Thursday 15 March 2012


click on the Chart for a more legible image

As the Welsh Government drafts its new Mental Health Strategy it could do worse than focus on the win-win potential of recovery as the way forward for people with a mental illness which not only delivers what they and their families want but also the most cost-effective results.

To illustrate this take a look at Hafal's nifty Cost-Recovery Chart above which illustrates that even modest progress by patients can save substantial sums, thereby releasing funding for new patients and potentially creating a virtuous circle of success with improved recovery leading to yet further improved services.

It's also worth noting that concentrating resources on recovery for people with the highest needs is a vastly more cost-effective way to deploy resources compared with prevention though that of course has a place in the Strategy.

The problem with preventive approaches is that to date nobody has found reliable predictors, still less prophylactic measures which could prevent most serious mental illnesses - a quite different story to (say) heart disease where there is plenty which can usefully be done.

There is certainly an argument for engaging the wider population in basic understanding of mental illness so that they can respond intelligently and without discrimination to people who are ill and when they or their loved ones become unwell. But there is no useful function for mental health services or the government in telling well people how to stay happy and content - on the contrary the language of mental health services is particularly disempowering and unhelpful to people trying to get on with their lives (see this post).

Of course I mean prevention in the pure sense: early intervention when symptoms first manifest themselves can be very effective (and cost-effective) and should be a core element in the Strategy.

So there is no dilemma on this. The Minister of Health Leslie Griffiths has correctly said that the priority for health and social services should be those with the highest needs; in the case of mental health the economics say likewise.