Improving mental health outcomes

Within our society there has been a long-standing lack of parity between mental and physical health, with those suffering from mental health issues often experiencing stigma and discrimination. Luckily this is beginning to change. In 2013, the Minister for Care Services, Norman Lamb, campaigned for parity of esteem between mental and physical health, following a report produced by the Royal College of Psychiatrists (Department of Health and The Rt Hon Norman Lamb, 2013). The report set out the rationale for a parity approach to mental and physical health, and made recommendations for how parity can be achieved, predominately in health and social care (Royal College of Psychiatrists, 2013). More recently, newly elected leader of the Labour party, Jeremy Corbyn, has created a dedicated Minister for Mental Health in his shadow cabinet. Liverpool Wavertree Labour MP, Luciana Berger, is the first to be appointed to this role. However, there is currently no equivalent position in the Conservative party.

Around 20% of the world’s population have mental disorders or experience mental health problems, with half of mental disorders beginning before the age of 14 years (World Health Organization (WHO), 2007). Additionally, it is estimated that around 800 000 deaths by suicide occur each year (WHO, 2014). However, it is argued that this is a conservative estimate due to the stigma associated with suicide, lack of reliable death recording procedures, and religious or legal sanctions against suicide in some countries (WHO, 2014). It is apparent that mental health forms a large portion of demand on health services worldwide, and should therefore be made a higher priority on the global public health agenda.

In March, NHS England launched an independent taskforce whose role was to develop a 5-year national strategy to improve mental health outcomes across the NHS. The subsequent strategy interim report, published in September, set out how national bodies will work together between now and 2021 to help people have good mental health and make sure they can access evidence-based treatment rapidly when they need it. In the report it was recognised that parity between physical and mental health is necessary but not sufficient, and that the huge variation in access to services between different groups of people must also be tackled (Mental Health Taskforce, 2015).

World Mental Health Day is observed on 10 October every year, with the overall objective of raising awareness of mental health issues around the world and mobilising efforts in support of mental health. This year the theme is ‘Dignity in Mental Health’. For more information, or to find out how to get involved, visit:


Department of Health, The Rt Hon Norman Lamb (2013) Achieving parity of esteem between mental and physical health. The Stationery Office, London

Mental Health Taskforce (2015) The Five Year Forward View Mental Health Taskforce: public engagement findings. (accessed 27 September 2015)

Royal College of Psychiatrists (2013) Whole-person care: from rhetoric to reality. Achieving parity between mental and physical health. Summary. RCPsych, London

World Health Organization (2007) 10 facts on Mental Health. WHO, Geneva. (accessed 28 September 2015)

World Health Organization (2014) Preventing suicide: A global imperative. WHO, Geneva. (accessed 28 September 2015)

Taken from Journal of Paramedic Practice, published 2 October 2015.

Mental health and older people

World Mental Health Day was initiated by World Federation for Mental Health (WFMH) in 1992 to highlight the importance of mental health. This year, the WFMH Board of Directors decided on the theme of “Mental Health and Older Adults”. Running on 10 October, the day focused on highlighting the mental health issues experienced by older people in their communities, and encouraged people to consider their needs for support and services.

There is no denying that people are gradually living longer, as improved healthcare and standards of living have made this possible. In fact, the

current number of people aged 60 years and over is more than 800 million, and projections indicate that this figure will increase to over two billion by 2050 (World Federation for Mental Health, 2013). It is thought that people aged 60 years can now expect to survive an additional 18.5 to 21.6 years (United Nations Population Fund, 2012). According to this statistic, soon the world will have a higher number of older adults than children.

It is therefore of the utmost importance that healthcare systems evolve so that they can manage this changing demographic. Increased awareness and education of common mental health problems of the elderly is a means in which this can be achieved. Whilst many associate elderly mental health problems simply with the effect of diseases such as Alzheimer’s, there are far more elements to bear into consideration.

Depression is common in old age. Whether this is related to grief at the loss of a close friend or member of family, anxiety as a result of a fear of approaching the end of life, or due to mistreatment by family or carers and a subsequent feeling of helplessness, these are just some of the many potential contributing factors that may affect the mental wellbeing of an older person.

For paramedics, there are many situations where they may be dealing with patients approaching the end of life. While this is not limited to older people, it is likely that they will make up a notable part of this group. As Mike Brady (2013) discusses in this issue of the Journal of Paramedic Practice, while paramedics may be comfortable with the practical and clinical elements of practice associated with a patient facing imminent death, such as pain relief, the conceptual and philosophical elements may be less well known.

Brady’s article highlights the importance of ensuring end of life patients receive what he terms a “good death”. While this is undeniably important, the general mental wellbeing of the elderly before they approach the end of life cannot be ignored. As mental health problems can have a high impact on an elderly person being able to carry out even the most basic of activities, awareness of any means to reduce these negative consequences is of great significance.


Brady M (2013) A good death: key conceptual elements to end of life care. Journal of Paramedic Practice 5(11): 624–31

United Nations Population Fund (2012) State of World Population 2012—By Choice, Not By Chance: Family Planning, Human Rights and Development. UNFPA, New York

World Federation for Mental Health (2013) Mental Health and Older People: World Mental Health Day, October 10 2013. WFMH, Occoquan, Virginia

Taken from Journal of Paramedic Practice, published 4 November 2013.