The incidence and severity of mental health issues in England throughout a typical week highlight the emergence of a significant public crisis. Anxiety and depression is observed in the population of the UK and it is observed that 8% of the population is facing the issue. Further, “Generalised Anxiety Disorder (GAD)” has been affecting 6% of individuals (Bandelow and Michaelis, 2015). The prevalence rates of “post-traumatic stress disorder (PTSD)” and depression have also been affecting approximately 4% and 3% of the population (Barton and Rogerson, 2017). Moreover, it can be stated that certain diseases such as phobias have been affecting approximately 2% of the population, and “Obsessive-Compulsive Disorder (OCD)” affects around 1% of individuals. It is also observed that an individual's diagnosis has the potential to undergo changes throughout their lifespan, resulting in a multifaceted landscape of mental healthcare requirements (Reynolds et al., 2022).
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Furthermore, certain psychiatric conditions such as “antisocial personality disorder (ASPD)”, “borderline personality disorder (BPD)", bipolar disorder, and psychotic diseases; including schizophrenia have been providing an additional level of intricacy (Dudeni, 2021). However, a persistent discourse exists over these diagnostic classifications owing to their contentious and sometimes stigmatizing implications. There exists a prevalent argument asserting that some categorizations, particularly those pertaining to personality disorders and schizophrenia, possess a greater potential for harm rather than assistance. Consequently, this viewpoint advocates for a reevaluation of our comprehension and approach towards these problems (Vladimirova, 2021).
Figure 1: Mental health disorders by age and sex
Beyond identifiable psychiatric disorders, the concealed aspect of mental health issues resides in the phenomena of self-harm, contemplation of suicide, and actual suicide endeavors. Throughout the course of an individual's lifespan, it is identified that approximately 20% of the population encounters ideations of self-harm or suicide (Journals, 2018). Moreover, it has been found that approximately 1 out of every 14 individuals engages in self-harming behaviors, while approximately 1 out of every 15 individuals make attempts to end their own lives. These statistics also indicate a gender imbalance, as women have a higher likelihood of experiencing suicidal ideation and engaging in suicide attempts, whilst men are unfortunately three times more prone to committing suicide (Cambridge, 2021).
Hence, it showed a significant increase, more From 2017 to 2022, there was a notable increase in the proportion of children aged 7-16, with the percentage rising from 12.1% to 18.0%. The observed trend is particularly noteworthy in the age group of 17-19 years when the previous doubling from 10.1% in 2017 to 25.7% in 2022. The observed pattern indicates a rising and pressing demand for mental health therapies and support systems specifically tailored to address the needs of this particular demographic (McGorry et al., 2022).
The COVID-19 pandemic has emerged as a global stressor, exerting its impact on multiple dimensions of human existence, encompassing health, economics, and social connections. The monitoring conducted by the “Office for National Statistics (ONS)” highlights the significant influence of the epidemic on mental health (Waite et al., 2021). Before the onset of the pandemic, the occurrence of moderate to severe depressed symptoms was estimated to be 10%. However, the rate of escalation significantly increased subsequent to the initiation of the pandemic, reaching its highest point at 21% in the early months of 2021 (Grau et al., 2021). By the end of 2022, there was a decrease to 16%, however, it should be noted that this percentage remained much higher compared to the levels observed prior to the onset of the pandemic. This implies that the impact of the pandemic on mental health is enduring and not limited to transient responses to an acute emergency (ScienceDirect, 2021).
There seems to be a positive correlation between the increasing cost of living, particularly in terms of housing and energy expenses, and the prevalence of depression. According to the statistics provided by the “Office for National Statistics (ONS)”, there is a correlation between those experiencing difficulties in affording housing or energy expenses and greater prevalence rates of depression (Castaño-Rosa et al., 2019). Furthermore, individuals who rent, a demographic that generally experiences greater financial vulnerability compared to homeowners, had elevated levels of depression. Although the Office for National Statistics (ONS) is cautious in stating that this association does not necessarily imply causation, it is evident that there is a clear relationship between the variables (Barton and Rogerson, 2017). The presence of economic stressors, particularly in the context of escalating expenses, has the potential to exert considerable pressure on an individual's psychological welfare. Economic policies and social safety nets play a crucial role in promoting both financial stability and mental well-being (Fancourt and Finn, 2019).
