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Mental Health NSF - Key facts:

• One in six adults in Great Britain suffer from mental illness at any one time
• Suicide rates are now at their lowest recorded level in England

Introduction
What does the NSF do?
What does the NSF mean for you?

Introduction

Even in modern society, mental illness carries a stigma - it is not well understood by most people and many people fear it. Yet as many as one in six adults in England, Scotland and Wales suffer from some form of mental illness - making the condition as common as asthma.

The publication in 1999 of the National Service Framework (NSF) for Mental Health marked a huge turning point for patients and the NHS and social care professionals who care for them. It puts mental illness on par with other priority conditions such as cancer and heart disease and sets clear quality requirements which every NHS and social care organisation needs to aspire to and meet.

What does the NSF do?

The overall aim of the NSF is to drive up the quality of mental health services for adults up to the age of 65, and reduce the unacceptable variations which have excluded some people - such as those from ethnic minorities - and left them to cope without the full range of care they need.

The NSF sets out seven standards relating to:

• The promotion of better mental health for everyone
• Improved access to mental health services in primary care
• More effective care for people with mental health problems
• Better support for those who care for people with mental illness
• Bringing down the suicide rate by at least a fifth by 2010.

The first five years of the NSF were focused largely on improving specialist care, including the development of specialist community mental health teams offering home treatment, early intervention to prevent a crisis occurring and intensive support for people with the most complex needs. The next five years will see this focus widen to look at the mental health needs of the community as a whole.

What does the NSF mean for you?

For everyone: The NSF is giving rise to a series of national and local campaigns to counteract the stigma and discrimination associated with mental illness. It's a powerful stigma which can make people with mental health problems reluctant to seek the help they need. It also means they are less likely to be in employment.

• In June 2004, the National Institute for Mental Health England (NIMHE), launched a five-year plan to raise awareness of mental illness especially among employers, young people and the media. A 'speaker's bureau' initiative, for instance, is training and supporting those affected by mental illness to talk to the media and take part in training programmes.

For all adults with mental illnesses: The NSF requirement is for primary care - for instance your family GP practice - to offer high-quality and accessible services to assess, treat and, if necessary, refer people to more specialist care. And, with fewer than a quarter of adults with long-term mental health problems in work, local initiatives set up to help people get back to work are having an important impact.

• A national network of 'Gateway' workers has been introduced to co- ordinate prompt access to mental health care.
• New graduate mental health workers are now in post in primary care teams across the country. They are offering first-line treatment and support to patients and significantly increasing the quality of care available to people in a community setting.
• There is a steady increase in local support services aimed at helping people with mental health problems gain employment or access social, educational and community activity. The First Step Trust in Lambeth, South London, for instance, is enabling people with mental illness to take part in small business projects and trade with the local community.
• The first national Suicide Prevention Strategy for England was published in 2002, bringing together health and social care agencies, the voluntary sector and others to spearhead efforts to reduce the suicide rate by at least a fifth by 2010.

For patients needing crisis or specialist care: The NSF stipulates that these patients should have a personalised and responsive care plan and access to 24-hour services whenever they need them.

• Assertive outreach teams are now in place to offer proactive care in communities for people with the most complex health and social care needs.
• Multi-disciplinary crisis resolution teams are operating 24-hour services and offering patients who are in crisis quicker assessment and treatment in their own homes.

For people from Black and minority ethnic minority backgrounds: The NSF stresses the need to improve mental health services for Black and minority ethnic (BME) people. The Department of Health has now published Delivering Race Equality in Mental Health Care - a five-year action plan for tackling discrimination and achieving equality in services for BME patients and communities. Among the key actions in the plan are:

• Trailblazing Focused Implementation Sites - 17 Strategic Health Authorities are now hosting projects to identify and spread best practice.
• 500 new community development workers are to be appointed to build bridges between services and their local communities.
• A new annual census of mental health patients has been established to provide data on exactly what mental health problems people have and what sort of help and care they are being offered.

For carers: The NSF highlights the need for services to recognise the vital role carers play and more investment is now going into services to support them.

• Spending on carer's grants and breaks is increasing.
• A network of 700 carer support workers is now in place across the country.

The NSF in detail

To view the NHF for mental Health and progress reports see the Mental Health pages on the Department of Health website.