How do I know where needs are greatest?

Knowledge about mental ill health is still relatively poor amongst members of the general public. This is why commissioners have often been helped by experts in secondary, specialised service provision.

This has been especially valuable where there are high numbers of people with complex needs and high morbidity and mortality risk. Indeed, most mental health services used to be commissioned using `block contracts’ rather than contracts specifying costs and volumes of service for the population as a whole. But the new commissioning framework puts local players such as service users and carers, and primary care, more firmly in the driving seat.

There is an opportunity through the development of the Joint Strategic Needs Assessment (JSNA) and the local Health and Wellbeing Plan, to match service provision more closely to the needs of the whole population – and to think harder about how public mental health should inform commissioning plans.