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:charlottegath@warwickshire.gov.uk• Web: www.warwickshire.gov.uk/publichealth

Huge thanks to:Paula Mawson, Claire Taylor, Mike Jackson