A policy framework is also essential for standardizing care, guaranteeing that everyone, regardless of location or economic status, has access to comparable high-quality treatments. Formal policies can also greatly lessen the stigma attached to mental health, increasing understanding and knowledge as well as motivating more people to get treatment. Furthermore, a comprehensive policy approach aids in the integration of social services, education, and physical health, all of which are linked to mental health and contribute to a more comprehensive approach to mental health care. The phenomenon of urban living, which is distinguished by its rapid pace, high levels of noise and pollution, and a conspicuous lack of green areas, has been associated with the aggravation of mental health disorders (Chen et al., 2021). The fast-paced and busy nature of urban environments, which frequently lack the presence of natural elements that promote relaxation, have a direct impact on the well-being, productivity, interpersonal connections, and general health of city dwellers. Urban green areas have been identified as a potential remedy in this context. Scientific evidence has demonstrated that being in natural environments can effectively alleviate stress, serve as opportunities for essential physical exercise, and create settings for social interactions and relaxation (Jamal, 2023).
Therefore, mental health is not solely a matter of personal or individual importance, but rather a substantial public matter that carries extensive consequences for society as a whole. As the body of evidence accumulates, the promotion of additional urban green spaces shifts its focus from mere city aesthetics to a proactive and vital intervention aimed at enhancing the mental well-being of our communities. In light of the significant importance of the prevailing mental health situation, it is crucial to accord priority and allocate resources toward urban green programs (Dey et al., 2023).
Why is a policy approach required?
The implementation of a comprehensive policy strategy is crucial in order to effectively tackle the complex and widespread societal problem of mental health. In this analysis, it will analyze the various rationales behind the significant impact of public policies in addressing mental health issues, beyond the scope of initiatives driven only by individuals and communities (Wickert et al., 2020).
The scope and scale of mental health concerns encompass a wide range of individuals throughout society, spanning various age groups, genders, socio-economic statuses, and cultural contexts. Although individual or localized solutions have their merits, they frequently prove inadequate in effectively tackling the magnitude of the issue at hand. Policies establish a structural basis for implementing interventions on a wider scale, enabling a greater reach among the population (ScienceDirect, 2021b). The Mental Health Strategy 2017–2027 emphasizes the importance of a policy approach because of the pervasiveness and profound effects that mental health problems have on people's lives and societies. It guarantees the distribution of essential funds for mental health services, such as prevention, treatment, and research. The process of standardization guarantees the preservation of care standards, promoting equal opportunities for accessing and providing mental health services of exceptional quality (Rokas Uscila and Dovil? Juodkait?, 2022).
The allocation of resources, including financial and human resources, is frequently influenced by public policies. Governments can effectively allocate resources to priority sectors by implementing a focused policy approach to mental health. This practice guarantees that sufficient financial resources, human resources, and physical infrastructure are allocated to mental health endeavors. The allocation of resources plays a crucial role in the establishment of a resilient and efficient mental health system (Bag et al., 2021).
Policies encompass a broader scope than just therapy by encompassing prevention and early intervention, both of which hold significant importance in the realm of mental health care. As an illustration, it is possible to implement policies that require the inclusion of mental health education into school curricula. This approach would serve to enhance emotional well-being among students and provide them with the necessary skills to effectively navigate and address their mental health concerns. Workplace mental well-being programs can serve as an additional component of early intervention, aiding employees in the management of stress and mental health concerns prior to their progression into more severe states (Zidaru, Morrow, and Stockley, 2021).
