Greater Manchester Devolution - A Chance for Mental Health Revolution

  • Dr Sandeep Ranote
  • 04 December 2017
  • Posted in: Health & Social Care

Revolution means change when it is desperately needed. As history tells, it only takes small things to motivate us to join together, overcome adversity and rise up to fulfil our potential. The NHS is under unprecedented pressure and within this mental health continues its battle to ensure that it is embedded in all health and care services despite its disproportionately underfunded history. With 1 in 4 adults now affected by mental illness, mental health problems are the largest single cause of disability in the UK. It is time for this to be our nation's priority and perhaps the time for its people to fulfil this potential and where better to shine the spotlight, than with our children, at the start of life's pathway and by doing so pave the way for a brighter and healthier future.

"Mental health problems are the largest single cause of disability in the UK."

In Victorian England our children were "seen but not heard." In contemporary England they have become "visible with a voice", in our future Digital England it is time to ensure that they are "partners that participate." Never before has the voice of young people been so important. 1 in 10 young people have a diagnosable mental health condition, that's roughly 3 young people in every classroom in England. But only a quarter of these young people are able to access the treatment and care that they so vitally need. We know that 75% of all adult mental illness begins before the age of 18 years so early intervention is not only vital, but could prevent conditions from becoming chronic, long term and disabling into adulthood.

Future In Mind, published in 2015 and supported by The 5 year Forward View for Mental Health, 2016, provides us with an excellent blueprint to connect the disconnected system and redesign our mental health and emotional wellbeing services for young people & families through local transformation plans (LTPs) across each clinical commissioning group area in the country. Supported by additional government investment, we must shift away from a tiered model of care to one where the whole system can meet the needs of the whole person and the whole family. We need an emphasis on building resilient communities by utilising the assets within them and the milieu of the young person, to develop a truly integrated service, and one that is close to home.

"The whole system must come together, work together and stay together."

To achieve this the whole system must come together, work together and stay together. A system where a shared language is developed to achieve our common goal of improved emotional health for young people. It is important to recognise the vital role of our clinical leaders with experience and expertise in care and treatment of mental health conditions. Moving forward, we must encourage a culture of whole system contribution to the local transformation plans. Research demonstrates that better clinical engagement means improved service quality, safety and outcomes for young people. We continue to support the importance of shared decision making with our patients in treatment and we must now support shared decision making with our clinicians in developing and delivering care. This will place value in the clinical voice alongside the skills and knowledge of our commissioners, and the views of young people & families. This true collaboration by all is what can create the mentally healthy eco-system for the future.

Greater Manchester pioneered the industrial revolution and we believe it could pioneer our mental health revolution. With a £134 million mental health investment proposal and 60% of this to support children and young people, the Greater Manchester health and social care partnership has a unique opportunity to radically transform the way we deliver and develop children and young people's mental health services. This has already been demonstrated in its first year by the success of a Greater Manchester young people's community eating disorder network of services working in partnership with the charity BEAT, ADHD being approached in the same way and plans for crisis care redesign across the devolved region.

"Where better to begin this journey than with our children and young people." 

In addition, we will see the development of a Greater Manchester THRIVE training hub to support the training and development of the whole system with a shared language and model, one which creates a connected pathway from prevention to prescription. This allows us to move away from a culture of illness to one of wellness where we are now seeing the voluntary and community sector working in partnership with health, social care and education. Where better to begin this journey than with our children and young people. For the first time, we can work together as a whole system to build a conurbation where our children do not just survive - they thrive. After all, they are one third of our population, but all of our future!

  • mental health
  • devolution
  • Greater Manchester
  • Article Author

About Dr Sandeep Ranote

Dr Sandeep Ranote is a Consultant Child and Adolescent Psychiatrist leading young people's eating disorder services and Director of clinical networks at North West Boroughs NHS Foundation Trust. She developed the award winning medical skin camouflage service for promoting recovery in self-harm in partnership with Changing faces charity and is now c…