Call for evidence outcome

Quick read version of the mental health and wellbeing plan: discussion paper

Updated 17 May 2023

This was published under the 2019 to 2022 Johnson Conservative government

Applies to England

About the mental health plan discussion paper

Trigger warning: this paper references suicide.

The government is committed to improving mental health and wellbeing outcomes across the country. This is a key part of its commitment to ‘level up’ and address unequal outcomes and life chances across the country.

The government is developing a new plan for mental health and wellbeing.

A government plan is a set of ambitions, actions and targets to ensure that the whole of government works together to solve a problem. It is agreed with every government department and can help bring about real change.

As the government develops this plan, it wants to make sure it includes what the public think is important, particularly people who have struggled with their own mental health or people who care for someone who has.

Therefore, the government has developed this discussion paper and call for evidence to ask the public a range of questions to help develop the plan for mental health and wellbeing.

This discussion paper is asking people how to:

• improve people’s mental well-being (chapter 1)

• prevent people experiencing mental ill-health (chapter 2)

• help people get support at the earliest stage (chapter 3)

• improve treatment for mental ill-health (chapter 4)

• make sure people with a mental health condition live well (chapter 5)

• best support people in mental health crisis (chapter 6)

We want to hear everyone’s views on these questions. This includes:

• children and young people, adults and older adults who have experienced mental ill-health

• people who have cared for someone affected by mental ill-health

• people who work or volunteer in health and social care services who support people with their mental health

• people who work or volunteer in places where they meet people who are affected by mental ill-health (such as schools, job centres and housing associations)

• academics and experts who work on mental health

You can respond to any or all questions via the online survey. The deadline for responses is 11:45pm on 7 July 2022.

Chapter 1: how can we all promote positive mental wellbeing?

What is mental wellbeing?

Mental wellbeing is about thoughts, feelings and how people cope with the ups and downs of everyday life. Having positive wellbeing means that every individual realises their own potential, can cope with the normal stresses of life, help engage in work productively and can contribute to their community.

The government wants to promote positive mental wellbeing as part of its new mental health plan.

Positive mental wellbeing is different for everyone, but it might include feeling, expressing and managing a range of positive and negative emotions, forming and maintaining good relationships with others, taking part in activities and coping with change and uncertainty.

To help us develop our plans, we are asking people for their views on the most important actions we need to take to improve mental wellbeing. This includes action that national and local government can take, public, private and voluntary sectors, and people in local communities.

Question

How can we help people to improve their own wellbeing?

Your ideas may include actions which can be taken by different types of organisations – such as national and local government, public services such as schools and the NHS, employers and the private and voluntary sectors. It can also include things that happen between family members and local communities.

Please provide your suggestions in relation to the wellbeing of different groups:

a) Infants and their parents or primary caregivers

b) Children and young people

c) Working age adults

d) Older adults

e) People that are more likely to experience poor wellbeing

Question

Do you have any suggestions for how we can improve the population’s wellbeing?

This can include ideas about what local people and communities can do together, as well as things you want to see in health services, wider public services such as education settings, places of employment and the private and voluntary sectors.

Please provide your suggestions in relation to the wellbeing of different groups:

a) Infants and their parents or primary caregivers

b) Children and young people

c) Working age adults

d) Older adults

e)  People that are more likely to experience poor wellbeing

Question

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

This includes a wide range of public services, including education settings, social care, the NHS, voluntary sectors, housing associations and businesses.

Chapter 2: how can we all prevent the onset of mental ill-health?

What do we mean by ‘prevention’?

Prevention in mental health aims to reduce the prevalence (proportion of the population), incidence (numbers of people) and recurrence (return of symptoms after recovery) of mental ill-health.

The government also wants to prevent the onset of mental ill-health and to reduce the number of people dying by suicide. It wants to address the significant difference between different groups who develop mental health conditions.

The government knows that we need to address the complex root causes of mental ill-health. We know that things like poverty, trauma and problem debt can have a significant impact 

We need to focus on early years and childhood because this is a crucial period which can influence whether someone develops a mental health condition. Negative experiences during this period can have lifelong impacts on that person’s mental health.  

To help us develop our plans, we are asking people for their views on what we can do to ensure all of society – including businesses and the private sector – play their part in preventing the onset of mental ill-health.

Question

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

This might include actions which can be taken by national and local government, public services such as education settings, social care, the NHS, and the private and voluntary sectors.