The establishment and modification of legal and regulatory frameworks through policies can serve to safeguard the rights and interests of individuals who experience mental health conditions. This may encompass the implementation of anti-discrimination legislation aimed at protecting individuals with mental health issues from discriminatory practices, guaranteeing equitable access to healthcare services, and upholding the confidentiality of patient information. The implementation of rules that offer legal safeguards is crucial in safeguarding the rights and preserving the dignity of those who face mental health difficulties (WHO, 2021).
The holistic approach recognizes the deep connection between mental well-being and other socioeconomic variables, such as education, employment, housing, and social services (Kühner, Lau, and Addae, 2021). Policies have the potential to promote a comprehensive approach by acknowledging the interdependencies between various factors and enacting solutions that effectively tackle mental health concerns within the wider framework of societal welfare. This approach acknowledges the interplay between mental health difficulties and social and economic concerns, emphasizing the need for treatments that effectively target these foundational determinants.
Accountability is a fundamental aspect of policy implementation, typically accompanied by structures designed to facilitate monitoring and evaluation. These systems are designed to ensure the achievement of the policy's objectives and offer insights based on data analysis to facilitate ongoing enhancements. Additionally, they are responsible for holding key institutions and stakeholders accountable for the successful implementation of mental health initiatives (Glonti et al., 2020). This includes ensuring that resources are efficiently utilized and that the desired impact is accomplished. The inclusion of long-term planning is a common feature in policy approaches. The current state of mental health difficulties needs a more comprehensive and long-term approach, as short-term and fragmented remedies prove inadequate. The implementation of a policy-oriented, enduring vision can serve as a foundation for the establishment of a sustainable framework for mental health care and assistance (Zidaru, Morrow, and Stockley, 2021).
Policies frequently emerge as a consequence of joint endeavors encompassing governmental entities, non-governmental organizations, experts, and the local populace. The utilization of a collaborative approach facilitates the attainment of a thorough comprehension of the matter at hand, as well as the development of initiatives that are holistic in nature. By engaging a wide range of stakeholders, policies can more effectively respond to the unique needs of persons with mental health difficulties and cultivate a feeling of ownership and community responsibility in solving this pressing matter.
The act of addressing mental health at the policy level serves as a significant indicator of the significance and validity of the matter, thereby enhancing public awareness and reducing stigma (Cheetham et al., 2022). Governments and institutions exert significant influence in influencing public attitudes. By placing emphasis on mental health within policy, policymakers indicate that it is a matter of utmost societal importance. However, this can have a significant impact on increasing societal consciousness, mitigating the negative connotations linked to mental health disorders, and fostering a proactive attitude towards seeking assistance and guidance.
The implementation of comprehensive, lasting, and standardized solutions to mitigate the significant social consequences of mental health necessitates the adoption of a systematic policy approach (Torous et al., 2021). This method guarantees the implementation of essential resources, safeguards, and support structures to address the varied requirements of individuals and communities grappling with mental health difficulties.
The United Kingdom possesses a rich and dynamic historical trajectory concerning legislative frameworks and strategies aimed at tackling mental health concerns. The policies and initiatives implemented in the UK have played a crucial role in establishing the mental health treatment and support environment (McGorry et al., 2022b). They demonstrate a dedication to enhancing the overall well-being of persons impacted by mental health difficulties.
The Mental Health Act of 1983, together with its later revisions, The Mental Health Act of 1983 is a fundamental legislative framework that governs the evaluation, therapy, and entitlements of those experiencing severe mental health conditions. The aforementioned legislation establishes the requisite legal structure for the involuntary detention and medical intervention of individuals in situations where it is deemed essential for their own welfare and the protection of others. Throughout its existence, the Act has been subject to various revisions in order to maintain its compliance with current standards of care and protection of human rights (Geovani et al., 2021).
