in total). Demographic information for respondents to the easy read survey is not presented in this report due to an error in data collection, whereby only partial data was collected.

Demographic information provided by respondents to the standard survey is summarised in the tables below. Please note that proportions are rounded to the nearest percentage and therefore may not sum to 100%.

Age of respondent

By age, 63% of respondents were between the ages of 25 to 54 (see table 2). This question was compulsory however, 2% of respondents preferred not to give their age.

Respondents under the age of 13 were required to have consent from their parent or guardian in order to participate in the survey. 35% of respondents under the age of 13 did not have parental or guardian consent and were not able to participate in the remainder of the survey.

Table 2: what is your age?

Age band	Proportion
Under 13	2%
13 to 15	4%
16 to 24	12%
25 to 34	20%
35 to 44	21%
45 to 54	22%
55 to 64	12%
65 to 74	4%
75 or above	1%
Prefer not to say	2%

Sex of respondent

Nearly all respondents (95%) said they, or the person they had in mind, are cisgender - meaning that their gender identity matches their sex registered at birth. 74% respondents were female while 22% were male (see table 3). This question was not compulsory and 4% of respondents preferred not to say or left the question unanswered.

Table 3: what is your sex?

Sex	Proportion
Female	74%
Male	22%
Prefer not to say	3%
Unanswered	1%

Ethnicity of respondent

By ethnicity, 89% of respondents identified with a white ethnic group, while 8% identified with a black, Asian, other, multiple or mixed ethnic group (see table 4). 3% of respondents preferred not to say or left the question unanswered.

Table 4: what is your ethnic group?

Ethnic group	Proportion
White - includes English, Welsh, Scottish, British, Northern Irish, Irish, Gypsy, Irish Traveller, Roma or any other white background	89%
Asian or British Asian - includes Indian, Pakistani, Bangladeshi, Chinese or any other Asian background	3%
Mixed or multiple ethnic groups - includes white and black Caribbean, white and black African, white and Asian or any other mixed or multiple background	3%
Prefer not to say	2%
Black, black British, Caribbean, African or any other black background	1%
Other, includes Arab or any other ethnic group	1%
Unanswered	1%

Location of respondent

The majority of respondents were from England (93%), while 5% were responding from Scotland or Wales, and 1% of respondents were responding from outside of the UK (see table 5).

Table 5: which of the following locations are you answering from?

Location	Proportion
England	93%
Scotland	3%
Wales	2%
Unanswered	1%
Prefer not to say	1%
I live outside the UK	1%
Northern Ireland	0%

Of respondents in England, 32% were responding from the South of England, 11% from the North West of England and 11% from London (see table 6). 8% of respondents preferred not to say or left this question unanswered.

Table 6: which area of England are you answering from?

Region	Proportion
South East England	20%
South West England	12%
North West England	11%
London	11%
West Midlands	9%
Yorkshire and the Humber	9%
East of England	8%
East Midlands	7%
Unanswered	7%
North East England	4%
Prefer not to say	1%

1. Promoting positive wellbeing

We asked respondents how we all can promote positive wellbeing. The questions and main themes raised in response are listed below.

How can we help people to take action to improve their own wellbeing?

The main themes raised in response to this question listed in alphabetical order, are:

• access to services
• community support
• crisis support
• early intervention
• funding for services
• relationship between physical and mental health
• support for older people, vulnerable groups, parents and families, children and young people
• system join-up
• the impact of school on mental health
• the impact of work on mental health
• training and education
• understanding and addressing the wider determinants of mental health

How can we improve the general population’s wellbeing?

The main themes raised in response to this question listed in alphabetical order, are:

• access to services
• addressing the wider determinants of mental health
• community support
• early intervention
• funding for services
• provision of culturally appropriate services
• relationship between physical and mental health
• service design
• support for children and young people, parents and families, older people and vulnerable groups
• the impact of school on mental health
• the impact of work on mental health
• training and education

How can we support different sectors within local areas to work together, and with people within their local communities, to improve the population’s wellbeing?

The main themes raised in response to this question listed in alphabetical order, are:

• access to services
• addressing the wider determinants of mental health
• community support
• funding for services
• join-up of services
• service design
• support for children and young people, parents and families, and vulnerable groups
• training and education

2. Preventing the onset of mental ill health

We asked respondents how we all can prevent the onset of mental ill health. The questions and main themes raised in response are listed below.

What is the most important thing we should address in order to reduce the number of people who experience mental ill health?

