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Presidential Blog

Prevention in mental health demands equity and justice

30 November 2016 | by Peter Kinderman

Following Brexit and the election of Donald Trump, in the era of benefits sanctions and with the shadow of the extreme Right in French presidential elections, we would be wise to remember the human consequences of social disadvantage.

Professor Sir Michael Marmot, Director of The UCL Institute of Health Equity, Professor Richard Wilkinson, Professor Kate Pickett and my own colleague Professor Dame Margaret Whitehead have all spoken powerfully about how social disadvantage affects our health.

To quote Professor Marmot; “All societies have social hierarchies in which economic and social resources, including power and prestige, are distributed unequally. The unequal distribution of resources affects people’s freedom to lead lives they have reason to value, which in turn has a powerful effect on health and its distribution in society”.

We can see these issues of practical health policy and social justice in the city of Liverpool, where the life expectancy of people born into the wealthiest ward is 10 years greater than that of people born into the poorest.

We can also see it – even closer to home, in some ways, for me personally – in the 10 to 15 year gap in life expectancy for people with a history of serious mental health problems.

I have always maintained that:

to promote genuine mental health and well-being we need to protect and promote universal human rights, as enshrined in the United Nations’ Universal Declaration of Human Rights. Because experiences of neglect, rejection and abuse are hugely important in the genesis of many problems, we need to redouble our efforts to protect children from emotional, physical or sexual abuse and neglect.

More generally, if we are serious about preventing mental health problems from developing, and about promoting genuine psychological well-being, we must work collectively to create a more humane society: to reduce or eliminate poverty, especially childhood poverty, and to reduce financial and social inequalities.

For us as psychologists, then, prevention means more than looking to the individual and his or her behaviour – whether in crime, employment, physical health or psychological wellbeing. It means looking to the social and structural forces that shape and constrain our choices and behavior – even thought.

I say all this to place into context the rather welcome challenge set by EFPA - the European Federation of Psychology Associations – through their Board on Prevention and Intervention that the British Psychological Society and other national bodies report back on steps undertaken to raise the issue of preventative approaches in healthcare and elsewhere and the contribution that psychology can make.

This is a challenge that we should embrace.

I am fortunate in that close colleagues (Professor Margaret Whitehead, Professor Jason Halford and Professor Daryl O’Connor all in different ways) are models of good practice in this regard.

But as members of the BPS, we could all do much more to think about prevention in our work.

With partners like the Faculty of Public Health and the Mental Health Foundation , and with all of our colleagues over time, I hope that prevention, and an approach to prevention rooted in an appreciation of the social context, and the links to social justice, will become a key element of our policies in the future.

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