Please provide your suggestions in relation to different groups:

a) Infants and their parents or primary caregivers

b) Children and young people

c) Working age adults

d) Older adults

e) People that are more likely to experience mental ill-health

Question

Do you have ideas for how employers can support and protect the mental health of their employees?

Question

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

This might include actions which can be taken by national and local government, public services such as education settings, social care, the NHS, and private and voluntary sectors.

Please provide your suggestions in relation to different groups:

a) Children and young people

b) Working age adults

c) Older adults

d) People that are at greater risk of suicide

Chapter 3: how can we all intervene earlier when people need support with their mental health?

What do we mean by ‘early intervention’?

Early interventions are actions which can prevent a person from developing a ‘clinical’ mental health condition, and/or prevent symptoms from getting worse or reaching crisis point

The government also wants to improve the support available for people struggling with their mental health. We particularly want to make sure people get early support. This is because the sooner someone receives support when they are struggling with their mental health, the more likely it is that they will recover.

This is the better outcome for the individual’s mental health and wellbeing and can also ensure they can stay engaged in life doing things that are meaningful to them, as well as staying in work or education.

The ‘right’ support does not always need to be given by a doctor, nurse or therapist. It may be better to get support from a parent or carer, or in places where people spend time or seek support like community groups, friends and other family, schools, workplaces, or job centres. Different approaches work in different circumstances.

To help us develop our plans, we want to hear people’s views on different types of support, and what we can do ensure that support is more readily available to people who are struggling.

Question

Where would you prefer to get early support for your mental health if you were struggling? Please tick all that apply.

• from family and friends
• from the NHS
• from your local authority
• from an education setting
• from a social care provider
• in your community
• from the voluntary and community sector
• from your workplace
• from digital-based support or advice
• from the private sector, for example by paying for counselling
• don’t mind – as long as the support is high-quality
• other – please specify

Question

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

Please provide your suggestions in relation to different groups:

a) Infants and their parents or primary caregivers

b) Children and young people

c) Working age adults

d) Older adults

e) Groups who face additional barriers to accessing support for their mental health

Question

Do you have any suggestions for how the rest of society can better identify and respond to signs of mental ill-health?

• yes
• no

If yes, please share your ideas.

You might want to consider community bodies, public services and private and community sectors. We are particularly interested in how society and different sectors can work together to get people support early.

Please provide your suggestions in relation to different groups:

a) Infants and their parents or primary caregivers

b) Children and young people

c) Working age adults

d) Older adults

e) Groups who face additional barriers to accessing support

Question

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

You might want to consider barriers faced by individuals, as well as how health and social care services engage with those people.

Chapter 4: how can we improve the quality and effectiveness of treatment for mental health conditions?

What are mental health conditions?

Mental health conditions are conditions that affect your mood, thinking and behaviour. Examples of mental health conditions include depression, anxiety, eating disorders, schizophrenia and bipolar disorder. More detail is available on the NHS website.

The government also wants the new plan to ensure that NHS treatment and support helps people to feel better. This is because the treatment and support people living with mental health conditions receive from the NHS plays an important part in supporting them to manage their condition and make their symptoms better. It can significantly improve their quality of life.

Over the past 10 years, the range of treatment options available on the NHS has increased. However, the government wants to understand how we can improve services. We want to improve treatment for people who report worse experiences and outcomes in mental health services.

We are asking people for their views on what ‘good’ should look like for treatment and care in the next 10 years, and how we get there. This includes what our research priorities should be, and how we can implement what we already know works for service users.

Question

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

We want to hear about the most important issues to address in order to improve NHS mental health care and treatment over the next 10 years.

We would be grateful for views on:

a) Infants and their parents or primary caregivers

b) Children and young people

c) Working age adults

d) Older adults

e) Groups who report worse experiences and outcomes from NHS mental health services

Question

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

Question

What should be our priorities for future research, innovation and data improvements over the coming decade to drive better treatment outcomes?

We would be grateful for views on priorities for research across the life course, including:

a) Infants and their parents or primary caregivers

b) Children and young people

c) Working age adults

d) Older adults

e) Groups who have worse experiences in NHS mental health services, and/or often do not experience good outcomes

Question

What should inpatient mental health care look like in 10 years’ time, and what needs to change in order to realise that vision?

Chapter 5: how can we all support people living with mental health conditions to live well?

What is meant by ‘living well’?

Sometimes mental ill-health and symptoms of a mental health condition will recur throughout a person’s lifetime. With ongoing support and help, people can learn how to manage this and ‘live well’ with a mental health condition.

