The government has made improving the nation’s health one of its defining missions. From prevention and bringing care closer to home to economic growth and tackling health inequalities, policymakers increasingly recognise that good health underpins a productive, resilient society.
Simultaneously, public debate has broadened and diversified. Awareness of common mental health conditions has improved significantly over the past decade, while the impacts of dementia and neurodegenerative diseases are better understood.
These are welcome developments, but we could go further. The World Health Organisation defines brain health as “the state of brain functioning across cognitive, sensory, social-emotional, behavioural and motor domains, allowing a person to realise their full potential over the life course, irrespective of the presence or absence of disorders”. This raises a question for the UK: are we thinking cohesively enough about conditions that affect the brain and the profound impact they have on individuals, families and society?
Although policymakers and healthcare systems often consider severe mental illness (SMI) and neurodegenerative conditions like Alzheimer’s disease (AD) separately, they share many of the same systemic challenges. Both place considerable pressure on health and care services and require coordinated, long-term support beyond clinical treatment alone. Their effects limit people’s ability to work, study, maintain relationships and live independently. Families and carers become the navigators of fragmented systems at significant emotional and financial cost that, although harder to quantify, is no less significant. Dementia alone is estimated to cost the UK £42bn each year, with families and unpaid carers shouldering 63 per cent of that burden.
Despite this, innovation is not evenly distributed. In the past 15 years, cancer has benefited from over 500 positive recommendations from the National Institute for Health and Care Excellence (NICE). For schizophrenia and AD, the last recommended treatment was in 2010/11.
One challenge is that standard appraisal methods are not designed to capture the wider value of mental health innovation – such as caregiver impact, and workforce and societal participation – while low-cost legacy comparators make new treatments harder to justify. This disparity reflects a pattern in which some of the most debilitating conditions continue to attract comparatively little research, investment and policy attention: NHS England has removed the dementia diagnosis rate target from its 2025/26 planning guidance, a move the Alzheimer’s Society called “a backwards step”.
This is not to say that innovation alone will solve all these challenges. Scientific advances must be matched by action to address the wider drivers that continue to shape people’s lives. For people living with SMI, enduring stigma and discrimination – in employment, housing and even healthcare itself – continue to compound health outcomes, while families often experience social isolation and bear responsibilities that go unrecognised.
These challenges are reflected in some of the starkest health inequalities in the country. People with SMI often live with a greater burden of physical illness throughout their lives and have a life expectancy that is 15 to 20 years less than the general population. This burden of stigma and isolation is also substantial for people living with AD, who live for an average of eight to 10 years following diagnosis, often with increasingly complex needs.
Evidence suggests that, for people with schizophrenia, outcomes may be improved when effective treatment is accompanied by family involvement and continued integration within the community, highlighting the importance of social as well as clinical support. That lesson should inform how we think about brain health more broadly. Success should not be measured solely by clinical outcomes, but also by whether people can actively participate in society, maintain their independence and live meaningful lives.
This points towards a broader understanding of what a modern brain health agenda could achieve. Rather than treating SMI and neurodegenerative disease as separate policy challenges, there is an opportunity to recognise common barriers that prevent people from accessing timely diagnosis, innovative treatments and coordinated care. Advances in research, diagnostics and therapeutics, alongside the government’s emphasis on prevention and neighbourhood health services, create
an opportunity to rethink how care is designed across these conditions.
Delivering this vision will also require a broader understanding of value. Traditional assessments focus on clinical outcomes and healthcare utilisation, but they often struggle to capture what matters most to people and families: maintaining independence, participating in work and community life, supporting carers and reducing inequalities. Recognising these wider benefits would encourage investment not only in new medicines, but also in the services and support that enable innovation to deliver its full impact.
As ministers develop future health policy, they have an opportunity to shape a more ambitious national conversation about brain health. This goal should encompass prevention – drawing on advances in scientific understanding – and healthy ageing, while also identifying SMI and dementia as among the UK’s most significant public health challenges.
If brain health is to become an organising principle for future healthcare, it cannot leave some of the people with the greatest unmet need at the margins of the debate. The question is no longer whether brain health matters. It is whether our approach is ambitious enough to include everyone whose lives are shaped by conditions affecting the brain.
NS-GB-2600124 | August 2026
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