For my chosen profession of clinical psychology, adopting this vision could have significant consequences. Clinical psychology is a profession that has its roots in mental health, and it is highly likely that addressing mental health problems will remain the key focus of our work for the foreseeable future. Clinical psychologists are obviously experts in psychological therapies (or, in the UK at least, must be competent in at least two forms of psychological therapy in order to retain their professional registration with the Health and Care Professions Council), so it is highly likely that we will continue to offer one-to-one therapy. But as well as merely providing therapy, clinical psychologists have been calling for more socially responsible, more fully holistic, services for many years. In practice that would mean a great deal more work across all the domains of well-being discussed earlier. That means linking with employment advisors in JobCentrePlus (the UK Government-run employment and benefits agency) and other occupational health and occupational psychology services - helping people reduce workplace stress, minimising the likelihood of absence due to emotional problems and maximising productivity. It means working with schools and teachers - helping children learn, but also helping children, teachers and parents deal more effectively with emotional issues. In the model for psychosocial mental health and well-being services I am discussing here, we would expect to see clinical psychologists working more closely with the physical health services - supporting patients with serious physical illnesses, helping them adjust to illness or injury, helping with rehabilitation, maximising the likelihood that people take steps towards becoming fitter and healthier. Across a wide range of community services we should see clinical psychologists offering their skills in sports and leisure, with charities, with local authority services ... across the full breadth of the domains of well-being.
To achieve that, our employers need to understand - and support - this move. Most clinical psychologists in the UK are currently employed by NHS Trusts. It is perhaps unfortunate that our history of close links with mental health services, and our undoubted expertise in one-to-one psychological therapies, mean that clinical psychologists are often seen as valued staff if and when they see individual clients, but are less often encouraged to pursue these broader roles. As I have made clear already but will expand upon in the next chapter, I believe it would be better if mental health services as a whole, including clinical psychologists, were managed in local authority settings. There could be many benefits for my profession.
A focus beyond 'mental health', or, worse 'mental illness', and instead addressing well-being more broadly would mean looking at our links with the other applied psychologist groups. A genuine view of well-being integrates clinical psychologists' interest in mental health with occupational psychologists' interest in employment, educational psychologists' interest in education, health psychologists, forensic psychologists and so on. All these professional groups apply our knowledge of psychological theory to addressing social problems and improving well-being. So this is less a call for clinical psychologists as a very specific group to broaden their ambitions across all of life, but rather more a call for applied psychologists to work together to apply their skills and knowledge in a coherent manner across all these domains of well-being. In my opinion, we should be bold. I believe that applied psychology itself needs to reform. We need to unify our currently disparate 'brands' of applied psychology into a single profession - and we need to make that profession more genuinely fit for purpose. That means looking at our professional body, the British Psychological Society, and reforming it such that it more closely resembles other Royal Colleges and representative professional bodies. It would also mean looking at our training. In a paper published in 2002 that was a few years ahead of its time, I recommended that one way to make our profession more suited to the model of mental health and well-being discussed here might be to have more integration in our training.4 I recommended that we should consider training occupational, clinical, health, educational and forensic psychologists together in a generic curriculum in the first year of our three-year doctoral training, tapering to specialist training in year three. I argued that this approach would retain specialist training through the tapered specialisation. This would ensure that each person would finish their training with the skills necessary to register as a clinical or occupational psychologist or indeed in any other branch of applied psychology, rather than have to adopt the rather vague and over-general term of 'applied psychologist'. The benefit of the scheme is that each person would have pursued a pathway through training that will have involved a much greater degree of integrated exposure to other approaches within applied psychology. That, clearly, would render applied psychology and hence clinical psychology, better equipped for the design of services I hope we will be able to adopt.