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Author of the UK government’s mental health strategy gives an insider’s perspective on how to make change in mental health care happen

As the man who wrote the UK government’s mental health strategy, No health without mental health, Paul Burstow knows better than most how to transform ambitions to reform mental health care into reality. The Member of Parliament for Sutton and Cheam and former care services minister spoke to Salzburg Global during the session New Paradigms for Behavioral and Mental Health Care about what he learned from his time in government.

“I think having the opportunity of being on the inside, you have a better idea of how it works, and therefore what the touch points are that can actually make change happen,” he said. “I think there are two things that are really important. One is the power of social movements. The second is having greater transparency and measurement of outcomes being one of the things that is a pull factor.

“So you need to have political leaders who are seeing the economic and moral case and are able to act on that. The most rapid progress happens where you get both social movements pushing and political leaders pulling in the same direction.”

The mental health strategy Burstow authored emphasized parity of esteem between mental and physical health, a lesson he feels developing countries would do well to follow and avoid the expensive mistakes of the West.

“The biggest thing we can teach is not to follow what we have done, because what we are busily doing in Western mental health systems is deconstructing them and trying to find ways to reintegrate them into the whole health care system, so we do not have set silos. That is a very costly thing to do in a mature health system, so do not do that. Avoid those costs by never separating in the first place, making sure your training and so on never separates."

Another piece of advice he has for those working to improve mental health care and service is “to challenge societal attitudes to mental health itself. Anti-stigma, anti-discrimination is a precursor to more rapid progress in terms of delivering the right sort of services,” he explains.

After leaving government in 2012, Burstow chaired the Commission on Mental Health at think tank Centre Forum. Following the publication of the commission’s report in July 2014, he continues to look ahead to the future of mental health care in the UK.

“I am optimistic, because I think now we have a series of well-proven innovations that are beginning to be implemented more consistently. I think we have some important reforms to payment mechanisms in the UK that are coming, not least the creation of a thing called The Better Care Fund, which is integrating health and care budgets and forcing integration between physical and mental health. Over the next four to five years that will be a very powerful driver for change.”

Burstow is cautiously optimistic about the potential benefits of the increasingly connected “Big Data” society, the subject of forthcoming session The Promise of Data: Will this Bring a Revolution in Health Care? However, he recognizes the risks of sharing ever-increasing volumes of patients’ personal data must be considered carefully.

“In my time as a politician, I have never found a silver bullet and I think there is no such thing.

“I think Big Data has a very important part to play in informing population level commissioning of health services and enabling those that are allocating resources and arranging services to think in those big picture terms.

“The issue is making sure that data is available to those people, and we are grappling with that in the UK at the moment. We have a program called Care.Data and that program is stalled because of fears of misuse of the data. So getting that right is very important.”

Paul Burstow was a participant at the Salzburg Global program New Paradigms for Behavioral and Mental Health Care, which is part of the multi-year series Health and Health Care Innovation in the 21st Century. The session was hosted in partnership with the Dartmouth Center for Health Care Delivery Science. More information on the session can be found here: www.salzburgglobal.org/go/536.