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Parity of esteem

Parity of esteem describes the need to value mental health equally to physical health. People with complex mental health needs should have the same access to health care services and support as people with physical health needs.

Evidence shows that people with serious mental health needs die between 15 to 20 years before the rest of the general population. This is also known as the mortality gap.

There are many complex reasons for this, including discrimination and stigma, poor life chances, poor physical health and lifestyle choices, the use of long-term medication and the way the mental health services are structured.


Parity of esteem - what can we do

#MakingParityReality – what can you do?

As well as read our publication there are lots of small, but impactful changes that our members and their colleagues can make in the workplace to help make parity a reality

Over the past year we have been raising awareness of the role that nursing staff have in achieving parity of esteem to improve health outcomes for people with complex mental health needs. The benefits of making parity of esteem a reality for everyone include:

  • Improving the quality of life for people with complex mental health needs
  • Creating health environments to support people with complex mental health needs - to get the best outcome for their physical health
  • Improving someone’s day to day experience when accessing health services
  • Helping people access support within their community e.g. through social prescribing
  • Improving people’s sense of self-esteem and self-worth – valuing someone as a whole person with a wide range of needs.

Whilst our primary focus is on improving physical health, there are also many other challenges for those with serious mental health needs to access the same type of support compared to the wider population. Many who have the most serious mental health needs are more disadvantaged and socially deprived than the wider population in areas such as housing, occupation, social support. See our pledge and who we are working with.

Based on the Parity of Esteem, the RCN has developed a practice based learning programme which focuses on improving nurses’ awareness and understanding of people’s physical and mental health needs. The programme provides an opportunity to apply learning through the development of a service improvement project in your local area, implementing evidence-based practice to improve standards for the benefit of patients, the public, health care workers and employers. To find out more about the programme please visit the RCN's Leading the way: improving physical and mental health.

What can you do?

We believe that only collaborative effort across many agencies, particularly working with people who experience serious mental health illness, will help us to deepen our understanding and discover what works best in improving health outcomes. That is why we are working with Equally Well UK. However, there are lots of small, but impactful changes that our members and their colleagues can make in the workplace to help make parity a reality. These include:

  1. Asking all of your patients this week how they are doing both physically and mentally
  2. Setting up a working group of like-minded staff to support wider change in the workplace
  3. Becoming aware of supporting services in your community for referring patients to
  4. Identifying healthy interventions to improve overall health and wellbeing
  5. Identifying the staff member responsible for training and development for colleagues who need further support

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See: Equally Well UK. Looking after your health during COVID-19: A guide for people living with severe mental illness - This resource has been created with input from Tim Coupland’s parity of esteem expert representative  to help people with Severe Mental Illness manage their physical health during the Covid-19 pandemic.

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Tom Sandford 145x145

“I think it’s fantastic that the RCN is addressing the issue of parity of esteem”.

Tom Sandford Former Director, RCN England

Page last updated - 22/08/2022