Change at work tends to be viewed as just that - change within the sphere of your profession and colleagues. The changes inevitably affect your clients, but the bubble by-and-large stops there. In the 1990s community mental health resource centres were being built with kitchens to cater for day care/hospital patients. Now many of those kitchens are not needed as mental health services have stepped away from day care provision. This move is a smart one, since if you read (and contribute to) mental health news groups you note that current and former users of mental health services recognise for themselves the dependency that prolonged day hospital attendance can promote. That said there are many acutely worried people out there. Having lost day care services, they face interviews that seek to address their level of disability. Depression and anxiety need no introduction to helplessness and hopelessness.
Enter a further phase of change and one with much wider ramifications - tackling worklessness.
There is a new EU strategy for 2008-2013 which includes (with my emphasis):
The Commission report to the 2006 Spring European Council urged Member States to reduce the high number of people inactive through ill-health13. It stressed that policy in many sectors has a role in improving health for the benefit of the wider economy.Does overall planning, action and evaluation in physical and mental health call for an overarching framework? When possible the drugs may be replaced or combined with information prescriptions, but care is still needed in preparation, administration and monitoring the positive and negative side-effects....
Spending on health is not just a cost, it is an investment. Health expenditure can be seen as an economic burden14, but the real cost to society are the direct and indirect costs linked to ill-health as well as a lack of sufficient investment in relevant health areas. It has been estimated that the annual economic burden of coronary heart disease can amount to 1% of GDP15, and the costs of mental disorders to 3-4% of GDP16. Healthcare spending should be accompanied by investment in prevention, protecting and improving the population's overall physical and mental health, which, according to OECD17 data currently amounts to an average of 3% of their Member States' total annual budgets for health compared to 97% spent on healthcare and treatment18. [p.5]
Brussels, 23.10.2007 COM(2007) 630 final
WHITE PAPER Together for Health: A Strategic Approach for the EU 2008-2013