No Health
Without Mental Health:
The mental health programme for Calderdale
Version 4
Version control
Version / Date / Author / Comments1 / 26/09/11 / MH / This version includes objectives 1 and 2 worked up from a consultation briefing and following workshops with stakeholders w/c 19th September
2 / 6/10/11 / MH / All objectives worked up and amendments following further consultations with MHPG
3 / 10/10/11 / MH / Initial changes following meeting with MM 10/10/11
4 / 25/11/11 / MH / Draft for last round of consultation incorporating various comments and observations
No Health Without Mental Health - The mental health programme for Calderdale – Version 3
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Foreword
This is the Mental Health Programme for Calderdale, in which we outline our commitment to improving the mental wellbeing of people who live in Calderdale, and how we are going to achieve that.
Mental Health is important to everyone. Having good mental health does not always guarantee happiness or freedom from difficulty. In most people’s lives there will be times when very difficult, and even terrible, things happen.
Good mental health helps us to make the most of our opportunities for happiness, but more importantly its real test will be in how well it enables us to cope with the disappointments, difficulties and crises which we all experience at some points in our lives.
Contents
Foreword
Contents
Executive Summary
Glossary and Explanations
Introduction
The Mental health Programme for Calderdale
Objective 1: More people will have good mental health
1.1 Who is particularly affected in Calderdale:
1.2 What are the quality of life conditions we want for our community and the children and families who live here?
1.3 How can we measure these conditions?
1.4 Who are the partners that have a role to play in doing better?
1.5 What works to do better, including no-cost or low-cost ideas?
1.6 What do we propose to do?
1.6.1 What we do now
1.6.2 What we need to differently and/or review
Objective 2: More people with mental health problems will recover
2.1 Who is particularly affected in Calderdale:
2.2 What are the quality of life conditions we want for our community and the children and families who live here?
2.3 How can we measure these conditions?
2.4 Who are the partners that have a role to play in doing better?
2.5 What works to do better, including no-cost or low-cost ideas?
2.6 What do we propose to do?
2.6.1 What we do now
2.6.2 What we need to differently and/or review
Objective 3: More people with mental health problems will have good physical health
3.1 Who is particularly affected in Calderdale:
3.2 What are the quality of life conditions we want for our community and the children and families who live here?
3.3 How can we measure these conditions?
3.4 Who are the partners that have a role to play in doing better?
3.5 What works to do better, including no-cost or low-cost ideas?
3.6 What do we propose to do?
3.6.1 What we do now
3.6.2 What we need to differently and/or review
Objective 4 More people will have a positive experience of care and support
4.1 Who is particularly affected in Calderdale:
4.2 What are the quality of life conditions we want for our community and the children and families who live here?
4.4 How can we measure these conditions?
4.4 Who are the partners that have a role to play in doing better?
4.5 What works to do better, including no-cost or low-cost ideas?
4.6 What do we propose to do?
4.6.1 What we do now
4.6.2 What we need to differently and/or review
Objective 5: Fewer people will suffer avoidable harm
5.1 Who is particularly affected in Calderdale:
5.2 What are the quality of life conditions we want for our community and the children and families who live here?
5.3 How can we measure these conditions?
5.4 Who are the partners that have a role to play in doing better?
5.5 What works to do better, including no-cost or low-cost ideas?
5.6 What do we propose to do?
5.6.1 What we do now
5.6.2 What we need to differently and/or review
Objective 6: Fewer people will experience stigma and discrimination
6.1 Who is particularly affected in Calderdale:
6.2 What are the quality of life conditions we want for our community and the children and families who live here?
6.3 How can we measure these conditions?
6.4 Who are the partners that have a role to play in doing better?
6.5 What works to do better, including no-cost or low-cost ideas?
6.6 What do we propose to do?
6.6.1 What we do now
6.6.2 What we need to differently and/or review
Executive Summary
Objective 1: More people will have good mental health
“Healthy lives, healthy people”,
The Mental Health programme will continue to fully engage with local action to deliver the objectives laid down in “Healthy Lives, healthy people”, and to ensure that people with mental health problems are fully included in this action.
Joint Strategic Needs Assessment (JSNA)
We will, continue to assess need following good practice indicated nationally, using the best possible data, including nationally data and service use data, but also including service user feedback. It will make this available in the JSNA. An annual suicide audit will be undertaken.
Mental health Impact Assessment
We work with policy makers and organisations to encourage the regular and routine use of Mental Health Impact Assessment to prospectively assess the impact of proposed policy and service changes,
A Mental Wellbeing Alliance for Calderdale
The programme will mobilise existing health improvement and commissioning resources to support and facilitate the development of a Calderdale Alliance for Mental Wellbeing with the clear aim of:
· supporting groups organisations to maximise their impact on mental wellbeing
· facilitate the creation of creative partnerships to achieve the positive outcomes highlighted by National Mental Health Development Unit’s wellbeing checklist: Enhanced control, Increased resilience, Supportive Community Assets, Opportunities and encouragement to participate
· encouraging the widest possible advocacy of understanding of mental health problems and challenge to discrimination
Although there are good reasons for having a single alliance which, like the Programme covers the whole life course, there are particular issues regarding the well being needs of children and young people, and also a range of partner organisations focused on young people. To encourage participation from partners and improve the likelihood of focussed action for this group we would explore the practicality of a specific Calderdale Alliance for Young People’s Mental Wellbeing.
Objective 2: More people with mental health problems will recover
The Programme will continue to commission mental health services for children, working age adults and older people.
