Public mental health and wellbeing has gathered greater currency following the publication of No Health without Mental Health in 2011. Public health is about improving the health of the population through preventing disease, prolonging life and promoting health. Local Authorities are now the public sector organisation with lead responsibility for public health and public mental health. This shift provides a platform for a more integrated approach to improving public health outcomes and an opportunity for a wider range of community resources to be utilised to promote improved health.
The Reading Well Books on Prescription scheme provides self-help reading for adults based on cognitive behavioural therapy (CBT) for a range of common mental health conditions including anxiety, depression, phobias and some eating disorders. The scheme has recently been highlighted by the Joint Commissioning Panel for Mental Health. It is delivered in a partnership between the Reading Agency and the Society of Chief Librarians with support from the Royal Colleges of Psychiatrists and GPs, the Department of Health and other professional bodies.
Libraries are important to their communities. This is perhaps best demonstrated by the large number of campaigns and initiatives across the country to maintain and run them on behalf of local people. Not only can they help to promote literacy and learning in the traditional educational sense, but they can also play a leading role in promoting good mental and physical health. They can provide access to health information in a non-health setting that for some, will be less intimidating or stigmatizing than a GP surgery, hospital or other health setting.
The Reading Well Books on Prescription Scheme is part of an ‘early intervention’ programme, that builds upon work done by Professor Neil Frude in Cardiff. The scheme has been running in Wales since 2005, is being used in Devon and Croydon and will launch across England next month. Books are recommended by health professionals and can be borrowed from libraries free of charge. For example a GP might prescribe a self-help book for someone they might not yet want to refer for talking therapy or while they are waiting for that service or treatment. The books are also available for loan without prescription. They offer a quality assured resource that has been endorsed by national experts and there are now over 30 titles (PDF).
The evidence for the effectiveness of self-help approaches has been highlighted by NICE, who have recommended CBT based self help approaches as a first step in the treatment of many common mental health disorders.
Enabling people to help themselves is not only empowering for individuals, it helps them to take responsibility for their own mental and physical wellbeing. Prevention and early intervention are part of this drive to ensure more person-centred care that is determined by the individual.
Commissioning managers in the NHS and social care who make decisions about what services should be provided are looking for innovative ways to prevent mental ill health. In part this is driven by a need to focus on intervening early to promote improved mental health and wellbeing. From a purely economic point of view, investment in effective prevention makes sense as they seek to ensure good value for the public purse. The argument is not only economic however, as effective prevention can significantly improve outcomes for individuals and increase the overall resilience of the population.
Enabling self-help, in this case by purchasing the books for people to access in libraries, is not a substitute for the provision of high quality specialist services, but it could be a useful starting point in making the shift in investment that is needed to promote improved mental health and wellbeing. It is important to bear in mind that such a service will not be of use to everyone and care will need to be taken to ensure that self-help is an appropriate way for an individual to understand and explore their experiences and find solution to their particular issues.
A diverse range of support that is easily accessible in different community settings is what people want. Giving access to information and encouraging people to take control of their mental health and wellbeing through effective self-help resources is public mental health in action.
Reading well books on prescription scheme. Joint Commissioning Panel for Mental Health website, accessed 20th May 2013.
Guidance for commissioning public mental health services (PDF). Joint Commissioning Panel for Mental Health, Dec 2012.