The main themes raised in response to this question listed in alphabetical order, are:

• access to services
• better community connection
• better join-up of services
• connection between physical and mental health
• early intervention
• funding for services
• improving support for vulnerable groups
• long term intervention
• relationship between physical and mental health
• relationship between work and mental health
• support for children and young people
• support for children, families and carers
• support for disadvantaged communities
• support for older people
• support for substance misuse
• system reform
• tackling health disparities and inequalities
• training and education
• understanding and addressing the wider determinants of mental health

Please share your ideas of how employers can support and protect the mental health of their employees

The main themes raised in response to this question listed in alphabetical order, are:

• access to services
• accountability for wellbeing and bullying in the workplace
• fair treatment of those with disabilities and health conditions
• flexible working, work-life balance and leave
• improving awareness and understanding
• promotion of wellbeing at work
• role of the line manager or organisation as a whole
• support for children and young people
• training and education

What is the most important thing we need to address in order to prevent suicide?

The main themes raised in response to this question listed in alphabetical order, are:

• access to services
• addressing poverty
• breaking down stigma
• crisis support
• early intervention
• funding for services
• holistic, personal support
• identifying and addressing the risk of suicide
• impact of school on mental health
• impact of tech and social media on mental health
• improved continuity of care
• join-up of services
• prevention
• support for parents
• support for vulnerable groups
• support in the community
• the impact of social media
• training, education and increased awareness
• understanding and addressing the wider determinants of mental health
• voluntary sector support

3. Intervening earlier when people need support with their mental health

We asked respondents where they would prefer to get early support for their mental health if they were struggling. Responses to the standard survey and easy read survey have been combined in table 7. Respondents were able to select multiple topics, therefore the responses will not sum to 100%.

The most popular topics selected by respondents were ‘NHS’ (70%) and ‘don’t mind - as long as the support is high quality’ (47%). Other popular topics were ‘family and friends’ (44%), ‘education setting’ (35%), ‘workplace’ (34%), ‘voluntary and community sector’ (30%) and ‘community’ (30%).

Table 7: where would you prefer to get early support for your mental health if you were struggling?

Response	Proportion
NHS	70%
Don’t mind - as long as the support is high quality	47%
Family and friends	44%
Education setting	35%
Workplace	34%
Voluntary and community sector	30%
Community	30%
Digital-based support or advice	24%
Local authority	22%
Private sector - for example, by paying for counselling	19%
Social care provider	19%
Other (aggregated)	3%

We also asked respondents how we all can intervene earlier when people need support with their mental health. The questions and main themes raised in response are listed below.

What more can the NHS do to help people struggling with their mental health to access support early?

The main themes raised in response to this question listed in alphabetical order, are:

• better support in the workplace
• community-based support
• crisis and trauma specific services
• early intervention tailored for vulnerable groups
• employing a whole system approach
• improved access to tailored support for men
• improving access to services at point of need
• improving diagnosis
• improving education and awareness
• improving mental health training
• improving signposting to support
• increased funding for services
• integration of services
• mental health service improvements
• tailored solutions to identify and remove additional barriers to support
• tailored support for older people
• tailored support for vulnerable groups
• wider variety of non-clinical interventions

How can the rest of society better identify and respond to signs of mental ill health?

The main themes raised in response to this question listed in alphabetical order, are:

• access improvement tailored for groups with specific needs
• better support in the workplace
• community-based support
• early intervention
• early intervention at school
• improve mental health services for young people
• improving access to support
• improving education and awareness
• improving mental health training
• increasing funding for services
• integration of services
• more support to families and parents
• providing support for housing
• stigma reduction though education and awareness
• wider variety of non-clinical interventions

How can we ensure that people with wider health problems get appropriate mental health support at an early stage if they are struggling?

The main themes raised in response to this question listed in alphabetical order, are:

• better support for disadvantaged communities
• community-based support
• early intervention
• improving access to services
• improving mental health training and awareness
• increase number of psychologists
• increased funding for services
• integration of services
• mental health service improvements
• relationship between mental and physical health

4. Improving the quality and effectiveness of treatment for mental health conditions

We asked respondents how we all can improve the quality and effectiveness of treatment for mental health conditions. The questions and main themes raised in response are listed below.

What needs to happen to ensure the best care and treatment is more widely available within the NHS?

The main themes raised in response to this question listed in alphabetical order, are:

• bespoke support for marginalised groups
• digital mental health
• earlier access to support for more children and young people
• expand range of interventions and treatments on offer
• have a plan for mental health workforce
• improve access to support and services
• improve mental health research and evidence base
• improve pathways to mental health support
• more NHS funding
• more personalised care
• more support for parents, carers and families
• support the role of education settings
• trauma informed care
• upskilling of workforce
• whole system working

What is the NHS currently doing well and should continue doing, in order to support people struggling with their mental health?

