delivering prevention concordat for better mental health
TRANSCRIPT
Delivering Prevention Concordat for
Better Mental Health
Chandraa Bhattacharya
National Public Mental Health Manager, Health Improvement
Directorate
Public Health England
Acknowledgements: PHE Teams -Public Mental Health; Mental Health Intelligence Network; Health Economics Expert Steering Groups -
Prevention Concordat for Better Mental Health Programme; Joint Strategic Needs Assessment; Health Economics
2 Prevention Concordat for Better Mental Health Programme
Case for change
Inequalities in overall life
expectancy and physical health are
influenced by mental health and
wellbeing. Social inequalities,
adversity and trauma create
stressors that impact directly on our
bodies – e.g. high blood pressure,
heart disease, diabetes) and
influence health-related behaviours
such as alcohol, drugs, exercise,
smoking and diet
• Mental health is the cause of 40% of new disability benefit claims each year in the UK
• 70% of people with severe mental health problems are economically inactive and on
disability benefit, compared with 30% of the general population.
A Public Mental Health Approach to Prevention
Concept informed by World Health Organization methodology for public mental health
which has been adopted by Public Health England
Everyone, irrespective of where they live, has the opportunity to achieve good mental health and
wellbeing - especially communities facing the greatest barriers and those people who have to
overcome the most disadvantages.
This includes those living with and recovering from mental illness. Mental health promotion
Reducing premature
mortality for those living with or
recovering from mental illness
Mental illness prevention and
suicide prevention
Key themes:
• Reducing health inequalities
• Community centred approaches
• Embedding and integrating mental health
• Improving workforce capacity and competency
Prevention Concordat for Better Mental Health Programme
A Public Mental Health Approach to Prevention
Prevention Concordat for Better Mental Health Programme
The Prevention Concordat for Better Mental Health* is :
• Underpinned by an understanding that prevention-focused approaches to improving the
public’s mental health make a valuable contribution to achieving a fairer and more
equitable society.
• Centred on promoting evidence based planning and commissioning to increase the
impact on reducing health inequalities.
• Intended to focus cross-sector action to deliver a tangible increase in the adoption of
public mental health approaches across: local authorities; the NHS; public, private and
voluntary, community and social enterprise (VCSE) sector organisations; educational
settings; employers.
• Inclusive of the active role played by people with lived experience of mental health
problems, individually and through user led organisations.
This definition of the Prevention Concordat has been agreed by the 30 original endorsing
organisations and all subsequent signatories.
* Represents a public mental health informed approach to prevention, as outlined in the Five Year Forward View for Mental Health, and
promotes relevant NICE guidance and existing evidence based interventions and delivery approaches e.g. ‘making every contact count’
Prevention Concordat for Better Mental HealthThe aim of the Prevention Concordat for Better Mental Health is to help every local area to put
effective prevention planning arrangements in place by March 2019.
The focus is to:
• Galvanise local and national action around the prevention of mental health problems and
promotion of good mental health;
• Encourage cross sector activity led by health and wellbeing boards, clinical commissioning
groups, and local authorities
• Enable every area to use the best data available to plan and commission the right mix of
provision to meet local needs, increase equity and reduce health inequalities
The development phase was guided by expert steering groups of national partners
Direction and scope was set by
wide stakeholder engagement
with every region of England and
the participation of people with
lived experience.
Five Priority Themes to Improve Prevention Planning
Needs and
assets
assessment
Partnership
and
alignment
Translating need
into deliverable
commitments
Defining
success
outcomes
Leadership
and
accountability
1 3 4 52
Prevention Concordat Consensus Statement
Prevention Concordat for Better Mental Health Programme
The Prevention Concordat for Better Mental Health Consensus Statement describes the shared
commitment of organisations to work together through local and national action, to prevent mental health
problems and promote good mental health. Signatory organisations and local areas agree:
1. To transform the health system, we must increase the focus on prevention and the wider determinants of
mental health. We recognise the need for a shift towards prevention-focussed leadership and action
throughout the mental health system; and into the wider system. In turn, this will impact positively on the
NHS and social care system by enabling early help through the use of upstream interventions.
2. There must be joint cross-sectoral action to deliver an increased focus on the prevention of mental health
problems and the promotion of good mental health at local level. This should draw on the expertise of
people with lived experience of mental health problems, and the wider community, to identify solutions and
promote equality.
3. We will promote a prevention-focused approach towards improving the public’s mental health, as all our
organisations have a role to play.
