Peninsula Teaching Public Health NetworkMarch 2010 Conference

Parallel SessionMental Health Improvement

Greg UsreyHealth Improvement Lead (Mental Health)

gusrey@nhs.net

There are many different definitions of the term mental health. More often than not it is used to denote mental illness and related issues of treatment. In this instance it is used as an umbrella term to cover both illness and wellbeing.

Mental wellbeing is an area which is often overlooked and misunderstood. However, there is growing international recognition of the benefits of addressing mental wellbeing in a comprehensive approach to mental health.

'Mental illness': Mental illness refers to a diagnosable illness that significantly interferes with an individual's cognitive, emotional or social abilities e.g. depression, anxiety, schizophrenia.

'Mental wellbeing': There are also many different definitions of mental wellbeing but they generally include areas such as: life satisfaction, optimism, self esteem, mastery and feeling in control, having a purpose in life, and a sense of belonging and support.

What is Mental Health?

http://www.healthscotland.com/mental-health-background.aspx

What IS Mental Health Improvement?

Mental health improvement (sometimes called mental health promotion) involves any action to improve mental health.

Like mental health, it is an umbrella term that may include action to do many things…..

• Mental Health Improvement refers to activity to promote good mental wellbeing in the general population; to reduce the prevalence of common mental health problems; and to improve quality of life for those experiencing mental health problems or mental illness.[1] The approach is based on a social model of health which recognizes that mental state is shaped by social, economic, physical and cultural environments, including people’s personal strengths and vulnerabilities, their lifestyles and health-related behaviours, and economic, social and environmental factors.[2]

• Small improvement in population wide levels of wellbeing will reduce the prevalence of mental illness, as well as bringing the benefits associated with positive mental health [3] as shown in Table / Figure X (distribution of mental health figure).

[1] Towards a Mentally Flourishing Scotland: Policy and Action Plan 2009-2011[2] Towards a Mentally Flourishing Scotland: Policy and Action Plan 2009-2011 p5[3] Mental Health, resilience and inequalities – Dr Lynne Friedli p 13

Protect and promote the mental wellbeing of the whole population, including those

experiencing mental illness

•increasing; self esteem and confidence, feelings of belonging, coping skills, resilience, cognitive skills, etc.)

•Promoting wellbeing focuses on the building of competences, resources and strengths and has a major contribution to make to personal and social development.

Prevent mental illness

•reducing risk factors for mental illness (e.g. lack of support services including transport, shopping and

recreational facilities, neighbourhood violence and crime, socio-economic disadvantage, parental mental disorder,

bullying, etc)

•increasing protective factors (e.g. social support, community connectedness, good physical health, positive

school environment, job control, infant attachment, etc) and (see table below for further information on risk and

protective factors)

Improve the quality of life of those people experiencing mental health problems

•recovery oriented services

•reducing stigma and discrimination

•job retention and rehabilitationetc.

Mental Health Improvement

not only concerns the beliefs, attitudes and behaviours of

individuals….

but also broader socio-economic and environmental

determinants.

Mental Health Improvement Network

• Network: Developing MHI Action Plans, Frameworks & Models

• Newsletter: Together Newsletter

• Seminar Programme: Research in Mind Seminar Series

• Website: www.phru.net/mhin - Dissemination & wider Communications

• Social and economic cost of mental health problems in Scotland amounts to £8.6 billion – 9 per cent of Scotland’s Gross Domestic Product

• 11 million sleeping tablets prescribed in Greater Glasgow and Clyde in 2007

• Self-reported work-related stress, depression and anxiety account for an estimated 12.8 million reported lost working days per year in Britain

• People with mental health problems have lowest rate of employment of any disabled group

• Depression on course to be the 2nd highest ranked condition across the world in terms of disability adjusted life years (DALYs) by 2020 - WHO

• Anti-depressant prescriptions have risen four fold in Scotland over last 15 years

• Glasgow City has amongst the highest rates of male and female suicide of any local authority area in the UK

Why invest in Mental Health Improvement?

A worthwhile goal in itself and leads to better outcomes:

overall prevalence / herd immunity

physical health: mortality / morbidity

positive health behaviours

greater employability, productivity, earnings

higher educational attainment / performance

Reduction in crime & violence

pro-social behaviour / social integration / relationships

quality of life / recovery

Benefits of positive mental health

HEAT targets – suicide, depression

Delivering for Mental Health commitments – e.g. Scottish Recovery Indicator (SRI)

Mental health dimensions of SOAs

Sections 25-31 of Mental Health Act

Planning and Priorities Guidance – mental health improvement framework

Equally Well – new national indicator for wellbeing

Mental Health Improvement: Performance and targets dimension -

examples

• Wellbeing (adults aged 16 years and over): WEMWBS; via Scottish Health Survey

(Warwick-Edinburgh Mental Wellbeing Scale - tool for measuring positive mental wellbeing at a population level; Scale comprises fourteen separate statements describing feelings related to mental wellbeing)

Monitoring frameworks

"Scotland's health is improving rapidly but it is not improving fast enough for the poorest sections of our society. Health inequalities ... remain our

major challenge."

Mental Health Improvement: Multiple Policy Connections

• Towards a Mentally Flourishing Scotland: Policy and

Action plan 2009 – 2011• Keep Well• Employment• Better Health Better Care• Living Better, Long Term Conditions• Healthy Working Lives, staff health and wellbeing,

absence management• With Inclusion In Mind (local authorities)• Choose Life – suicide prevention• Children’s services planning• Equalities legislation and inequalities policy• And many many more…

Mentally Healthy Children and Young People

Suicide Prevention and Choose Life

Physically Healthy Inpatient Mental Health Services

Challenging stigma and discrimination(Glasgow Anti Stigma Partnership)

Mentally Healthy in Later Life

Mentally Healthy Communities

Mentally Healthy Employment and Working Life

Young ParentsPupils

Students

SafeTalkASIST Scottish Mental Health First Aid

BME Groups Carers

LGB Groups

LocalNational

International

HPH / HPHS

Service Users

NHS

Local Authorities

Voluntary / Charitable organisations

Community PlanningScottish Government /

Westminster?

Community Groups

Schools

Uni / HE / FE

Faith Leaders

Asylum Seekers / Refugees

Winning arts and minds

Storytelling Project

School Mental

Health

Curriculum Pack

LGB Mental Health NHS & Local Authority ‘Single Outcome Agreements’

Greg UsreyHealth Improvement Lead (Mental Health)Mental Health PartnershipNHS Greater Glasgow & ClydeDalian House, 1 West350 St Vincent StreetGlasgow G3 8TST: 0141 201 4987    F: 0141 201 4548Web: www.phru.net/mhin Email: gusrey@nhs.net