The main themes raised in response to this question listed in alphabetical order, are:

• integration with wider health and social care
• NHS funding
• provision of support and services
• quality of NHS workforce
• range of treatments and interventions
• support for children and young people
• the NHS is not doing enough
• the role of GPs

What should be our priorities for future research?

The main themes raised in response to this question listed in alphabetical order, are:

• adopt wider research methods
• children and young people
• drivers and treatment of mental ill health
• earlier access to support and services
• improve diagnosis
• improve mental health data
• improve quality of care
• link between physical health and mental health
• marginalised groups
• more NHS funding
• outcomes
• personalised care
• prevention and promotion
• service improvement
• the role of education
• treatments and interventions
• upskilling of the workforce
• widen the evidence base on treatments and interventions

What should inpatient mental healthcare look like in 10 years’ time?

The main themes raised in response to this question listed in alphabetical order, are:

• care closer to home and in the community
• don’t know what it should look like
• earlier access to support and services
• expand the range of interventions and treatment on offer
• focus on prevention and promotion
• improve care for children and young people
• improved quality of care
• more NHS funding
• more personalised care
• upskilling workforce

What needs to change in order to realise that vision?

The main themes raised in response to this question listed in alphabetical order, are:

• care closer to home and in the community
• focus on prevention and promotion
• improve care for children and young people
• improved access to support and services
• improvement of mental health research and evidence base
• more NHS funding for staff and training
• more personalised care
• raising mental health awareness and reducing stigma

5. Supporting people living with mental health conditions to live well

We asked respondents what things have the biggest influence on their mental health and influence their quality of life. Responses to the standard survey and easy read survey have been combined in table 8. Respondents were able to select multiple topics, therefore the responses will not sum to 100%.

The most popular topics selected by respondents were ‘social and family relationships’ (77%), ‘money and debt management’ (64%) and ‘employment and job security’ (64%). Other popular topics were ‘physical health’ (62%) and ‘housing’ (53%). 12% of respondents selected ‘other’, which included topics such as the influence of education, trauma and religion and spirituality on people’s mental health.

Table 8: what things have the biggest influence on your mental health and influence your quality of life?

Response	Proportion
Social and family relationships	77%
Money and debt management	64%
Employment and job security	64%
Physical health	62%
Housing	53%
Connection to your community	37%
Provision of social care	26%
Other (aggregated)	12%

We also asked respondents how we all can support people living with mental health conditions to live well. The questions and main themes raised in response are listed below.

What do we as a society need to do to improve the lives of people living with mental health conditions?

The main themes raised in response to this question listed in alphabetical order, are:

• earlier intervention
• embed more integrated, holistic, person-centred care and support
• ensure mental health care and support meets needs of all users including those with specific needs or those from more marginalised groups
• further consider the role of wider determinants of mental health
• improve access to and provision of services and support
• improve parity of esteem between mental and physical health
• improve relationship between physical and mental health
• improve workforce capability and capacity
• providing support to whole family and caregivers
• reduce stigma, improve awareness and understanding of mental conditions

What more can we do to improve the physical health of people living with mental health conditions?

The main themes raised in response to this question listed in alphabetical order, are:

• improve research into the impact of mental health medications on physical health
• improve the provision of physical health services
• integrate mental and physical health services and improve training for staff
• make services and healthy behaviours more accessible for all
• promote better awareness of the importance of health behaviours for good mental health
• provide services that take account of the needs of the individual
• provision of affordable exercise facilities and activities
• reduce weight stigma

How can we support sectors to work together to improve the quality of life of people living with mental health conditions?

The main themes raised in response to this question listed in alphabetical order, are:

• better data sharing across organisations
• enable people to access the right support at the right time
• evaluate impact of government policies on mental health
• funding and resources for services
• improve awareness and reduce stigma
• improve provision of and access to support and services
• improve training for staff and care providers
• improve wider determinants - for example, access to housing and nature
• integration and join-up of services, including non-health services (VCSE) and people with lived experience
• parity of esteem
• tailor services to meet individual needs
• work with marginalised groups to co-produce and provide support
• workforce training and capability

What can we change at a system level to ensure that individuals with co-occurring mental health and drug and alcohol issues encounter ‘no wrong door’ in their access to all relevant treatment and support?

The main themes raised in response to this question listed in alphabetical order, are:

• address wider determinants and drivers of mental ill health or substance and alcohol misuse
• better care for those in contact with justice system
• ensure support is tailored to individuals’ needs
• improve community provision
• improve services (access, funding, training and specialist provision)
• more joined-up working across organisations
• support and treatment for mental health and substance or alcohol misuse should be available together

6. Improving support for people in crisis

We asked respondents how we can improve support for people in crisis. The questions and main themes raised in response are listed below.

