Beyond Pills All Party Parliamentary Group makes nine calls to action to overhaul mental health system, in line with WHO and UN demands
The Beyond Pills All Party Parliamentary Group has today released a report entitled Shifting the Balance Towards Social Interventions: A Call for an Overhaul of the Mental Health System. Addressing the pressing need to resolve the current crisis in mental health outcomes, the report endorses the proposals put forward by World Health Organization (WHO) and the United Nations (UN) in their calls for fundamental reforms. It includes specific recommendations to bring about a radical overhaul in mental health care, including:
- Boost provision for social interventions, including social prescribing and community-based resources
- Reforming the MHRA, the regulator of medicines in the UK and implementing a UK Sunshine Act for financial transparency
- Funding drug deprescribing services as well as a national withdrawal support helpline
- Reverse rates of unnecessary antidepressant prescribing, particularly among young people; over four million under 25s were prescribed antidepressants in 2022/23
It concludes by calling for ‘a paradigm shift away from the traditional biomedical model that has presided over poor clinical outcomes and the over medicating of distress, towards a more holistic, person-centred approach that more fully recognises and addresses the social, economic and psychological determinants of mental health’.
The current mental health system is marked by an over-reliance on psychiatric drugs, with nearly a quarter of all adults prescribed a psychiatric drug in any given year and soaring rates for children and young people. There is also a failure to provide effective social, community and relational approaches. This has led to persistently poor outcomes despite substantial research and investment over four decades.
Alongside the suffering of millions of individuals, societal costs have spiralled. The total cost of poor mental health is estimated to be around £300 billion in England alone in 2022; this includes costs due to absenteeism and reduced quality of life as well as healthcare expenditure.
The report proposes six principles for mental health reform, including recognising the social and relational nature of most mental health issues, addressing social determinants of distress, promoting positive narratives to support recovery, using psychiatric drugs with caution and reducing over-prescribing.
The report makes nine calls to action across services, regulation, education and public awareness to help bring about the necessary changes. These include additional provision of social interventions such as community-based mental health hubs and social prescribing, reforming the MHRA to improve drug regulation, implementing a UK Sunshine Act for financial transparency, integrating Social Emotional Learning (SEL) into the national curriculum, improving health professional training, funding nationwide deprescribing services (including a national helpline) and demedicalising mental health language.
These recommendations align with recent calls from the WHO and UN, which stress the importance of a holistic approach that prioritises psychosocial and community-based interventions over biomedical treatments. ‘Mental ill health affects people from all backgrounds, from early years to the elderly, so addressing the crisis in the mental health care system concerns everyone,’ say the authors.
The report is being launched at a Beyond Pills APPG event today. Speakers include Dainius Pūras (former UN Human Rights Council Special Rapporteur for Health), Michelle Funk (Unit Head of the WHO Policy, Law and Human Rights team) and Sir Norman Lamb (Chair of the South London and Maudsley NHS Foundation Trust).
Danny Kruger MP, chair of the Beyond Pills APPG, writes: “We have a mental health crisis in the UK and giving psychiatric drugs to nearly a quarter of our adult population isn’t working. We urgently need to invest in the social determinants of good mental health: stronger family and community relationships, activities that give people a sense of agency and belonging, and social rather than purely medical models of mental health treatment.”
Lord Crisp, co-chair of the Beyond Pills APPG, writes: “This important report points the way to a higher quality and more effective approach to mental health which will improve the lives of millions of people and strengthen the UK economy. It shows that existing policies are simply not working and proposes practical alternatives.”
Dr James Davies, Associate Professor of Medical Anthropology and Psychology, University of Roehampton and lead author of the report, writes: ”The solution to our mental health crisis isn’t cutting disability payments which will worsen the lives of the most vulnerable, but tackling the social determinants of poor mental health and better funding for effective psycho-social interventions. Forty years of biomedical dominance in mental health has not improved clinical outcomes - we need to entirely overhaul our approach.”
Dainius Pūras, former UN Special Rapporteur and Professor at the Clinic of Psychiatry, Faculty of Medicine, Vilnius University, writes: ”There is an increasing understanding globally, supported by the UN and WHO, that mental health services need to abandon the current model of care, and replace excessive biomedical interventions and forms of coercion with effective services that respect peoples’ rights to mental health, based on mutual trust between providers and users. The UK has the opportunity to become a global leader by adopting this UN and WHO-backed approach, by addressing the social determinants of mental health and by investing in effective psychosocial interventions.“
Rachel Kelly, author, mental health campaigner and SANE ambassador, writes: “As someone who has had mental health problems myself, and who now works with young people who are struggling, I know that we need a new approach. Dishing out more medication isn’t working, yet the rate of prescribing for teenagers is soaring. My experience is that young people’s psychological difficulties are often an understandable response to life’s challenges, particularly relationship difficulties and growing up in a world of social media, exacerbated by loneliness and bullying. Yet these are not essentially medical problems to be solved by strictly medical means: there’s so much else we can offer young people, starting with teaching them (and their parents) more about their physiological and psychological health. When I look back at my own experience of anxiety and depression, I only wish that such a holistic, person-centred approach had been available.”
About the Beyond Pills APPG
The Beyond Pills APPG aims to move UK healthcare beyond an over-reliance on pills by promoting social prescribing, lifestyle medicine, psychosocial interventions and safe deprescribing. As well as reducing unnecessary and inappropriate prescribing, this integrated approach will improve outcomes and reduce health inequalities. The officers of the Beyond Pills APPG are Danny Kruger MP, Lord Crisp, Steve Brine MP and Lord Hunt of Kings-Heath. https://beyondpillsappg.org/
For more information or interviews, please contact:
Beth Farrer beth@farrerkane.com 07985 242726
Holly Allen hollyallen@farrerkane.com 07823 358811
To join the webinar (11am BST 14 May 2024) please register at the following link: https://us06web.zoom.us/webinar/register/WN_C0_PIDKVS_ax8rZRc63BjQ#/registration
Fact sheet
The current dominant biomedical model of care has led to the current crisis in mental health outcomes, characterised by high rates of psychiatric drug prescriptions, lengthy waiting times for treatment, soaring societal and individual costs of worsening mental health, and persistently poor outcomes despite significant investments in services and research over the past four decades.
- Nearly a quarter of the adult (18+) population in England is prescribed a psychiatric drug in any given year NHS Business Authority 2023) NHS releases mental health medicines statistics for 2022/2023 in England. Website: https://media.nhsbsa.nhs.uk/news/nhs-releases-mental-health-medicines-statistics-for-20222023-in-england
- One in five children and young people under 18 now meet the criteria for a mental health diagnosis.
- Nearly 450,000 children and young people under 18 were prescribed antidepressants in 2022/23; over four million (4,119,463) under 25s were prescribed antidepressants in the same year, according to the NHS Business Authority in a written answer for Parliament
- https://www.theyworkforyou.com/wrans/?id=2024-03-04.HL2971.h
- Waiting lists for NHS treatment for children/young people are up to three years
- NHS provision for psychotherapy is patchy and often of low quality
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