Short Guides
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The conclusion highlights that mental health is a growing and critical public health challenge. Mental health remains poorly understood and services have been underfunded and underdeveloped. Mental health problems are not distributed equally across the population; rather, they are disproportionately associated with poverty and disadvantage. While there has been considerable progress in this policy area, much work is required to address long-standing systemic issues.
This chapter explores the development of mental health policy in the UK. It describes the history of provision for people with mental disorders, then outlines the move from asylums to community care. It notes that forensic mental health services gained importance in the early 1990s, when the focus was on public concern around mental health patients in the community. It also covers legislation on detention and looks at the failure of the government to take forward proposed amendments to the Mental Health Act 1983. Mental health legislation in the devolved nations of the UK are summarised. The role of multidisciplinary teams in community-based care in England is described.
What we know about mental health is shaped by the information that we engage with. Media representations of people with mental illness are extremely influential, as they contribute to the shaping of attitudes, perceptions and social norms. We are exposed to a range of media content, including nonfiction and fiction, conveying messages about mental health. This chapter looks at the positive and negative role that the media can play. It highlights that media representations can oversimplify and trivialise mental illness. Key aspects of representation of mental illness are discussed, including gender and mental illness and the representation of suicide and self-harm. The chapter also covers safe and responsible coverage.
This chapter sets out the contested nature of mental health and the terminology associated with this area of policy. It discusses the prevalence of mental illness nationally and internationally. It also covers the challenges of measurement and classification systems. Models of mental health are discussed. The chapter briefly outlines common mental disorders. Finally, responses to mental illness are described.
This chapter looks at the delivery of mental health services in the UK, noting the crisis in provision. It outlines the role of the state in delivering care, including child and adolescent mental health services and services for adults of all ages. The call for a ‘no wrong door’ approach to accessing mental health services is covered. It then describes the role of the voluntary, community and social enterprise sector as a crucial partner for delivery of mental health services in the community. The barriers that exist around commissioning, funding and retaining staff in this sector are discussed.
An antipsychiatry movement in the UK and the US in the 1960s led to the rise of the service user movement and an academic movement, led by ‘survivors’ of mental health services, known as the mad movement and mad studies. The concepts of person-centred care and co-production are discussed. The significance of the idea of recovery and what this means to a range of stakeholders is also outlined. The concept of co-production is now an important part of care delivery and central in recovery colleges for those recovering from mental health issues.
In this clear and concise primer, Deirdre Heenan and Jennifer Betts lay out key concepts and debates in the field of mental health.
With overviews of recent developments and stakeholder perspectives, the book introduces contemporary themes in policy and practice. It explores the prevalence, cost and social determinants of mental illness, the changing attitudes and stigma around them, and the roles of the state, voluntary and community sectors in designing and delivering services. Assuming no prior knowledge of the subject, the guide includes:
• text boxes and figures to illustrate key points;
• end of chapter summaries;
• international case studies;
• further reading guides.
For students, practitioners, policy makers and newcomers alike, this is an accessible and comprehensive guide to an increasingly prioritised and debated topic.
This chapter discusses the societal problems that disrupt mental health and increase the risk of poor mental health. Social determinants of mental health include age, education, ethnicity, gender, economic circumstances, neighbourhood and environmental events. It is argued that these factors play a major role in shaping mental health inequalities.
Mental health stigma is internalised by individuals and may act as a barrier to individuals seeking treatment services. It is associated with poorer recovery from mental illness and lower self-esteem. Stigma, prejudice and discrimination can be subtle or obvious, and they are associated with harm and marginalisation. This chapter looks at the nature of stigma and outlines three types of stigma – self-stigma, public stigma and structural stigma. It examines the impact, including on employment. It also highlights that language can reinforce stigma. The concept of toxic masculinity is discussed. Finally, interventions to reduce stigma are discussed and the extent to which they have achieved their aims and objectives is assessed.