The significance of preventive actions in mental health is emphasized in the Mental Health Foundation's Framework for Prevention. The focus is on therapies that aim to reduce the likelihood of mental health issues from occurring initially. This method acknowledges the need to proactively address mental health disorders, as it has been found to be more efficacious and resource-efficient compared to a reactive approach that waits until the difficulties reach a severe stage (Marx et al., 2022).
The mental health strategies of each constituent country within the United Kingdom are characterized by their distinctiveness, which is a reflection of the diverse healthcare systems and priorities that exist in each nation. In 2016, the NHS in England introduced the “Five Year Forward View for Mental Health” which presents a comprehensive vision and action plan aimed at enhancing mental health services within the healthcare system.
Scotland's 'Mental Health Strategy 2017-2027' states a comprehensive outlook for the forthcoming ten years centering on several facets of mental health and overall well-being. The 'Together for Mental Health' strategy in Wales is an initiative implemented by the Welsh government with the objective of improving mental well-being and tackling mental health concerns among the population of Wales (Hannigan, 2021).
In Northern Ireland, the suicide prevention plan known as 'Protect Life 2' and the 'Service Framework for Mental Health and Wellbeing 2019-2021' establish distinct guidelines and benchmarks for the delivery of mental health services.
The Green Paper on “Children and Young People's Mental Health” and the main point of this policy effort is the enhancement of mental health services for children and adolescents, with a specific emphasis on the school setting (García-Carrión, Villarejo-Carballido and Villardón-Gallego, 2019). This statement highlights the significance of providing timely intervention and assistance to young individuals who are facing challenges related to their mental well-being.
Public Health England regularly implements initiatives, campaigns, and resources with the objective of enhancing public awareness and fostering mental health promotion. The 'Every Mind Matters' initiative, for example, aims to promote increased mindfulness among adults regarding their mental health and offers a range of resources to facilitate mental well-being (Bladek, 2021).
The Thrive framework which has been implemented in various places, including London, presents a comprehensive approach to mental health treatment for children and young individuals. The mental health needs are classified into different stages, including 'Seeking Guidance' and 'Seeking Further Assistance,' to ensure that individuals are provided with a suitable amount of assistance.
The toolkit is used for the “Joint Strategic Needs Assessment (JSNA)” on Mental Health and Wellbeing. The provided toolkit serves as a helpful resource for local authorities and the National Health Service (NHS), facilitating the evaluation and resolution of mental health requirements within their respective populations (Baska et al., 2021). This facilitates the customization of mental health care to suit the distinct needs of each geographical region.
The Crisis Care Concordat which was established in 2014 is a comprehensive national agreement that encompasses many services and entities responsible for providing care and assistance to those experiencing crisis situations. Specific policy approaches, each focusing on a particular area of mental health care and administration, play essential roles in addressing mental health. The goal of preventive policies is to avoid mental health problems by raising public awareness, implementing educational activities, and supporting community-based projects that lessen isolation. Treatment and Access policies guarantee that people can receive mental health services; these include financing for mental health clinics, training for professionals, and insurance coverage for therapies. Another important strategy is the integration of mental health services with primary healthcare, which promotes comprehensive treatment by recognizing the link between mental and physical health. Integrated Care Systems (ICSs) refer to collaborative partnerships that aim to integrate healthcare services by bringing together providers and commissioners of National Health Service (NHS) services, in conjunction with local authorities (Das-Thompson et al., 2020). The primary objective of ICSs is to effectively address the health requirements of the local population through the seamless integration of care. Incorporated within the healthcare ecosystem are provisions that encompass mental health treatment as an essential component.
The assortment of policies and frameworks in question collectively exemplify the United Kingdom's dedication to completely tackling mental health, encompassing prevention, treatment, and a holistic approach that takes into account many societal causes. The aforementioned statement elucidates the dynamic nature of mental health comprehension and emphasizes the imperative of collaborative endeavors spanning several domains to foster the overall welfare of persons within the nation (Disu, 2023).
Which approach are you advocating and why?