What can we do to improve the immediate help available to people in crisis?

The main themes raised in response to this question listed in alphabetical order, are:

• ensure a range of services are in place to respond to people’s needs
• ensure access to a 24/7 crisis line whenever needed
• ensure support can be widely and quickly accessed
• improve support for children and young people
• improve support for families
• improve the quality of services
• improve training on crisis support
• improve understanding and education of mental health needs
• increase funding
• provide specialist and person-centred support
• reduce police involvement

How can we improve the support offer for people after they experience a mental health crisis?

The main themes raised in response to this question listed in alphabetical order, are:

• develop crisis plans to prevent relapse
• encourage family and peer support
• ensure there is follow-up support after contact with crisis services
• improve access and quality of community support
• improve access to services
• improve connections with the community
• improve information sharing
• improve investment and capacity of services
• improve mental health training and education
• improve multi-agency working
• improve quality of services
• improve support available for families and carers
• increase funding and improve quality of services
• increase investment and capacity of services
• oversight of services
• provide people with support to manage in the community or workforce
• reduce police involvement
• work with minority groups to identify barriers

What would enable local services to work together better to improve support for people during and after an experience of mental health crisis?

The main themes raised in response to this question listed in alphabetical order, are:

• improve connections with the community
• improve information sharing
• improve multi-agency working
• improve training and education for staff
• increase investment and capacity of services
• oversight of services
• reduce police involvement

Next steps and implementation

We asked respondents to select what they thought are the most important issues that a new, national mental health plan needs to address. Responses to the standard survey and easy read survey have been combined in table 9. Respondents were able to select multiple topics, therefore the responses will not sum up to 100%.

Overall, the most popular topics selected by respondents were ‘early intervention and service access’ (81%) and ‘prevention’ (53%). This was followed by ‘crisis care and support’ (46%), ‘treatment quality and safety’ (45%) and ‘wellbeing and health promotion’ (42%).

Table 9: what do you think are the most important issues that a new, 10-year mental health plan needs to address?

Response	Proportion
Early intervention and service access	81%
Prevention	53%
Crisis care and support	46%
Treatment quality and safety	45%
Wellbeing and health promotion	42%
Quality of life for those living with mental health conditions	38%
Stigma	35%
Other (aggregated)	5%

Other issues raised by respondents in the open-ended question were:

• better integration of services
• community-based support and services
• decentralised approach
• equal distribution of resources to all geographical areas
• increasing funding
• link between physical and mental health
• mental health services improvement
• mental health support for children and young people
• specialist workforce
• tailored access routes for different needs

Other questions in this chapter and main themes raised in response are listed below.

What ‘values’ or ‘principles’ should underpin the plan as a whole?

The main themes raised in response to this question listed in alphabetical order, are:

• children and young people
• equality of access to services
• importance of community
• informed choice about care
• parity of esteem with physical health
• person-centred approach
• prevention and early intervention
• respect and compassion for patients and staff
• treatment

How can we support local systems to develop and implement effective mental health plans for their local populations?

The main themes raised in response to this question listed in alphabetical order, are:

• better integration of services
• community-based support and services
• decentralised approach
• equal distribution of resources to all geographical areas
• increasing funding
• link between physical and mental health
• mental health services improvement
• mental health support for children and young people
• specialist workforce
• tailored access routes for different needs

How can we improve data collection and sharing to help plan, implement and monitor improvements to mental health and wellbeing?

The main themes raised in response to this question listed in alphabetical order, are:

• collect feedback from communities and professionals
• employers to report on mental health
• improve approach to wellbeing measure of mental health
• increase collection of more representative data
• increase sharing of national and local mental health data
• invest in research
• national protocol for data sharing
• person-centred care
• publicise service outcomes for children and young people

Wider stakeholder engagement

DHSC received over 100 responses from organisations who submitted papers and evidence via email and post. These responses were considered and will be used to inform the suicide prevention strategy and the mental health aspects of the major conditions strategy, as well as our broader policy work.

Alongside the call for evidence DHSC also undertook engagement with a range of charities, academics, clinicians and individuals with lived experience into emerging issues as the call for evidence progressed.

Many themes emerged from these conversations, a number of which are listed below:

• the need for increased join-up between different mental health services
• the value of further research into protective and risk factors for mental ill health
• making access to services easier and more equitable between different population groups
• the presence of disparities between different demographic groups in the receipt of high-quality and timely mental health interventions
• the need for more inclusive, culturally sensitive and community-centred support
• addressing workforce shortages and building capability through training and supervision across the mental health pathway
• the role of the internet in mental health, wellbeing and suicide
• the relationship between loneliness, self-harm and suicide
• the stigma faced by those with mental health problems
• the value of trauma-informed care for mental health professionals

The findings of this in-depth engagement are now under consideration as to how they can be reflected within future strategies and/or policy work.

