In the 1970s, cancer was stigmatised and support was underfunded. We have come a long way since then – albeit with road still left to travel. A key factor in this turn of fortune was hope that things could be a lot better for people living with cancer. That hope is often missing from discussions on mental health. But it is there.

You are right to flag some key issues in mental health in your editorial (The Guardian view on mental health: this emergency requires a response, 12 April). We are still some way off parity of esteem, there are problems in ensuring that the workforce is in place to meet demand, and there are genuine concerns about the prevalence of severe mental illness in young adults. But what the editorial didn’t mention was that there is a quiet revolution under way, led by the NHS and supported by the charity sector and public bodies, to transform community mental health services.

What this transformation recognises is that as much as access to clinical services is important, so too is access to social care, good housing and employment, and volunteering opportunities for people severely affected by mental illness. Improving clinical services, while necessary, will neither prevent mental illness nor adequately support those severely affected on its own. It must be matched by efforts to challenge a punitive welfare system, confront racism and discrimination, and ensure adequate funding of social care.

We know that when people are provided with the right support that meets all their needs, they can manage and live with mental illness. Hope exists. We need to provide it to many more people.
Mark Winstanley
Chief executive, Rethink Mental Illness

It is indeed scandalous that the pandemic has most brutally affected the mental health of children, NHS and social care frontline staff, and citizens from ethnic minority backgrounds, leaving many without timely access to skilled support. To tackle this head-on, we need significant investment in psychological therapy resources, but we also need leaders with vision and creativity.

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The best evidenced therapies or medications only help a certain proportion of people. Research by those with mental health problems shows that for many, an environment that provides a network of healthy relationships characterised by mutual respect and support can be the most important resource.

An increase in NHS treatments is essential, yet only part of the answer. While resilience can become a cheap catchphrase that diverts attention and funding from real needs, a more nuanced understanding of compassion-based resilience in a social context is possible. This approach would allow the public access to psychologists not just in therapy rooms, but in more natural environments, where they can be consulted like any other professional. Evidence suggests that where this is available, many people use psychologists to help them solve problems before they become mental health crises.

To create such change requires awareness of psychological science and informed action by our political leaders to shape a more compassionate 21st century, where psychological wellbeing isn’t a scarce fragile resource, but a new normal.
Dr Patrick Roycroft and Dr Sarajane Aris
Consultant clinical psychologists, British Psychological Society

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