The data provided suggests a significant increase in the occurrence of mental health issues in children and young adults, highlighting the importance of evidence-based prevention strategies. The need for preventive interventions is underscored by this. The Mental Health Foundation's Framework for Prevention and the Prevention Concordat for Better Mental Health place emphasis on interventions aimed at averting the onset of mental health issues. By prioritizing prevention strategies, the United Kingdom can adopt a proactive approach to effectively tackle anticipated difficulties, thereby alleviating the strain on healthcare systems and enhancing the overall welfare of society (Singh, Kumar, and Gupta, 2022).
The provision of integrated care is essential for the comprehensive treatment of mental health since it recognizes that mental health is not an isolated phenomenon. The phenomenon under consideration exhibits a profound interconnection with a multitude of sociological, economic, and physical health issues. Integrated Care Systems (ICSs) are characterized by their emphasis on fostering collaboration among many stakeholders, including providers, commissioners, and local authorities, in order to provide a more comprehensive and inclusive approach to addressing mental health concerns (van der Feltz-Cornelis et al., 2023). By taking into account all the dimensions of an individual's life, integrated care systems (ICSs) have the potential to offer a more comprehensive and tailored approach to healthcare.
Theoretical approaches
Social Determinants of Health
This theory states that a person's mental health is greatly influenced by outside factors in addition to personal decisions and inherited predispositions. The outcomes of mental health can be significantly impacted by social determinants of health, including cultural background, social support, work, education, and money. This paradigm informs policies that aim to improve the mental health environment and address larger socioeconomic injustices (Bosqui, 2020). They concentrate on programs that try to lessen economic disparity, enhance educational chances, offer steady work, and promote a feeling of community because these things can all help people's mental health on an individual and societal level.
Cognitive Behavioural Theory
This theory has had a significant influence on how psychology and mental health services are provided. It focuses on the complex connections that exist between a person's ideas, emotions, and actions. Cognitive-behavioral therapy (CBT), a popular and successful method for treating a range of mental health conditions, is based on this notion (Psycnet, 2019). The foundation of CBT is the idea that a person's ideas and beliefs have a big impact on their feelings and actions. People's mental health can improve by recognizing and changing unhealthy thought patterns and behaviors. By enabling people to comprehend and control their thought processes, cognitive behavioral theory eventually promotes better emotional and psychological health (Stallard, 2019).
Psychoanalytic Theory
Rooted in the pioneering work of Sigmund Freud, psychoanalytic theory delves into the profound influence of the unconscious mind on human behavior. This theory posits that early childhood experiences and inner conflicts, often hidden from conscious awareness, significantly shape an individual's mental health and personality development (Heinonline, 2021). While contemporary psychology has evolved beyond many of Freud's specific ideas, psychoanalytic theory continues to emphasize the role of unconscious processes, unresolved conflicts, and the importance of early life experiences in understanding mental health issues. It provides a framework for exploring the deeper layers of an individual's psyche, shedding light on underlying emotional issues that can impact mental well-being.
Attachment Theory
Proposed by John Bowlby, attachment theory highlights the critical role of early relationships and attachments in shaping an individual's emotional well-being and future relationships (Rohani, Jamaluddin, and Manaf, 2019). It asserts that secure attachments in infancy and childhood lay the foundation for healthy emotional development, while disruptions in these attachments can lead to emotional challenges in later life. Attachment theory informs our understanding of how early experiences with caregivers influence an individual's ability to form and maintain relationships, as well as their emotional regulation and overall mental health (Genc and Arslan, 2022). Recognizing the significance of secure attachments, it can be stated that the importance of nurturing early relationships is to promote positive mental well-being throughout one's life.
Presentation
Why Is This a Public Issue?
It is critical to recognize that a person's diagnosis may vary throughout the course of their lifetime, creating a complex web of needs for mental health services (Reynolds et al., 2022).