Improving the way recovery is delivered by services is a priority for commissioners and providers in Calderdale. In the light of this and the feedback from our consultation we have identified there are priority areas for action as a part of this programme.
Mental Health Programme Priorities for improved Recovery
1 Place Recovery at the centre of the commissioning-provider relationship
Explore with providers how to report on patient outcomes and progress towards recovery using an appropriate version of the recovery star
2 Prioritise service reconfiguration to achieve significant and sustainable improvements to recovery
Specifically:
· Improve the range of long and medium term residential rehabilitation care available in Calderdale to minimise the need for out of area placements which however good the quality of care cannot be conducive to future more independent living in Calderdale.
· Develop more wrap-around that will enable clients to move out of 24hr care earlier in the rehabilitation journey
· Develop the use of personalised budgets and direct payments to support greater degrees of independence earlier in the journey to recovery.
3 Develop co-production as a routine process for service development by service providers
This will specifically mean:
· Creating more robust user and carer involvement in commissioning and delivery of care packages
· Ensuring that users and carers understand and are involved in the implementation of new commissioning arrangements
Objective 3: More people with mental health problems will have good physical health
· We will routinely review whether CQUINs continue to be the best way of achieving or reporting action in respect of the physical health needs of patients with mental health problems. If they are not we will need to consider alternative methods.
· We need to ensure that the in primary care services mental health interventions such as those through IAPT recognize the importance of the supporting the mental health needs of patients with long term physical conditions.
· In line with the National Operating Framework for the NHS 2011/12 this will also include following the Lead of the DoH to “extend access to talking therapies for children and young people, older people, for people with severe and enduring mental health problems and for people with co-morbid mental and physical health long term conditions”.
Objective 4 More people will have a positive experience of care and support
· If we are to address the shortcomings in the delivery of timely and high quality care we cannot be complacent. While the picture that emergences from patients reporting their experience is not entirely negative, and suggests services are improving, there is no strong evidence that they are improving fast enough to deliver outcomes in a reasonable period of time.
· We need to review all access times to services and identify those areas where timely access is problematic. We need to work together as a health community, involving providers (managers and clinicians), commissioners, and patients and carers, to identify ways of delivering good quality care with shorter access times.
Objective 5: Fewer people will suffer avoidable harm
· Effective risk management In respect of patient care and protection, and harm reduction are requirements of contracts with service providers, and serious untoward events have to be routine reported along with the outcomes of any internal investigation to the commissioners
· We need to maintain the current robust safeguarding arrangements, a suicide prevention action plan and group, and self harm is routinely monitored in Accident and Emergency Services. There is a local review process established for drug-related deaths.
· There was a positive response during the consultations to the range of activities already happening, within individual services and collectively. But improvements need to be made specifically to:
· Information for clients
· Training for front line working
· Engage users in commissioning and service design
· Collection of data re sexual orientation
Objective 6: Fewer people will experience stigma and discrimination
The work of agencies across Calderdale, and across sectors needs to be supported and commended although the current financial situation will present challenges.
There is hope of seeing an expansion of current activity, and to make some activities and organisations more secure. The need for a better understanding of black and minority ethnic communities viewpoints on how to tackle issue of stigma.
There was a need to better understand mental health issues that are specific to men and which have not been directly addressed.
During the consultation there was consideration about how to strengthen and extend the partnerships that are critical to making this work successfully. It was concluded that the development of a Mental Wellbeing Alliance for Calderdale would be an ideal
Glossary and Explanations
A note on the way words are used when discussing mental health and mental wellbeing
In discussing mental health policy and strategy we sometimes need to produce a glossary explaining the meaning of technical expressions and even abbreviations to make it more understandable.
When discussing “mental health” we need be clear about what we mean and sometimes about the subtle difference of meaning between apparently similar expressions.
Mental Health
“Mental health” describes the entire field that we are discussing. Mental health is part of everyone’s make-up - from those with good mental health to those with severe and long term mental health problems. The definition of mental health used here is from the National Mental Health strategy, which is based on that used by the World Health Organisation.
Mental Wellbeing
“Mental Wellbeing” is harder to define, but is about experiencing good mental health, or improving the experience of positive mental health. As with mental health it is experienced by everyone: it is possible to improve mental wellbeing of those with severe mental illness.
There is a sense in which mental wellbeing can be assessed over reasonable period of time: acknowledging that circumstances will occur that cause stress and distress to individuals who generally experience good mental wellbeing. Indeed the ability of individuals to cope with distress is one indicator of their mental wellbeing.
Mental Illness
“Mental Illness” is used to indicate specifically diagnosable conditions. In practice it is often used to indicate a long term condition.
Mental Ill-health
“Mental Ill-health” can be used interchangeably with “mental illness” to indicate specifically diagnosable conditions. In practice it often used to indicate a short term condition, perhaps where diagnosis is harder to arrive at.
Mental Health Problems
“Mental Health Problem” is a much more general term which includes short, medium and long term illness, common mental disorder, and personality disorders It also includes stress and distress which may be related to specific personal circumstance such as bereavement, relationship breakdown and serious physical illness. It also includes addictive behaviours such as gambling and hazardous drinking.
Personality Disorder
“Personality Disorder” is defined as
‘an enduring pattern of inner experience and behaviour that deviates markedly from the expectation of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early childhood, is stable over time, and leads to distress or impairment’
The two types of personality disorder are antisocial personality disorder (ASPD) and borderline personality disorder (BPD).