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It is nearly eight years since the National Service Framework for Mental Health was published, setting ambitious 10‐year targets. This article draws on findings presented in a recent Sainsbury Centre for Mental Health report on progress to date. It concludes that although the framework confirmed the status of mental health as a health priority for the government, a likely shortfall in funding means that goals will not be met in full. The authors stress that this is not a criticism of policy; rather it reflects the ambitious nature of the government's mental health agenda.

The National Service Framework for Mental Health was published in late 1999, setting ambitious 10‐year targets. This article draws on findings presented in a recent Sainsbury Centre for Mental Health report on progress to date. It concludes that although the framework confirmed the status of mental health as a health priority for the government, a likely shortfall in funding means that goals will not be met in full. The authors stress that this is not a criticism of policy; rather it reflects the ambitious nature of the government's mental health agenda.

English governance has repeatedly had a tendency to veer between national, regional and local centres of power and influence. This has often led to profound disagreements, sometimes even open conflict. National policy guidance is usually helpful, if developed through consultation, to steer a clear, coherent direction for the system. But a narrow, excessively top‐down, mechanistic target‐driven approach can lead to a prevailing culture of ticking boxes at the expense of real patient priorities. Government ministers and civil servants, however, are often caught in a tension between being too dogmatic, or alternatively too flexible and giving responsibility to local agencies, whereupon people may complain about a ‘postcode lottery’ in services. Balancing perspectives and narratives in a coherent way for policy development and implementation and service improvement is a major challenge of leadership. The creation of the National Institute for Mental Health in England (NIMHE) was designed to bring together the local, regional and the national in a form that would see policy and practice mutually developed and nurtured at all levels of governance.

The European Union‐supported Child and Adolescent Mental Health in an Enlarged Europe (CAMHEE) project aimed to provide an overview of the challenges, current practice and guidelines for developing effective mental health promotion and mental illness prevention policy and practice across Europe. As part of this work, an analysis was undertaken of the situation in England, making use of a bespoke data collection instrument and protocol.Our analysis suggests that there has been significant effort and investment in research, needs assessment, policy, human resource and service developments in CAMHS over the last 20 years, leading to a more detailed understanding and availability of services. Much of the emphasis has been on assessment and management of difficulties, however in recent years attention has begun to focus on mental health promotion. National standards and programmes such as Every Child Matters (Department for Education and Skills, 2004) have acted as catalysts for a number of national initiatives.

Despite the emergence of NICE guidelines regarding the effectiveness and appropriateness of psychological therapies for the majority of common mental health problems, access to these services is still dramatically underdeveloped and uneven. Estimates of untreated problems such as depression and anxiety in primary care signal the extent of these problems and the scale of investment in new services, if these needs are to be adequately met in the future.The Department of Health's and the Care Services Improvement Partnership's (CSIP) Improving Access to Psychological Therapies (IAPT) programme sets out a framework and a series of co‐ordinated actions, including two national demonstration sites, to begin to address these issues in England.This paper examines the origins and policy drivers that have given rise to the IAPT programme, outlines the progress to date and specifically assesses the implications for the mental health workforce of this programme. Issues addressed include the workforce profiles of existing services, career frameworks for psychological therapists, the capacity of training providers to train new and existing staff in psychological therapies and the challenges implicit in devising a workforce delivery plan to support the IAPT programme.

This paper is an account of the discussions and recommendations by the exper t advisory panel on potential metrics and ‘sentinel indicators’ for improved outcomes in housing and mental health, as par t of an inter‐agency seminar called to advise on the development of metrics and measures for community mental health, for Fair Society, Healthy Lives: The Marmot Review (Marmot, 2010). The seminar covered all aspects of mental health in both its broadest and narrower senses.Much of the background material for these discussions, therefore, cuts across familiar knowledge silos between the fields of health and housing. Where it is necessary to elucidate the text, references are included to relevant research and policy frameworks that may be unfamiliar to the general reader. This paper is not, however, intended as a general literature review nor is it an evaluation of the available research. A paper on this subject will feature in a future issue of the Journal.1The conclusions from the panel discussion are presented in four main areas, reflecting the need to specify metrics across the wide‐ranging interface between housing and mental health, while still keeping the task manageable. Five current or potential health service metrics were proposed as having par ticular value as signal indicators. Two of these (relating to primary care prevention and public health) have no precision as yet, par tly as new services and approaches are still evolving. Among existing health datasets, the Mental Health Minimum Dataset (MHMDS) (NHS Information Centre, 2009a), SITuation REPor ts (SITREPS) (Department of Health, 2003), and the Summary Care Record data were singled out, though each is thought to need more work to improve the current data categories as well as data collection.One rather more fundamental point made was that the identifying, assessing and encouraging of effective inter‐sector par tnership work will be the key to tackling health inequalities. The use of other, non‐health services data therefore holds great potential for a better recognition both of needs and of outcomes in successful par tnership work, especially where this can be interpreted at local level. These wider comments are elaborated in the context of housing, but may be applicable to all effor ts to evidence and work with the social determinants and the social outcomes of mental health. For the future, a combination of well‐crafted nationally sanctioned metrics and the ‘soft intelligence’ of locally identified meaning may be most effective.Subsequent developments confirm the potential in cross‐sector development work, and indicate the potential for fur ther collaboration via the local performance framework. As policy frameworks continue to evolve rapidly, the ar ticle ends with a Codex, updating the relevant policy frameworks context since the seminar (in Spring 2009) and especially in the context of a new coalition government with aspirations to ar ticulate and promote public health in the context of the local performance framework and the ‘new localism’ agenda. This final section and comments therein are therefore entirely the responsibility of the author.

The Australian National Standards for Mental Health Services (Commonwealth Department of Health and Family Services, 1996) were developed as a plank of the first National Mental Health Plan (Commonwealth Department of Human Services and Health, 1992). Over the two subsequent national five‐year plans, they have become the basis for accreditation surveys for all Australian mental health services, both hospital and community components, whether acute or rehabilitation oriented, throughout the psychiatric career of all mental health service users and their families. The development and implementation of these standards are described. Innovations in this set of standards are detailed, specifying requirements of each phase of care, including access, entry, exit and re‐entry, and the parallel development and training of paid consumer and family carer surveyors. Largely due to the brevity and clarity of these innovations, because of a broad consultation process, and incorporation of interventions and service delivery systems that are both evidence‐based and congenial to service users, they have achieved a wide acceptance among, and championing by, service user and family carer networks. A recent review of the national standards was timely and welcomed, but is still incomplete, contentious in its protracted process, has a lack of consistent consultation and contains diluted and disorganised results. Implementation guides will now be developed to be superimposed on this revision in an attempt to improve and navigate it.

The purpose of this paper is to review some of the key mental health education and training developments of the last decade of immense change to the service system in England. This change was part and parcel of the Labour Government's mental health modernisation agenda.

This article summarises the recently published mental health physiotherapy strategy, Recovering Mind and Body: A framework for physiotherapy in mental health and wellbeing (Chartered Society of Physiotherapy, 2008a) and its companion document Commissioning Mental Health Services: The contribution of physiotherapy to integrated services for health and wellbeing (Chartered Society of Physiotherapy, 2008b), and discusses how the documents can be used to ensure that more mental health service users and carers can benefit from the skills of physiotherapists.