4. We will work collaboratively across organisational boundaries and disciplines to secure place-based
improvements that are tailored to local needs and assets, in turn increasing sustainability and the effective
use of limited resources.
5. We will build the capacity and capability across our workforce to prevent mental health problems and
promote good mental health, as outlined in the Public Mental Health Leadership and Workforce
Development Framework Call to Action.
6. We believe local areas will benefit from adopting the Prevention Concordat for Better Mental Health.
7. We are committed to supporting local authorities, policy makers, NHS clinical commissioning groups and
other commissioners, service providers, employers and the voluntary and community sector to adopt this
Concordat and its approach.
2016 2017
How can Elected
Member Mental
Health
Champions
model prevention
focussed
leadership?
Prevention Concordat Resource Partnerships
What
does a
good
mental
health
JSNA
look like?
2018
How prevalent
are local
prevention
planning
arrangements?
What is their
scope?
Facilitating learning, sharing what works and generating opportunities across sectorsWhat
does the
evidence
tell us
about
what
works?
How do
psychosocial
approaches
improve action
on health
inequalities?
Endorsement and Adoption
Prevention Concordat for Better Mental Health Programme
The Prevention Concordat for Better Mental Health was launched on13th September 2017 at the Public
Health England Conference, together with the Association of Directors of Public Health and the Faculty
for Public Health
Starting with 30 endorsements at launch each have declared a pledge to engage in specific actions to
deliver cross sector change . The number of signatories continues to grow including the first wave of
local areas.
✓ Age UK
✓ Association of Directors of Public Health UK
✓ Association of Mental Health Providers
✓ British Islamic Medical Association
✓ Care Quality Commission
✓ Catholic Bishops’ Conference of England &Wales
✓ Centre for Mental Health
✓ Children and Young People’s Mental Health
Coalition
✓ Department of Health (on behalf of government)
✓ Faculty of Public Health
✓ Health Education England
✓ Homeless Link
✓ Housing Associations’ Charitable Trust
✓ Local Government Association
✓ Mental Health Foundation
✓ Mind
✓ Muslim Council of Britain
✓ Network Rail
✓ NHS Clinical Commissioners
✓ NICE
✓ The National LGBT Partnership
✓ National Suicide Prevention Alliance
✓ National Survivor User Network
✓ National Voices
✓ NHS Digital
✓ NHS England
✓ NHS Improvement
✓ Public Health England
✓ Rethink
✓ Royal College of Nurses
✓ Royal College of Psychiatrists
✓ Samaritans
✓ Student Minds
✓ StreetGames
✓ Youth Access
✓ County Durham
✓ Derby City
✓ Hertfordshire
✓ Middlesbrough
✓ Redcar and
Cleveland
✓ Warwickshire
Sign-up Protocol - June 2018Local areas:1. Have a named mental health champion who is either: an elected member, a member of the
Health and Wellbeing Board, the chief executive (LA or CCG or both)
2. Confirm that they have: • Completed and published a public mental health JSNA in the last 18 months, and have plans to
refresh it or to do a focussed report on one of their priority themes OR
• Completed and published a public mental health JSNA in the last 6 months OR
• In the absence of a public mental health JSNA, arrangements are in place to initiate one within 3
months of signing
3. A multi-agency suicide prevention plan in place
4. Indicate plans for evaluation
5. Agree to schedule the public mental health on the agenda of a scrutiny board in the next 18
months.
6. Sign off by the Health and Wellbeing Board
National organisations:1. Commitment to do specific actions centred on the prevention of mental health problems and
promotion of good mental health
2. Indicate plans for evaluation
3. Confirmation of arrangements to provide reports on progress and governance through an
appropriate Board
Signatories as Champions of Change
Insights drawn from the extensive Prevention Concordat engagement and learning events, expert
steering groups and London School Economics/PHE work on mental health promotion ROI
• Identifying, modelling and demonstrating collaboration on resources and benefits
• Taking action to strengthen and share the evidence of what works
• Taking action to reduce current fragmentation through building cross sector partnerships,
developing multi-sector actions as part of health & wellbeing strategies (including public mental
health in joint strategic needs assessments)
• Raising profile of prevention and promotion focussed approaches and fostering change
in in own sector and others
• Facilitating access to quality data and intelligence including working in partnership to
make it easier to obtain information on the benefits of mental health, wellbeing and mental ill-
health prevention
• Workforce capacity building and seeking mechanisms to embed capacity building into
routine training e.g. teachers
Sign-up the Prevention Concordat For Better Mental
Health:
Download the full suite of resources: https://www.gov.uk/government/collections/prevention-concordat-for-better-
mental-health
Read the blogs from the learning events and watch
recordings of the webinars: http://www.preventionconcordat.co.uk/
National Approach to
Suicide Prevention
Suicide in England – ONS statistics
14 National Approach to Suicide Prevention
▪ ONS statistics for 2016 – 4575 deaths, 6% fall in the suicide rate in
England, 245 fewer deaths. The male suicide rate has fallen for three
consecutive years and the recent rise in female rate has reversed.
