Editorial

Citation

Caan, W. (2013), "Editorial", Journal of Public Mental Health, Vol. 12 No. 3. https://doi.org/10.1108/JPMH-06-2013-0047

Editorial

Article Type: Editorial From: Journal of Public Mental Health, Volume 12, Issue 3.

Woody Caan

The relationship between evidence from the Public Health community (including the analysis of gaps in knowledge or uncertainty) and Government policy has been much on my mind recently. One catalyst has been the Department of Health's current consultation on the Regulation of Public Health Specialists (to respond online, from any standpoint, see www.consultations.dh.gov.uk): in the 18 pages of the consultation “paper” there is not a single piece of “evidence”, even from Public Health specialists who would be directly affected by new Government regulations. As promised in my previous Editorial, I took part in the conference Future Directions for scientific advice in Whitehall (at the Royal Society on 18 April 2013).

The latest Chief Scientific Adviser, Mark Walport, stressed a contemporary need in Whitehall for intermediaries or “brokers” who were not themselves “experts” in one small area of knowledge, but rather could guide policy makers to the most valuable developments across broad scientific frontiers. In order to address UK priorities like strengthening Resilience, Government departments need guidance now on issues like “engaging the public”. Doesn’t that sound like an opportunity to share experience from Public Health?

The retiring Chief Scientific Adviser (Beddington, 2013) has summarised the reciprocal partnership that is needed, between researchers and civil servants. All scientists should be involved in “ensuring government is properly informed by science” and in every branch of government scientific advisors need to nurture the “ability to draw on the ever-developing knowledge of the wider scientific community that ensures the best advice possible is brought to bear” (p. 31). More transparent use of data is needed for “contestable” policy (Rutter, 2013). The open tradition of the Chief Medical Officer's annual reports on the State of the Public's Health was identified as a good model for informing wider policy agendas. In making the case for advisors with scientific hindsight alongside those developing policy. Foresight, Higgitt and Wilsdon (2013) cited a former Cabinet Secretary:

“Those who make major policy decisions in ignorance of relevant history are like a driver who commits to a manoeuvre in the road without looking in the rear mirror” (p. 80).

Public mental health has broad frontiers of knowledge. So how could its varied stakeholders connect UK policy makers better, with experienced practitioners and researchers?

Sometimes there are individuals whose insider knowledge spans research, practice and policy areas. An outstanding example is Baroness Hollins, professor, psychiatrist and the current president of the British Medical Association. Her specialist field is the psychiatry of disability. For years, the evidence was available that people with learning disabilities experienced grave inequalities in health (Caan and Hampton-Matthews, 1999) but planners did not respond. From within the House of Lords, Sheila Hollins has worked for “a strong commitment at policy level” (Hollins and Tuffrey-Wijne, 2013) using what she calls “informed advocacy”. Learning lessons from the practice of intellectual disability mortality reviews in the USA, and following seminars that linked the BMA and Parliament, the Department of Health was persuaded to support the Nora Fry Research Centre in developing a Confidential Inquiry into premature deaths of people with learning disabilities. In March 2013 the final report from the Research Centre (with clear advice for healthcare commissioners) was widely communicated, with the strategic involvement of the Minister of State for Care and Support.

Such multitalented individuals are rare. Professional bodies have often provided a bridge between academic experts and policy makers. Where they combine a long history and an innovative membership, they can address the needs for both hindsight and foresight in making policy. For example, the Royal Society for Public Health has been lobbying planners at national and local levels to ensure their policies help to reduce inequalities in mental health and wellbeing, rather than aggravate inequality. A cornerstone of this RSPH approach is promote use of Mental Wellbeing Impact Assessment (Donaldson, 2013).

Career politicians may not understand how knowledge about population health is developed. Terms like longitudinal birth cohort study and multivariate statistical analysis might be incomprehensible. The Academy of Social Sciences (2013) recently held a symposium on the value of epidemiology with a life course perspective inside the government department of Business, Innovation and Skills – including a thoughtful dialogue with the Minister for Universities and Science. He agreed to champion the development of future birth cohorts.

It helps to get the right people together, in the right place. Specialists in public health can collaborate constructively and proactively, with elected politicians, civil servants and members of local government Health and Wellbeing Boards. That is what I saw at a Public Health England conference Early Intervention and Public Health, held in Parliament on 15 May 2013. Will that new partnership have any impact? Well, the shrewd organisers involved the Secretary of State for Health in the conference and a follow-up briefing on evidence to inform his policy on early intervention.

Advice lines

Faced with unfamiliar problems and difficult choices,

Politicians feel bombarded with Experts’ voices.

“Research shows […]”, “the evidence is […]” and “we now know […]”:

Data sources (but not understanding) grow.

Share research cards like your Aces, and never Jokers:

Telling science, connect with honest brokers.

News and views

A new Centre to share skills and knowledge:

On 3 June 2013, a centre for activities relevant to “awareness or learning around mental health and wellbeing” opened in London: ORTUS. ORTUS is run by a community interest company, Maudsley Learning, to engage with mental health professionals, service users and carers from around the UK.

Details of learning opportunities and events at the new centre are available at: www.maudsleylearning.com

The WHO collaborates in two International courses on mental health:

The Indian Law Society in Pune, India is offering an International Diploma on Mental Health Law and Human Rights, details available at: http://cmhlp.org/applications-and-fees/download-prospectus-and-forms

NOVA University in Lisbon, Portugal is offering a Master Degree in International Mental Health Policy and Services (MHPS), details available at: www.fcm.unl.pt/

For this Academic Year, both courses include residential sessions in October 2013.

National Institute for Health Research's Health Technology Assessment conference:

“What's in it for you?”, London, 9-10 October 2013.

HTA grant funding now includes research on the effectiveness of both clinical and public health interventions. Conference web site: www.profbriefings.co.uk/nihrhta2013

Local Government Association conference:

National Children and Adults Services Conference, Harrogate, 16-18 October 2013.

This is the first LGA conference for “policymakers” since statutory leadership for Public Health in England moved from the Health Service to 150 Local Authorities.

E-mail: mailto:info@local.gov.uk for information about this conference.

References

Academy of Social Sciences (2013), Making the Case for the Social Sciences. No. 8, Longitudinal Studies, SAGE, London

Beddington, J. (2013), “The science and art of effective advice”, in Doubleday, R. and Wilsdon, J. (Eds), Future Directions for Scientific Advice in Whitehall, Centre for Science and Policy, Cambridge, pp. 22-31

Caan, W. and Hampton-Matthews, S. (1999), “One from the heart, for people with a learning disability”, British Journal of Nursing, Vol. 8 No. 2, pp. 97-100

Donaldson, C. (2013), “Working to improve mental health and wellbeing”, Perspectives in Public Health, Vol. 133 No. 3, p. 140

Higgitt, R. and Wilsdon, J. (2013), “The benefits of hindsight: how history can contribute to science policy”, in Doubleday, R. and Wilsdon, J. (Eds), Future Directions for Scientific Advice in Whitehall, Centre for Science and Policy, Cambridge, pp. 79-85

Hollins, S. and Tuffrey-Wijne, I. (2013), “Meeting the needs of patients with learning disabilities”, BMJ, Vol. 346 No. 8, p. 8

Rutter, J. (2013), “A better formula: will civil service reform improve Whitehall's use of expert advice?”, in Doubleday, R. and Wilsdon, J. (Eds), Future Directions for Scientific Advice in Whitehall, Centre for Science and Policy, Cambridge, pp. 39-48