DHSC would like to place on record our thanks to everybody who contributed.

Lived experience engagement

To ensure the voices and perspectives of people with lived experience were captured, DHSC commissioned additional research in this area and is grateful to the following for conducting research with people with lived experience of mental health problems to inform policy work:

• Mind
• YouGov
• YoungMinds

Mind worked with YouGov and YoungMinds to carry out research with adults and young people with experience of mental health problems. They conducted nationwide surveys with over 5,000 adults and young people, as well as listening sessions, interviews and an online community to hear from a wide range of people. We particularly wanted to hear from groups who are at higher risk of experiencing mental health problems and disparities and Mind identified 6 at-risk groups of particular interest and relevance to the research:

• black African Caribbean people
• people living in poverty
• young women with experience of trauma
• people with severe and enduring mental health problems
• LGBTQ+ people (lesbian, gay, bi, trans, queer, questioning and ace)
• young people with learning disabilities

Findings

The views received from the adults and young people consulted can be categorised into 4 main themes:

Ensuring care is individualised and holistic

Respondents said support from systems should be holistic and respond to a person’s needs as a whole, including experiences of trauma. They said support should be culturally sensitive rather than one size fits all.

Tackling stigma and discrimination

Respondents wanted a focus on recognising and tackling stigma and discrimination at both the individual and systemic level.

Addressing the social determinants of mental health

Respondents wanted to see the issues tackled which impact on mental health alongside making improvements to the mental health system. These include housing, financial wellbeing, employment, education and physical health.

Improving mental health services

Both adult and young person respondents said they wanted to see improved access to services, shorter waiting times, a greater range of treatment and support options available and the prioritisation of prevention and early intervention.

Adults and young people were asked to indicate the 3 priority issues they thought should be addressed. The most common issues were:

• improved access to services and support (priority for both adults and young people)
• provision of early support for mental health problems (priority for both adults and young people)
• support for people in need of immediate care or experiencing a mental health crisis (priority for adults)
• improving treatment and quality of mental health services (priority for young people)

When adults were asked what would have the most positive impact on their mental health, over half (55%) said shorter waiting times, a third (33%) said treatment being more easily accessible across the country, and 31% said increased treatment or support options being available.

There were disparities in experiences of people from marginalised or at-risk groups:

• 48% of people in deep poverty reported not feeling supported by mental health professionals compared to 24% of people not in poverty
• 30% of people from racialised communities reported having experienced stigma and discrimination which negatively impacted their mental health, compared to 16% of white people
• 54% of people who have experienced trauma reported not feeling supported by the NHS compared to 22% of people who have not experienced trauma
• a third (31%) of people with severe and enduring mental health problems experienced stigma or discrimination when accessing support, compared with a 22% of participants overall
• over two-fifths (43%) of LGBTQ+ people had experienced stigma and discrimination which negatively impacted their mental health compared to 8% of non-LGBTQ+ people
• half (48%) of young people with learning disabilities reported a lack of treatment or support options available compared to a third (32%) of participants overall

Suicide prevention-specific engagement

DHSC has worked closely with voluntary sector partners who have conducted engagement with people with lived experience to support policy development.

We are grateful to the Suicide Prevention Consortium, which is led by Samaritans, alongside the National Suicide Prevention Alliance, Support after Suicide Partnership and With You as part of the VCSE Health and Wellbeing Alliance. The consortium hosted 4 virtual focus groups with people with lived experience of suicide, self-harm and/or alcohol or drug misuse. Key themes from this engagement include:

• education and awareness raising to reduce stigma
• improving access and quality of care, and consistency of services
• better crisis support services
• personalisation of care and support for individuals experiencing suicidal feelings
• targeted support for, and awareness-raising among, higher-risk groups

We are also grateful to our many other partners who have supported in lived experience engagement on suicide prevention. This has included, among others:

• Samaritans, who have conducted engagement among their networks, which included people with lived experience of self-harm, suicidality or mental ill health
• Papyrus, who have conducted engagement with children and young people to understand their experiences
• Harmless, who have engaged with people with lived experience of self-harm
• the Independent Advisory Panel on Deaths in Custody, who have engaged with current prisoners and other experts by experience to understand priorities for reducing self-harm and suicides among those in custody

All of this engagement will help to inform the new suicide prevention strategy as well as our ongoing policy work.