Rebuilding mentally healthier communities

Mental ill health costs thousands of lives and more than £105 billion every year – an average of £700 million per upper-tier council area in England alone.

If everyone was free of abuse and poverty, living in decent homes, with access – via tree-lined walking and cycling routes – to nearby, high-quality work, community and green spaces, much of this could be avoided.

That may sound ambitious, but the founders of modern local government in Victorian Britain ended cholera by clearing slums and building a massive clean-water system. About a century later, a bankrupt and exhausted post-war UK built the NHS, welfare state and two million homes. 

Open sewers and unpayable doctors’ bills in this country are long gone, but inequality, air pollution and chronic mental ill health are modern equivalents that need urgent action.

“Tackling inequality – most visible in different health outcomes – is the challenge of our times”

Coronavirus, and the measures taken to counter it, have exposed glaring health inequalities and caused huge health and economic harm. That makes supporting mentally healthier communities even more important. In doing so, we must also tackle the inequalities that lead to black people being four times more likely to die of coronavirus than white people – a disproportionality reflected in serious mental illness rates.

During the pandemic, councils have shown how their local knowledge, relationships and powers can transform services, behaviour and public health outcomes. Now, we must use these tools to tackle the more deep-seated structural problems that cause disproportionate levels of physical and mental ill health among our poorest communities.

As part of that effort, the LGA has produced a councillor workbook on creating mentally healthier communities. Written in partnership with the Mental Health Foundation, it brings together academic expertise and practical experience from the NHS, charities and research, to assist you in your vital work supporting better mental health in your communities.

The workbook is structured around the World Health Organization’s three determinants of health: individual characteristics and behaviour; physical environment; and economic context.

The individual section uses psychological insights to suggest how councils can support better relationships and more exercise, among other behaviours, to improve mental health.

In the physical environment section, we explore how planning and licensing powers can be used to encourage better housing, transport and community relations while reducing crime, air pollution, and access to cheap alcohol, harmful gambling and poor-quality food.

Finally, improving the economic context is going to be the biggest challenge as we enter a deep recession, but there is much more councils can do to support living-wage-accredited ‘anchor’ institutions at a time when global supply lines have been exposed as environmentally and socially unsustainable.

Along with the related issue of climate change, tackling inequality – most visible in different health outcomes – is the challenge of our times, with the failure to deal with it seriously destabilising our global and local communities.

From cholera to coronavirus, councils have been at the forefront of tackling many health inequalities. Now, we must turn our attention to creating mentally healthier communities, where everyone can thrive.


A councillor’s workbook on supporting mentally healthier communities’ is available at


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