Intended for healthcare professionals


Parity of esteem between mental and physical health

BMJ 2014; 349 doi: (Published 14 November 2014) Cite this as: BMJ 2014;349:g6821
  1. Chris Millard, Wellcome Trust medical humanities research fellow 1,
  2. Simon Wessely, chair of psychological medicine2
  1. 1Queen Mary University of London, London E1 4NS, UK
  2. 2King’s College London, London, UK
  1. Correspondence to: C Millard Chris.millard{at}

Means different things to different people, making it difficult to enforce

Although parity of esteem between mental and physical health has been a high profile political issue in the UK since 2011, debates about the relative esteem and provision for mental and physical health are long standing. For example, the report that preceded the 1959 Mental Health Act (which removed all restriction on mental health treatment in general hospitals) claimed—prematurely perhaps—that “most people are coming to regard mental illness and disability in much the same way as physical illness and disability.”1

The recent coinage of “parity of esteem” is uncertain. The term parity became enshrined in US law in 2006, when it was mandated that mental health and substance misuse problems should treated the same as medical and surgical conditions in health insurance coverage and not be excluded. It became a key part of the 2010 UK coalition government’s mental health strategy, No Health Without Mental Health, in 2011. The Health and Social Care Act 2012 was altered during its passage into law to include specific reference to mental health, and the NHS Constitution and NHS Mandate for 2014-2015 both include specific commitments in this area. Since 2012 there have …

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