Paul Burstow


Professor Paul Burstow PC, Professor of Mental Health Policy

Good relationships are essential to good mental health.  Strong and supportive relationships can help to protect people’s health against the damage that the social determinates of ill health – poverty and social disadvantage – can inflict.  From the earliest moments of our childhood our ability to develop and maintain good relationships is shaped by how our parents connect with us – our ability to form secure attachment is the foundation on which so much of our life chances are built.

There is good evidence that social factors such as isolation and the quality of relationships is a better predictor of health than medical factors.  When we are lonely, our risk of poor health increases, with estimates that it is as harmful to our health as smoking 15 cigarettes a day.

One in four of us will experience a mental health problem at some point in our lives.  So it is likely that at some point you or a friend, colleague or relation will experience a mental health problem.

According to a survey by Time to Change, nine out of ten people with mental health problems experience stigma and discrimination that makes it difficult for them to live a normal life.

Our media often serves to perpetuate this.  Our day-to-day language and behaviours amplify it.  It is why tackling stigma and discrimination remain a work in progress.  There is still much to do to shift attitudes and behaviours.

Stigma isolates people, fearing how people might react.  It has a real impact on people’s lives, one in four people with a mental illness have been refused insurance, one in three report having been dismissed or forced to quit work.  Worse still stigma stops people seeking help.

Mental disorders are the cause of one-quarter of years lived with disability globally, which places it above cardiac disease and cancer in terms of disability.  The life expectancy of people with schizophrenia is 15-20 years shorter than the general population, as a result of undiagnosed or poorly treated physical health problems and significantly higher rates of smoking.  Put another way a person with a serious mental health problem has the life expectancy of the general population in the 1950s!

We can all play a part in challenging the stigma and ending the scandal of 20 stolen years of life.  It is good to talk.

And since the launch of Time to Change in 2007 attitudes have begun to shift.  Whether that is in the workplace, in our friendships, where we live public attitudes are changing.  A survey in 2014 found that since 2007 attitudes had improved by 8.3 per cent.  The campaign’s impact has been evaluated by King’s College London who found a clear and consistent link between awareness of the campaign and having a more positive attitude.

In my view not only have the campaign helped to shift attitudes and behaviours it has created the conditions for a much wider and more informed public debate about the priority we as a society should award to mental health.  It has helped to secure political commitments of more money for mental health. The trouble is tracking down where the money is and when it will arrive.

When it comes to the money there are two figures that matter when it comes to mental health: the first, announced in the March 2015 budget, £1.25bn building over five years to deliver the ambitions of Future in mind; the second, an extra £1bn per year by 2020 to deliver the recommendations of the Five Year Forward View for Mental Health, as the prime minister recently announced.

Given the parlous state of NHS finances there is a compelling case for investing in better mental health services.  Poor mental health is a great accelerant of physical healthcare costs, as much as a 50% increase, according to the mental health taskforce.

There is much to be done to improve access to better mental health services across the UK, especially services for children and young people.  But just increasing the amount of services alone will not be enough to close the treatment gap.  We must go upstream to tackle the causes of mental illness, recognising the critical contribution that good relationships make to our childhood development and throughout our lives.  By do this we have the possibility of reducing the number of people who need help.

A concerted effort is required to understand the evidence and put in place the most promising actions to promote better mental health, prevent mental illness, and act earlier to avoid mental health problems becoming entrenched.  This Autumn the University of Birmingham will launch a Policy Commission looking at these questions with the goal of setting out a compelling case for investing in mental health promotion and illness prevention.

Mental Health Awareness Week 2016 takes place from 16-22nd May with the theme of relationships.