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In 2018, we carried out a survey regarding parity of esteem. The survey was specifically focused on mental health settings. In 2023, the survey was expanded to include all health care settings where RCN members work.

The main objective was to establish members’ views on the progress in clinical settings towards achieving greater mental health equality. The survey acknowledged that:

• Individuals with serious mental health issues tend to die many years before the general population, with a gap of 15-20 years sometimes observed. Unfortunately, this gap has increased over time (Office for Health Improvement and Disparities, 2023).
• Those diagnosed with mental health problems also tend to have one or more long-term conditions, which necessitates regular interaction with physical health services (Public Health England, 2018).
• Up to 30% of individuals with serious physical health problems are likely to experience mental health issues like anxiety or depression (Mental Health Foundation, 2023).

What RCN members told us:

Nurses must address the mental health needs of patients alongside their physical needs. Although there has been progress, systemic challenges such as unequal funding and resources for mental health, inadequate staffing levels and a lack of specialist services still hinder patient care.

To overcome these challenges, nurses suggest focusing on training and education, improving resources and promoting better collaboration across services. The RCN should collectively aim to build a clearer research base, influence the training and education of nurses and develop programmes to improve health outcomes for vulnerable communities.

See the full survey report: Five Years On: Are we Achieving Parity between Physical and Mental Health?

What can you do now? 

We believe that only collaborative efforts across many agencies, mainly working with people who experience complex mental health needs, will help us to deepen our understanding and discover what works best in improving health outcomes. That is why we are working with . However, our members and their colleagues can make many small, impactful changes in the workplace to help make parity a reality. These include:

1. Asking all of your patients how they are doing both physically and mentally in any care setting they may be.
2. Setting up a working group of like-minded staff to support initiatives that promote mental and physical health equality.
3. Becoming aware of support services in your community which help to meet patients' whole needs, both mind and body.
4. Identifying healthy interventions and health promotion activities to improve overall health and wellbeing.
5. Having a staff member responsible for training and development for colleagues in aspects of mental and physical health equality.

Enhance your knowledge and skills

Based on our Parity of Esteem pledge, we have developed a practice-based and specialist learning programme to improve nurses’ awareness and understanding of people’s physical and mental health needs.

This accredited programme provides an opportunity to apply learning through developing a service improvement project in your local area and implementing evidence-based practice to improve standards for the benefit of patients, the public, health care workers and employers.

Learn more about the RCN’s Leading the way: improving physical and mental health programme.