Mental Health Services 2020: High Quality, Low Carbon

Tuesday, March 16, 2010 - 10:30 - 15:45

The Royal College of Psychiatrists, in partnership with the Campaign for Greener Healthcare, is organising a national summit on the opportunities and challenges of a sustainable future for mental health services. Senior clinicians and policy makers will be invited to explore the low-carbon future of healthcare, and the transformation of mental health services for sustainability, patient experience and cost efficiency.

Topics covered are planned to include:

  • Climate change and the low carbon future of healthcare
  • Lessons from the Green Nephrology project
  • “The future is here - it’s just not evenly distributed”: case studies from mental health services illustrating: 
    • Prevention & health promotion
    • Supported self-care
    • Leaner care pathways
    • Low carbon treatment alternatives
  • Implications for training of mental health professionals
  • Next steps towards Greener Mental Health

The Summit promises to be an innovative, inspiring and transformative event, and is being supported by President of the Royal College of Psychiatrists, Prof. Dinesh Bhugra, and National Clinical Director for Mental Health Services, Department of Health, Prof. Louis Appleby.


The New Horizons in Mental Health consultation has identified prevention and public mental health among its key themes, calling for the development of sustainable, connected communities. Mental health trusts not only provide care for people with mental health problems, through sustainable partnerships and practices, they can be a force for mental wellbeing in the wider community.
In delivery of clinical services, the inclusion of environmental sustainability as a key driver alongside cost and quality of care will encourage innovation and ultimately produce a service which is preventative, personalised, efficient and makes best use of low carbon technologies. Building in sustainable principles now will not only safeguard the natural environment on which we depend for our physical and mental health, it will ensure that systems of care are fit for a carbon- and energy-constrained future.

Climate change is a cause of mental health problems

The UCL Lancet Commission has identified climate change as “the biggest global health threat in the 21st century” through changing patterns of disease, water and food insecurity, vulnerable human settlements, extreme weather events and population migration (footnote 1). These impacts have their greatest effect on the poor, exacerbating health inequities. Extreme weather events in particular are strongly associated with an increase in mental health disorders (footnotes 2 and 3).

Why should mental health services adopt sustainable practices?

1. Sustainable communities are health-promoting

Many of the changes needed to increase the environmental sustainability of our communities will benefit mental health directly. For example, through increasing local access to amenities (reducing dependence on the private car), increasing physical activity, improving the quality and quantity of green space, strengthening local economies and supporting community groups. By promoting this agenda, mental health services can improve their image and reputation and be truly seen as health services, rather than illness services.

2. Sustainable clinical care is high quality care

In order to provide care at just 10 or 20% of current carbon costs, health services must display far greater rigour in identifying and pursuing value to patients, while discontinuing those interventions and activities which provide minimal benefit to patient outcome.
In designing health systems of the future, the Campaign for Greener Healthcare uses four principles of sustainable clinical practice:

1. Prevention
2. Patient partnership – supporting service users in managing their own condition
3. Leaner care pathways
4. Access to effective low-carbon treatment alternatives

The continued provision of care in a low carbon health service is contingent upon finding low carbon models of care. Meanwhile, the inclusion of sustainability as a key driver alongside cost and quality of care in the delivery of clinical services will encourage innovation and ultimately produce a service which is preventative, personalised, efficient and which leads by example in the transition to a healthy sustainable society.

3. Healthcare providers will face increasing legislative and financial pressure to reduce carbon

In the context of global agreements and national legislation on greenhouse gas emissions (in addition to rising energy prices), healthcare providers will be forced to reduce their carbon footprint. In the UK, from April 2010, NHS Trusts will already be subject to the government’s Carbon Reduction Commitment (CRC), requiring them to pay up front for each year’s energy-related carbon emissions (footnote 4). The NHS’ own carbon reduction strategy, based on the national targets set by Climate Change Act 2008, commits the health service to more than 80% reduction in emissions over the next decades (footnote 5).


1. UCL Lancet Commission (2009) Managing the health effects of climate change. The Lancet, 373(9676), 1693-1733.

2. Confalonieri et al (2007) Human Health: Climate Change 2007 Impacts, Adaptation and Vulnerability, Contribution of Working Group II to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change

3. Galea et al (2007) Exposure to hurricane-related stressors and mental illness after Hurricane Katrina, Archives of General Psychiatry, vol 64, no 12, pp 1427-1434

4. Department of Energy and Climate Change (2009) Consultation on the draft order to implement the Carbon Reduction Commitment. Available at: Accessed on: 2/10/2009

5. NHS Sustainable Development Unit (2009) Saving Carbon, Improving Health: NHS Carbon Reduction Strategy for England.

Please note this summit is invitation only.  For enquiries please contact


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