While positive progress has been made, the government wants to improve the lives of people of all ages living with mental health conditions, particularly severe mental illnesses.

Social circumstances play an important part in supporting someone’s overall health and wellbeing. This is true for people living with mental health conditions.

Sadly, we know that living with mental health conditions can also mean experiencing worse outcomes than the general population in many ways. This includes worse outcomes in employment, physical health, and in school.

We are asking for views on how to improve the quality of life of people living with mental health conditions. We want to hear from people with lived experience about what is most important to them, and views on what would help services to join up and support people.

Question

What do we (as a society) need to do or change in order to improve the lives of people living with mental health conditions?

You might want to consider priorities at national and local government, wider public services such as social care and education settings, and the private and voluntary and community sectors

We would be grateful for input relating to:

a) Infants and their parents or primary caregivers

b) Children and young people

c) Working age adults

d) Older adults

e) Groups who face additional barriers to accessing support

Question

What things have the biggest influence on your mental health and influence your quality of life?

• housing
• provision of social care
• employment and job security
• money and debt management
• social and family relationships
• physical health
• connection to your community
• other – please specify

Question

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

This will support our ambition to reduce the gap in life expectancy between people with severe mental illness and the general population.

Question

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

We would be grateful for input relating to:

a) Infants and their parents or primary caregivers

b) Children and young people

c) Working age adults

d) Older adults

e) Groups who face additional barriers to accessing support

Question

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?

This includes people in contact with the criminal justice system.

Chapter 6: how can we all improve support for people in crisis?

What is a mental health ‘crisis’

Mental health ’crisis’ refers to someone experiencing extreme distress. This may lead to self-harm or suicidal ideation. Someone may experience a crisis for a range of reasons, such as a big life change, or because an existing mental health condition is getting worse. All crises will be different in their cause, presentation and progression.

The government’s ambition for the plan is to improve the support available to people who are struggling with their mental health at the earliest possible stage, and to prevent them from reaching the point of crisis.

However, sadly people of all ages do experience mental health crises and require more intensive support. We want to improve the support which is available for people in crisis. We want to prevent people tragically dying by suicide.

There are many different reasons why someone might experience crisis, so it’s important that different types of support are available. We are particularly interested in people’s views on what the best support in crisis is for different people, and how local partners can work together to ensure everyone can get the right support.

Question

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

We want to hear from people who have experienced a mental health crisis, to understand what help you need.

We also want to hear from those who work or have worked within services who support people experiencing a mental health crisis.

We are interested in ways to embed ‘best practice’ of multi-agency working, considering the role of the NHS, social work and social care, the voluntary and community sector, local government, education settings and the police.

Please consider:

a) Children and young people

b) Working age adults

c) Older adults

d) Groups who face additional barriers to accessing support

Question

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

We want to hear from people who have experienced a mental health crisis, to understand what help you need.

We also want to hear from those who work or have worked within services who support people experiencing a mental health crisis.

Please consider:

a) Children and young people

b) Working age adults

c) Older adults

d) Groups who face additional barriers to accessing support

Question

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

We would like you to consider the range of public services involved in crisis support, including the police and NHS services, as well as voluntary and community sector and businesses.

Next steps

The government will give people 12 weeks to respond to the discussion paper and tell us what is important for the new mental health plan to address.

We will also ensure that we get input from people who live with mental health conditions. We want to hear from people who experience poorer mental health than the general population.

We will then work with different sectors, including the NHS, to develop a society-wide plan for mental health. This is because improvements to mental health cannot be driven by the government alone. This will include a plan for the NHS workforce.

We will also be using these responses to help develop a separate suicide prevention plan.

Question

What do you think are the most important issues that a new, 10-year national mental health plan needs to address?

• wellbeing and health promotion
• prevention
• early intervention and service access
• treatment quality and safety
• quality of life for those living with mental health conditions
• crisis care and support
• stigma
• other – please specify

Question

Please explain your choice.

Question

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

‘Principles’ and ‘Values’ can help us to agree what the purpose of a plan should be, and what it should be seeking to achieve for people.

Question

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

You might want to consider barriers local systems currently face, as well as enablers which would support more effective ways of working.

Question

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

Read the full version of the discussion paper to find out more about:

• why it is important to develop a cross government long term mental health plan
• what progress has been made to date
• the research and evidence we have used to consider our key themes
• which groups face disparities in mental health outcomes