A systemic approach to understanding mental health and services

•Mental health services are faced with increasing demands and pressure.•Systemic modelling provides a means of understanding this situation.•This analysis includes the role of culture, politics and ideology.•This paper can contribute to future policy developments relevant to mental health.

In the UK mental health and associated NHS services face considerable challenges.This paper aims to form an understanding both of the complexity of context in which services operate and the means by which services have sought to meet these challenges. Systemic principles as have been applied to public service organisations with reference to interpersonal relations, the wider social culture and its manifestation in service provision. The analysis suggests that the wider culture has shaped service demand and the approaches adopted by services resulting in a number of unintended consequences, reinforcing loops, increased workload demands and the limited value of services. The systemic modelling of this situation provides a necessary overview prior to future policy development. The paper concludes that mental health and attendant services requires a systemic understanding and a whole system approach to reform.