▪ Provisional data for 2017 suggests a further fall. Exception for 15-19 year
olds – concerning as rising since 2010
▪ Leading cause of death for men and among the leading causes of death
for new mothers
▪ Inequalities persist – 3-fold difference in LA rates from Middlesbrough to
East Hertfordshire
National policy context
Local suicide prevention planning15 National Approach to Suicide Prevention
Zero suicide
16 National Approach to Suicide Prevention
In addition in 2018, Secretary of State announced zero suicide
ambition for mental health inpatients. These deaths by suicide are
important as are closest to proximity of care and will therefore contribute
to the 10% reduction commitment.
“Today I am announcing the next step in our ambition – a
new requirement that all NHS mental health
organisations should draw up detailed plans to achieve
zero suicides, starting with those in inpatient settings,
meaning that the NHS in England will be the first country
in the world to roll out zero suicide as a national
ambition.”
PHE approach to support delivery
17 National Approach to Suicide Prevention
PHE Support and Guidance
18 Making the Forward View Plans a Reality
• PHE, working with NSPA, have released a suite of
guidance, data, and research to support local delivery.
• https://www.gov.uk/government/collections/suicide-
prevention-resources-and-guidance
• Our 9 Local Centre Public Mental Health leads provide
expert advice and support
•
18
Building a partnership approach
1. Suicides are the result
of a wide and complex
set of interrelated
factors
2. Requires work across
a range of settings
targeting a wide variety
of audiences.
3. No single agency is
likely to be able to
deliver effective
suicide prevention.
19 National Approach to Suicide Prevention
Existence of suicide prevention plans
Green – prevention plan exists
Amber – prevention plan in
development
Red - no prevention plan
Click on area to see
value and obtain more
information
20 National Approach to Suicide Prevention
PHE survey (December 2017)
• All local authorities will have a
plan in place by June 2018
Local Authority Self Assessment (planned)
• In 2018 - LGA, ADPH and PHE to invite Local Authorities to
complete self assessment as part of collaborative Sector Led
Improvement approach
• September 2018 - high level analysis of self assessment
setting out regional and national themes
• January 2019 - a final in depth thematic report will be
produced and published leading to a 3 year SLI process from
April 2019
Presentation title - edit in Header and Footer2121 National Approach to Suicide Prevention
Transformation funding
Presentation title - edit in Header and Footer22 National Approach to Suicide Prevention
£25m investment over 3 years:
• £5m 18/19
• £10m 19/20
• £10m 20/21.
Approach & Alignment
Public Health
Suicide Community-
Based Prevention
Interventions
Improving quality of
mental health
services & patient
safety (rec 57)
Incl. MH inpatients
8x priority high
rate STPs 18/19
funding plans
(drawn from multi-
agency plans rec 3)
Zero Suicide
Ambition
£ focus: Middle-aged men, self-harm,
primary care access, MH service quality
• Priority fund STPs identified in 18/19 due to high rates submitted funding proposals, which include
improving quality of mental health services - this covers mental health inpatients.
• This will be supported by a National Quality Improvement offer delivered by National Confidential
Inquiry into Suicide and Homicide for people with mental illness (NCISH) & RCPsych. These
partners have extensive evidence on what works to improve safety and reduce in patient suicides to
zero. Further STPs to receive funding in 19/20 to widen reach.
• In addition, all STPs via the Mental Health Delivery Plan 18/19 were asked to ensure LA led multi-
agency plans for suicide prevention form part of STP MH delivery, including specific plans on zero
suicide ambition. Progress will be tracked at quarterly deep dives.
All STPs
Embedded in core STP MH programme
Delivery support: National Quality Improvement Programme (18/19 priority STPS) and Regional
Implementation Support Offer (all STPs)
Thank you