Improving Mental Health for All

• 23 March 2017
• Posted in: Healthcare

“I’m proud of the staff who didn’t give up on me even when I gave up on myself.”

Iris Benson MBE shared her experience as a service user with delegates at Mental Health: Moving Forwards – The Implementation Plan and explained how those strengths and skills of lived experience was helping to improve recovery. Mersey Care NHS Foundation Trust’s Lynn King went on to explain how peer support was helping the Trust identify service user needs and reduce the likelihood of crisis care and distress.

Co-production was a key theme of Jacqueline Dyer’s talk as she stressed that the voices of those with lived experience need to be included in decision-making, from commissioning to co-design of mental health services. Dyer highlighted some of the work being done in Lambeth to tackle inequalities for groups that are overrepresented in the system through the Black Thrive model but described key areas of race inequality across employment, crime, education, living standards and healthcare. The power of co-production was later highlighted by Grief Recovery specialist Phyl Edmonds who shared her personal experiences of loss and recovery and how those with lived experience can better support steps to recovery and well-being.

Jacqui updated the audience with the key taskforce priorities that were focused on preventing poor health, delivering an integrated approach to mental and physical health and improving timely access to treatment.

“How different will the outcomes be for our young people if we can intervene at a much earlier stage?” Jacqui Dyer

Early interventions are a core focus of NHS England’s Five Year Forward View for Mental Health and Jacqueline Cornish explained and children and young people were being embedded in key programmes such as data and new care models. Cornish stressed the importance of ensuring a good start for the future health of children for the sustainability of the NHS. Although new funding was welcomed it amounts to a 1% budget increase and still lags significantly behind adult services. Improved crisis care and access to and use of inpatient care can reduce overall bed usage and match local demand with capacity.

“Transitions are a horror – too often they are poorly planned and poorly executed.” Jacqueline Cornish

New pilots are aiming to link mental health services with schools and early signs are promising of improvements in interventions, staffing and training capacity and whole school policies for mental health. Improving joint working between professionals was later highlighted by the National Mental Health Director at NHS England, Claire Murdoch, who said that not only all sectors had a role to play in mental health care but also employers, communities and families.

“The money is a worry. Society is acute trust centred and the money gets sucked in. We are working closely with CCGs and STPs to ensure that the money goes where it is meant to.” Claire Murdoch

Large progress had been made on the Forward View so far including 70,000 more children accessing evidence based care interventions. 87.8% of people entering treatment waiting less than 6 weeks and new training place available for therapists. Murdoch finished by firstly highlighting the importance of housing, employment and social care packages, and for all services to now get on with the challenges ahead in delivering the plans for better mental health care in England.

“We need to get mental health front and centre of STPs or else we have failed our communities.” Andy Bell

The Centre for Mental Health’s Andy Bell pointed to the inequalities in health services and funding, with those co-morbities having a life expectancy up to 20 years shorter, and evidenced the benefits of integrated physical and metal health care and multi-disciplinary working. Multi-agency working and integrated care formed the catalyst of some impressive improvements in care in Bradford District NHS FT, with police support services, third sector partners, criminal justice and housing all working together on a whole-system approach.

“This a big moment to change the way politics works in this country.” Andy Burnham

Andy Burnham told the audience that, as former Secretary of State for Health in Cabinet, he observed first-hand that the political system is not connecting with people and failing to respond effectively as it should. He said that in the future more change will come from local inspiration in Greater Manchester than from direction from Westminster. Using the World Health Organisation definition of health as a state of complete physical, mental and social wellbeing he argued that services had not been set up to deliver this and that mental health and social care were treated as the poor relations for too long. Burnham stressed that a 21st Century NHS needs to move away from the medical treatment model to social prescribing and a more person-centred approach.

“It’s a great opportunity for us to get our act together. If we don’t look after vulnerable groups of people then we will have failed.” Maqsood Ahmad

Ahmad said the health and social care devolution in Greater Manchester allows services to work from the bottom-up and have the flexibility to ensure there is an emphasis on place and connecting people. The strategic plan aims to ensure care standards are both high and consistent and that health professionals to work together to deliver care largely in their community. He said there was a shift in focus of care to prevention, early intervention and resilience.

From care in the community John Short focused on acute settings and how West Midlands was supporting improvements in secure care pathways through a pilot site project. He explained how three trusts with different areas and expertise were now working in partnership with providers to provide community recovery, clinical and service user engagement and more visible accountability.

“There is a real conflict in the NHS, we need to stop doing tenders that fragment care. One year contracts do not give providers the security they need or help with joined-up planning.” John Short

Online therapies and digital solutions are a core focus of the Five Year Forward View in Mental health and this was well represented by innovative examples. Stephen Freer from Ieso Digital Health how evidence-based therapy and online services can help to deliver affordable, widespread access and help tackle core challenges such funding and providing 24/7 provision of quality care. Helios’ Richard Andrews made the case for family-based therapy and how digital channels can ensure that service users are more engaged and connected and services are more adaptable.

Delegates heard how a project at Tameside Oldham and Glossop Mind was providing active monitoring and a dedicated local network that was improving ease of access to services and simplifying pathways. The results had seen a 69% reduction in people needing GP services for mental health care.

“It really does work, it’s really cheap and we can make it happen.” Jason Bromley

At a national level Head of Local Services Strategy and Development at Mind Hazel Flynn discussed how evidence-based and community-based care was supporting and driving better service outcomes. With many speakers highlighting a crisis point on bed flow and capacity, housing and accommodation was raised throughout the agenda as a considerable problem. Rachael Byrne, of housing provider Home Group, and Helen Lynch from Lancashire Care NHS FT, shared real life examples of how improvements in safe discharge pathways had a positive impact on patient flow, hospital costs and, more importantly, speed of referral was improving people’s lives.