Agenda item
NORTH EAST LONDON SUSTAINABILITY AND TRANSFORMATION PLAN; MENTAL HEALTH
Minutes:
Ms Milligan introduced this item, together with Mr Fradgley, and explained that the report would provide Members with an overview of the work being undertaken to develop mental health services as part of the North East London Sustainability and Transformation Plan.
Mr Fradgley referred to the fact that there was now significant drive to make mental health a national priority. He stated that investment in that area was needed as much as it was in acute illnesses. Mr Fradgley then explained that inner North East London had the highest level of mental illness in the country and that there was significant increasing demand for mental health services. He also stated that there had been a 10% increase in those with mental health issues requiring primary care and that it was expected that that growth would continue. Mr Fradgley highlighted the fact that good mental health services were provided in inner North East London and that they were leading the way in terms of innovation.
Mr Fradgley pointed out that they were focussing on mental health inequality and the fact that mental health issues were often a problem for those with complex needs. He confirmed that 51% of those with complex needs had a mental health problem. He also pointed out that East London NHS were focussing on improving access to talking therapies for those from BME communities.
Mr Fradgley then referred to the following key priorities for East London NHS around mental health:
· Improving the number of mental health sufferers in the inner North East London area
· Suicide prevention
· Helping those with mental illnesses to find employment
· Improving access and parity in relation to mental health services (whilst keeping the waiting list to two weeks)
· Considering how mental health would fit into the ACS system
Mr Fradgley went on to explain that approximately 50% of those individuals who were known to mental health services were under 65 years old. He stressed the importance of ensuring mental health services were not placed at risk and the need to give due consideration to how the above priorities would be delivered.
Rhiannon England, Mental Health Clinical Lead for the City of London Corporation and the London Borough of Hackney, referred to the innovative models that they had developed. She pointed out how important such services were as there was a high need for mental health services due to the high levels of deprivation in the borough concerned. Ms England stated that there was a very strong level of primary care in her boroughs and that a particular area of interest and focus was frequent users of primary care services. She pointed out that many frequent users had a mental health problem.
Ms England also referred to the difficulty in balancing good patient care with a lack of funding. She confirmed that inner North East London could learn from the outer North East London boroughs in relation to crisis care. She explained that the number of children and young people requiring crisis care was small and thus, it was difficult to provide a good service. She stated that a 24 hour crisis phone line was a consideration and could potentially make the service more efficient and effective.
Paul Binfield, Personal and Public Involvement (PPI) representative, referred to a set of priorities set by PPI, including the fact that there was a significant amount of work needed to challenge an existing stigma around mental health which he described as a big barrier. He referred to a project currently being implemented involving a mental health worker engaging with the public on the Docklands Light Railway. He also explained that there was work being undertaken to raise awareness of mental health issues. Mr Binfield pointed out that clinical work was only one aspect and that it was also important to consider social and health education.
Mr Binfield stated that considering practical options was also a priority, such as assisting users of the service to find employment. He gave an example of certain individuals using the PPI service and being trained to become fitness instructors.
Mr Binfield confirmed that PPI had a wealth of experience and expertise on how to engage people on the subject of mental health. He offered that expertise to other organisations represented at the meeting to assist in delivering positive outcomes and explained the importance of a community approach to mental health issues.
David Maher, Deputy Chief Executive & Programme Director for the City and Hackney, explained the importance of allowing people with mental health issues to live normal and independent lives. He referred to the issue of substance abuse, giving the view that the issue should sit with public health and pointed out that relevant organisations had an opportunity to undertake joint work on this issue. He stated that everyone involved should be proud of the work that has been done by this committee.
The Chair agreed that linking up relevant systems was important, especially in relation to individuals with mental health problems having access to housing and employment. She referred to the fact that there were many undiagnosed people with mental health problems and pointed out that finding new methods of accessing relevant services was paramount.
Councillor Maxwell referred to page 2 of the report which stated “The Development of additional psychological therapies so that at least 19% of people with anxiety and depression access treatment…” She asked how that 19% was prioritised and what would happen to the remaining 81%. Mr Maher explained that they work closely with providers to prioritise and explained the importance of ensuring there was a system in place for people to rise through the system should their mental health needs escalate.
Ms England suggested that that the system be prescribed and evidence-based as many people might show recovery from mental health symptoms in ways that are unseen by relevant professionals, for example, faring better in relationships or gaining employment. She also pointed out that housing was a big problem for many suffering from mental health and stated that the solution for many might not be prescribed medication, but a more practical solution such as access to housing.
Councillor Masters asked how mental health was being integrated into GP services. Mr Gilvin confirmed that there were additional mental health services from General Practitioners and that practices were being consolidated which was helping to improve quality.
Councillor Hayhurst asked whether they were a victim of their own success. Mr Fradgley explained that they had experienced success in reducing the length of patients’ stay, however, given the financial situation with regard to the NHS, it was important to consider how beds would be managed in the future. Councillor Hayhusrt asked whether there was a possibility of consolidating sites and Mr Fradgley responded that there were no plans for consolidation and that they were looking at available options.
Councillor McAlmont referred to highest spend per head, saying that the trend seemed to be upwards for the London Boroughs of Newham and Tower Hamlets especially. He asked what was being done and how much was being spent on prevention. In response, Mr Binfield explained that part of a nurse’s role was to provide support to whoever came in to them. He also said that challenging the stigma associated with mental health would go a long way to raising awareness and encourage people to seek help earlier.
Councillor McAlmont asked for a breakdown of the number of mental health sufferers who were in employment. Mr Binfield confirmed that approximately 5% of mental health sufferers were in employment, compared with 8% nationally. He stated that there was a need to look at the strategic priority. Mr Binfield added that Job Centre staff in the London Boroughs of Hackney, Newham and Tower Hamlets were being trained to identify mental health issues.
The Chair stated that BME communities were a hard to reach group in terms of mental health and asked why there was such a low take up on talking therapies. Councillor Beckles agreed and pointed out that some communities had their own stigmas. He asked what was being done to alleviate the issue. Mr McMahon explained that there was a work-stream being developed around prevention and workplace prevention. He said that he hoped that this issue would be looked at as part of the work-stream and that they were considering their approach. He added that the plan was to look at establishing a work place health charter for smaller organisations. Ms England confirmed that there was a lot of work being undertaken on the BME community. She expressed the importance of looking at recovery rates as those of the Turkish and Kurdish communities very low. Mr Maher said that recovery rates were very low for the Turkish community when IAPT talking therapies were used, however he pointed out that when local engagement methods were used, such as gardening, recovery rates were excellent.
Mr Binfield explained that they were working closely with the Metropolitan Police, whilst explaining that some boroughs were more receptive than others. He stated that the national Police did not receive adequate training on mental health however he said that the situation was improving. Mr Maher referred to a pilot that was currently running on street triage. Councillor Beckles asked if those participating in the pilot were trained. Ms England confirmed that those involved were mental health professionals who were receiving training by observing on the job.
Supporting documents:
- item 5 cover sheet STP, item 5. PDF 52 KB
- Item 5 - Mental Health Deep Dive INEL JHOSC 260617, item 5. PDF 416 KB
- Item 5 - Mental Health Deep Dive INEL JHOSC, item 5. PDF 2 MB