By: Ivan Rudd, Public Health Specialist for Mental Health and Wellbeing

To: West Kent CCG Health and Wellbeing Board

Subject: Mental Health and Wellbeing Task and Finish Group: Updated July 2014

Classification: Unrestricted

Summary

The Mental Health Task and finish Group was tasked by the HWBB to review key issues and make recommendations to the HWBB on how it could support wellbeing and the prevention of mental ill health.

1.    Introduction

The Task and Finish Group for Mental Health was formed subsequent to a presentation made to West Kent Health and Wellbeing Board.

The membership of the T&F Group membership varied and included:

Ivan Rudd, Public Health Specialist KCC (Chair - Hayley Brooks Manager Sevenoaks District Council unable to attend meetings)

Anton Tavernier-Gustav, Sevenoaks Council 

Katie Latchford, Maidstone BC

Heidi Ward, Tonbridge and Malling BC

Sara Watkins, Tunbridge Wells BC

David Chesover , Deputy Chair NHS  West Kent CCG

Ivan Rudd, Public Health Specialist KCC

Dave Holman NHS West Kent CCG

Sue Scamell, KCC

Jill Roberts, CEO Sevenoaks Mind

James de Pury NHS West Kent CCG

The aim of the Group was to understand four issues:

1.    Mental health improvement opportunities funded by Section 256,

2.    Opportunities for supporting employers and schools in prevention

3.    The need for a communications strategy to make sure that everyone who might need the service finds it easy to access.

4.    How can we build community resilience? What would districts/ boroughs, the various sectors of the NHS need to do to enhance this?

1. Mental health improvement opportunities funded by Section 256

Section 256 Services.  Section 256 provides funding for the Local Authority to support voluntary sector providers to provide the Services for people with severe mental health needs to enable them to live independently. The services are also designed to meet the needs of people diagnosed with common mental illness and people can self-refer enabling a ‘universal’ approach.  The core vision being developed is to grow the ‘wraparound’ holistic support offered that helps people into employment, meaningful activity, care navigation and building resilience and coping skills.  This year’s Section 256 agreements have been signed off and future plans will be shared with all HHWBB partners as they are developed this financial year; the  Programme Oversight Group (POG) chaired by West Kent CCG is the current forum for exploring the development Section 256 services.

2 a) Opportunities for supporting employers and schools in prevention

Schools

Mental health prevention has two strands - keeping well, and preventing people with mental health issues from further ill health through promoting recovery. There are many initiatives within schools to maintain health and improve emotional wellbeing but it is difficult to map them or to have a strategic sense of their quality in West Kent.  For schools governing bodies are responsible for ensuring that wellbeing and pupil support structures that seem most appropriate are in place.  It is not clear how good targeted and universal provision is in primary and secondary schools, and how it complies with NICE Guidance on school emotional Health and Wellbeing.  Two recent developments may help understand opportunities for supporting schools better, these are the development of the COG in West Kent and the work surrounding the Lottery’s HeadStart work programme which is developing interventions and these will be shared with the Board. 

Note on parenting support provision. Parenting is most important determinant of mental health and resilience across the life course. It influences a child’s ability to benefit from primary education and builds the confidence and skills that contribute to a successful secondary education.  The infant’s emotional and social brain is very plastic and it is the relationship with parents and carers that shapes it.  This dictates risk and resilience for mental illness and psychological distress throughout life. The current universal support for parenting picture is unclear.

Question – does the Board wish this T&F Group to continue to explore the emotional health and wellbeing support available in schools or should this be a priority for the COG to consider?  Should the COG also consider including a review of access and barriers to universal parenting opportunities in West Kent?

2 b) Workplaces

Workforce mental health and wellbeing.  The workplace is a key environment to promote good mental health and there is a range of guidance on how to maintain and improve health and wellbeing in the workforce.   Sevenoaks Mind is leading a major ‘Chatter Matters’ campaign based on improving health in the workplace amongst other objectives and it will link into the wider communications strategy.  Public Health at KCC have a significant workplace programme and are funding training for GPs in Mental Health First Aid to contribute to the Kent Suicide Prevention Strategy and Action Plan.  . 

Action The Board is asked to note the growing interest in workplace wellbeing and to consider receiving a presentation from KCC PH Workplace Leads on current progress and what more can be achieved in West Kent.

3 The need for a communications strategy to make sure that everyone who might need the service finds it easy to access

There is a wealth of mental health and wellbeing support services in West Kent and the T&F Group recognised the benefits of closer working to develop a communication plan to enable the public to understand what free NHS services are available. 

The T&F group identified that more can be done to make the public aware of the MH support that is available to them and those they care for.  We looked at the communication resources that existed such as the Live it well website – www.liveitwell.org.uk which was a key product of the Live It Well strategy. 

Communicating services example: Access to Improving Access to Psychological Therapies services. The T&F Group noted the low numbers accessing Improving Access to Psychological Therapies (IAPT) services, and West Kent CCG has led a partnership to develop a strategy and action plan that seeks to close the gap in the population’s understanding of Improving Access to Psychological Therapies services available. It will facilitate the development of a wider communications approach. The Board is asked to note that as part of the IAPT communication strategy there is an IAPT publicity event at the Hop Farm in the evening of 17^th July.

Recommendation.  The T&F  group recognised the Live it Well strategy should be revisited and recommends that the revision process should form part of a wider communication strategy with an action plan to ensure greater understanding in West Kent of services available throughout the life course.         

4 How can we build community resilience? What would districts/ boroughs, the various sectors of the NHS need to do to enhance this?

A World Health Organisation report for the European region [1]  has made the case for both individual and wider societal public health solutions to increase resilience and improve mental health and well-being which is described as a community or individuals ‘ordinary magic’ which allows them to achieve good outcomes in spite of serious threats to adaptation or development.”  [2]

How is resilience grown in communities?  The literature suggests we focus on growing those key assets that make a difference.  Assets can be individuals, community groups, associations, buildings and spaces.   KCC PH is has funded some pilot research in Kent to understand further how community wellbeing - are utilised using mapping and resident ‘deep dive’ interviews and workshops

This asset pilot should help the T&F Group start to understand the individual experience and value of different community assets as a step towards making recommendations to enhance community resilience.

Question: Does the Board wish the T&F Group to continue to further develop this resilience work in West Kent?

Ivan Rudd

July 2014