public mental health and wellbeing developing and implementing a local strategy in warwickshire
TRANSCRIPT
Public Mental Health and Wellbeing Developing and implementing a local strategy in
WarwickshireJune 2016
Dr Charlotte GathConsultant in Public Health
Why a Public Mental Health Strategy?
• Living in Warwickshire survey, 2014
– “1 in 5 people in Warwickshire either never or rarely feel relaxed, while 1 in 10 people do not feel close to other people”
PMH strategy – the theory
1. Analyse local public mental health intelligence to assess risk factors and need
2. Select appropriate and cost-effective PMH interventions
3. Evaluate, and measure population outcomes for PMH interventions
Evidence for cost-effective interventions
Evidence for public mental health interventions to:
• Improve healthy lifestyles, physical health, life expectancy
• Improve resilience, social functioning and quality of life
• Reduce burden of mental disorder• Reduce inequalities• Reduce associated health risk behaviour,
crime and violence
Economic reasons for investment in public mental health
2011 DH published a report by Knapp et al – for every £1 invested in public mental health interventions, the net savings were:• £84 saved – school based social and emotional
learning programmes• £44 saved – suicide prevention through GP
training• £18 saved – early intervention for psychosis• £14 saved – school-based interventions to reduce
bullying
Knapp savings 2
• £12 saved – screening and brief interventions in primary care for alcohol misuse
• £10 saved – work-based mental health promotion (after 1 year)
• £10 saved – early intervention for pre-psychosis• £8 saved – early intervention for parents of children
with conduct disorder• £5 saved – early diagnosis and treatment of
depression at work• £4 saved – debt advice services
Evaluation and outcomes
Public mental health outcomes
• Promotion of population wellbeing – WEMWBS
• Prevention of mental disorder by addressing risk factors –measure reduction
• Early and effective treatment of mental disorder to improve recovery outcomes, reduce associated health risk behaviour, reduce associated physical illness and early mortality, reduce suicide
What we did…
• The strategy outlined the reasons – including economic reasons – for investing in public mental health
• It included a review of cost-effectiveness of public health interventions to improve mental wellbeing
• Outlined a series of priorities linked to Warwickshire JSNA and national strategy “No Health Without Mental Health”
Tailoring presentation for different audiences….
The three tier approach
Priority areas are given as key aims, laid out in traditional three tier public health model –• Level 1 – universal interventions to improve
mental wellbeing• Level 2 – targeted interventions to prevent
mental ill health• Level 3 – health improvement for vulnerable
population groups including people with severe mental illness
Key aims for strategy 1
Level 1• to champion mental health for all, and to
promote and improve public mental health and wellbeing across the life course, from childhood to all age, working in partnership with key stakeholders
Key aims for strategy 2
Level 2• To promote and improve the mental health and
wellbeing of looked after and vulnerable children and young people in Warwickshire
• To commission evidence-based public health interventions to prevent mental ill health, suicide and dementia
• To increase access to, and availability of, low level support and early intervention services for people at risk of mental health problems
Key aims for strategy 3
Level 3• To narrow the gap in health inequalities for
people living with severe mental illness• To increase timely diagnosis rates for
dementia, and improve availability of post-diagnosis support
What have we done so far? Level 1Champion mental health for all and reduce stigma: Time to Change Warwickshire campaign
What else have we done? Level 1
• Five Ways to Wellbeing campaign, e-learning• Mental Health First Aid training and Dementia
Awareness for frontline staff• Early intervention and mental health awareness
training for schools, school-based programmes to prevent bullying and conduct disorder, parenting support through Smart Start
• Dementia Friends 10,000 target reached• Older people – befriending schemes and
enhanced physical activity
Five ways to wellbeing in Warwickshire
The five ways to wellbeing
Background to the campaign• Campaign uses evidence and guidance developed
by the New Economics Foundation (nef)• nef commissioned by the Government's Foresight
Project on Mental Capital and Wellbeing to develop a set of evidence-based actions to improve personal well-being
• Evidence suggests small improvements in wellbeing can help to decrease some mental health problems and also people to flourish.
• Good mental health and resilience are fundamental to our physical health, our relationships, our education, our training, our work and to achieving our potential.
An engaging and eye catching brand
Resources developed for Mental Health Awareness Week:
Five ways websitepublichealth.warwickshire.gov.uk/5ways
Business cards with inspiring quotesBadgesBannersWellbeing Hub prompt sheet for staff Happy cards ‘What made you feel happy in the last few days?’Pledge for wellbeing cards ‘My pledge for my wellbeing is to’:
Branding and Resources
My pledge for my wellbeing is to:
• To take more notice & look around while walking• Be active, do something rewarding• Get a new radio fitted in my car next week• To go to lunchtime meditation this week• Carry on going to my social groups• To talk to people more• Take time to observe my environment & take pleasure in those
things that we take for granted – time to reflect
• Encouraged to build wellbeing into daily life• Wellbeing goodies• Visit five ways website:
publichealth.warwickshire.gov.uk/5ways• Follow us on twitter: @WCCPublicHealth • Tweet how you got on with your pledge• Come back to wellbeing service• Support from Hubs• Signposting to other services
Support for wellbeing
Evaluation• Website hits / tweets / facebook likes etc• Living in Warwickshire survey, 2014
– 1 in 5 people in Warwickshire either never or rarely feel relaxed, while 1 in 10 people do not feel close to other people
– 2016 new version just launched, results awaited
• Wellbeing Hubs evaluation - uptake of low level mental health and wellbeing services, WEMWBS
Mental Health First Aid
• Accredited course and provider (Rethink)• 5 x 2 day sessions across Warwickshire
2015-16• 23 external organisations, 14 different
county council departments• Cost £12k• Roll-out continuing
What have we done so far? Level 2
• Big White Wall• Books on Prescription scheme• Commissioned three cross-county Wellbeing Hubs
aligned with CCGs• Criminal Justice Strategic Group and Youth Justice
mental health needs assessment• School nurses – YP emotional resilience training• Programmes aimed at improving emotional
wellbeing of looked after children and other vulnerable groups of children and young people
Level 2 cont’d
• Improving working lives - workplace mental resilience and early intervention
• Suicide prevention education programmes specifically for GPs, ASIST
• Effective signposting to wellbeing support for people with long term physical health conditions
• Veterans’ mental health
What have we done so far? Level 3
• Enhanced smoking cessation support for people using mental health services in all settings, and use of MECC (Making Every Contact Count)
• Enhanced role for Wellbeing Hubs with greater emphasis on physical health and activity, weight management and smoking cessation – eg FCH Dance Programme
• Supported development of integrated physical health pathways for people with serious mental illness
Level 3 cont’d
• Mental Health and Employment Service – commissioned IPS-based model
• Co-production and user involvement, WREP recommendations
• Development of dementia community support (Dementia Navigators)
• Improved service access and care for people with dual diagnosis – drug and alcohol service review
• Suicide audit 2015
Next steps
• 5WTW e-learning roll-out• Suicide Prevention strategy• Young people and preventing self-harm• Mental health and employment service launch• Smart Start early years, infant and maternal mental
health• Crisis Response, Crisis Care Concordat • Primary care MH development, mental health
prevention for STP• Dementia risk factor reduction campaign
Contact us…
• Email:[email protected]• Web: www.warwickshire.gov.uk/publichealth
Huge thanks to:Paula Mawson, Claire Taylor, Mike Jackson