What is the mission of mental health services — and why does this matter?
Oxfam’s mission is: “to help create lasting solutions to the injustice of poverty.”
Amnesty International’s mission is: “to undertake research and take action focused on preventing and ending grave abuses of human rights.”
The TED Foundation’s mission is simply: “spreading ideas”
These are complicated organisations facing very complicated tasks — but articulating what they are for in a way which is simple and powerful. What should the mission of mental health services be? Not just your organisation, which may be very generalist or very specialist — but mental health services’ overall role and purpose in society. What should we be working together to achieve?
There are twenty possible roles listed here for mental health services. All form (or have formed) part of the task of groups and organisations working in mental health. Some of you may recognise and readily agree with; others you may disagree with. For each of the twenty roles, ask yourself:
· Should this form part of the mission of mental health services at all?
· If so, why? If not, why not?
· If this should form part of the mission of mental health services, should it be an essential part of that mission, to be protected and prioritised? Or a “nice-to-have” if we have the resources to do it?
· Why is this essential? Or why is this only a “nice-to-have”?
· If your answer to a question is “it all depends” — on what, and why?
Here are the twenty roles:
1. Caring for and treating people whose mental health problems mean they present a risk to their own health or safety
2. Helping people who have addictions to overcome their addictions
3. Ensuring that people who have mental health problems and break the law are helped instead of punished
4. Supporting the families of people who have mental health problems
5. Helping people to avoid behaviour which society considers sexually deviant
6. Helping people facing difficult life events (for example bereavement, divorce, unemployment, debt) to think through how best to deal with them
7. Helping people with mental health problems to find somewhere suitable to live
8. Helping people with mental health problems to find or keep a job
9. Helping people with mental health problems find or keep a place in a school, college or university
10. Trying to change the beliefs and behaviours of people whose views society considers politically or religiously extreme
11. Caring for and treating people whose mental health problems mean they find it difficult to maintain the daily life they hope for
12. Stopping people committing suicide
13. Protecting the public from people whose mental health problems mean they present a risk to other people
14. Helping people with mental health problems to find or maintain a circle of friends
15. Helping people with mental health problems to take up or maintain a healthy lifestyle — exercise, diet, drinking, smoking
16. Helping people to adjust to serious physical health diagnoses — for example, cancer, or heart disease, or diabetes.
17. Advising and training staff of other services how best to work with people who have mental health problems
18. Campaigning to reduce the stigma faced by people who have mental health problems
19. Helping people to understand and protect their own mental health
20. Increasing the mental health and mental wellbeing of the whole community
Which roles emerge from this as your priority ones for mental health services? What does that mean for our overall mission? What does that mean for your organisation and its priorities?
This matters because the expectations of mental health services are increasingly complex, and perhaps increasingly diverse. Responsibilities have moved over time from the separated worlds of asylums to a gradually more integrated role in wider society. Some of these roles are readily compatible, some are more difficult to combine — certainly difficult for a single organisation, and perhaps difficult philosophically and practically for “mental health” as a sector. And the things for which mental health services are held to account are not necessarily the things which would from the central part of any mission.
Any plan, strategy, or target for mental health services will — either explicitly or implicitly — be driven by an understanding of our mission. Service specifications routinely describe at the beginning the purpose of the service in question — who it is for, who it is not for, and what it is intended to achieve. Perhaps a better shared understanding of that “specification” for the whole of mental health services would put us in a clearer position to agree what matters most, and how it should be developed next.