Moreover, a further degree of complexity is added by specific mental illnesses, such as schizophrenia, bipolar disorder, borderline personality disorder, antisocial personality disorder (ASPD), and BPD (Dudeni, 2021).
The Office for National Statistics (ONS) surveillance program demonstrates the epidemic's major impact on mental health (Waite et al., 2021).
The COVID-19 epidemic has become a worldwide stressor, affecting several aspects of human life, such as health, economics, and social relationships. The hectic and fast-paced metropolitan surroundings, which often lack natural features that encourage relaxation, have a direct effect on city people's overall health, interpersonal relationships, productivity, and general well-being. In this situation, urban green spaces have been suggested as a possible solution. Research has shown that spending time in natural settings can be a beneficial way to reduce stress, provide chances for important physical activity, and foster social connections and relaxation. Policies pertaining to workplace mental health are becoming more and more crucial, with the goal of fostering a friendly work environment and offering resources to staff members.
Why is a policy approach required?
To properly address the intricate and pervasive social issue of mental health, a comprehensive policy approach must be put into place.
In the field of mental health, standardisation is essential since it guarantees the provision of high-quality, consistent care (Cheetham et al., 2022).
Further policy measures are essential to further improve the efficacy of mental health interventions.
Laws that protect the rights and dignity of people with mental health disorders are essential; they promote nondiscriminatory behavior and the integration of people with mental health disorders into all facets of society.
Policies can better address the special needs of people with mental health issues and foster a sense of community ownership and responsibility in resolving this urgent issue by involving a broad variety of stakeholders. The Mental Health Foundation's Framework for Prevention places a strong focus on the importance of preventative measures for mental health. The 'Protect Life 2' suicide prevention plan and the 'Service Framework for Mental Health and Wellbeing 2019-2021' set specific standards and principles for mental health service delivery in Northern Ireland.
Which approach are you advocating and why?
The available data indicates a noteworthy rise in the prevalence of mental health disorders in juveniles and young adults, underscoring the significance of evidence-based preventive tactics (Barton and Rogerson, 2017).
Among these is enhancing community-based care through the creation of nearby mental health services that are less stigmatizing and more easily accessible than those provided by hospitals.
The UK can take a proactive stance in addressing predicted challenges by giving priority to prevention efforts (Thatcher, Nayak and Waterson, 2019).
This would reduce the burden on healthcare systems and improve the general well-being of the population. Since integrated care acknowledges that mental health is not a singular occurrence, it is crucial for the all-encompassing treatment of mental health. The phenomena in question demonstrate a close relationship with numerous sociological, economic, and physical health concerns. Integrated Care Systems (ICSs) are distinguished by their focus on promoting cooperation among numerous stakeholders, including commissioners, providers, and local governments, to offer a more inclusive and thorough method of managing mental health issues. Moreover, digital health policies are emerging, focusing on the use of technology and telehealth services to expand access to care, especially in remote or underserved areas.
Theoretical approaches
Since early detection and treatment can greatly enhance long-term outcomes, it is particularly critical to emphasize early intervention and youth mental health services.
This concept emphasizes the significance of social variables in determining the well-being of individuals and society as a whole (Torous et al., 2021).
It recognizes that in addition to individual choices and genetic predispositions, external influences can have a significant impact on an individual's mental health.
The provision of psychology and mental health services has been greatly impacted by this theory. It focuses on the intricate relationships that exist between an individual's thoughts, feelings, and behaviors. Rooted in the pioneering work of Sigmund Freud, psychoanalytic theory delves into the profound influence of the unconscious mind on human behavior. According to this view, an individual's mental health and personality development are greatly influenced by early childhood events and inner conflicts, which are frequently concealed from conscious awareness. According to John Bowlby, attachment theory emphasizes the significance of early connections and attachments in determining a person's mental health and interpersonal interactions in the future (Dey et al., 2023). It makes the claim that stable attachments during early life provide the groundwork for a child's healthy emotional development and that emotional difficulties in later life can result from the disruption of these attachments.
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