Consequently, mental health concerns remain a priority for: research through contributions to the evidence base; healthcare through improving prevention and management; workplaces and education centres to support children and adults who experience mental health concerns; and policy to improve legislation and structures that allow for more equitable opportunities and access, and for instance, reduce discrimination.
Within schools and education centres, there are increased reports of depressive thoughts and anxiety. Body image concerns develop from an early age; indeed, research has highlighted that body image concerns are reported by children as young as 3 years old, and continue to be a factor that influences self-esteem, and educational engagement, achievement and opportunities. It is also reported that weight-related teasing is one of the most common forms of bullying reported by children, which is concerning given that experiencing weight stigma is associated with mental and physical health concerns including depression, anxiety, lowered self-esteem and increased cardio-metabolic risk factors.
In workplaces, increased prevalence of mental and physical health concerns that impact presenteeism and absenteeism rates have become a focus for employers to act given the associated impacts. Workplaces play a vital role in society, where a large proportion of the population are contactable directly or indirectly. They therefore represent an ideal setting to house intervention. Thus, whilst they often represent environments that contribute to ill-health (e.g., stress, prolonged sitting time), they can also play an important role in reversing the current prevalence of mental health. There is increasing recognition from business that engaging on this agenda supports, not only their Corporate Social Responsibility position, but also impacts positively on their bottom line.
For National and local government, mental health concerns remain a public health priority. There are inevitable challenges that impact the speed, level and type of response. There is a need to continue to raise awareness of mental health concerns in the community, particularly in schools and workplaces where both children and adults respectively, spend most of their waking hours of the week. These are also key environments that can contribute to health and wellbeing more generally, which includes identification, and where appropriate early intervention. There is some evidence of good practice in the UK. For example, in Darlington, there has been improved recognition amongst schools and large employers such as EE and Cummins of the importance of identifying and supporting student or employee mental health concerns more effectively. Institutions and employers are understanding their roles and potential influence that can support positive changes within their organisations.
However, there is an ongoing debate around whose responsible for mental health, but more generally health, despite the more recent understanding that multiple domains within society contribute and can act within a system to influence outcomes. This is underscored by current whole systems thinking that requires co-ordinated and multidisciplinary actions, where stakeholders work collaboratively towards common goals across all levels of governance. Collaboration is key; certain groups are often overlooked such as patients. The concept and developing evidence base of using whole systems approaches offers hope, and highlights that throughout all levels of society, we all have a role in promoting improved health.