The Sub-Committee will receive a presentation on food poverty for older people and low-income families.

The Sub-Committee received a presentation that provided a high-level summary of the impact of the pandemic on the mental health of LBTH residents alongside the experience of local mental health services as they have rapidly adapted and developed new ways of working to address the various emerging pandemic trends and look to transform services going forward to meet the ongoing demands and opportunities. Members then participated in open discussion on the challenges and opportunities the Covid-19 pandemic has had on local mental health service provision, including the new ways of working to support the wellbeing of local residents and the future strategic approach to address the forecasted ongoing increasing demand.  The questioning on the presentation maybe summarised as follows:

The Sub-Committee

v  Noted that the presentation had a specific focus on local community, crisis and talking therapies services, which demonstrate the impact across the full spectrum of mental health experiences from common mental health disorders to severe mental illness.

v  Were concerned to note that the combination of social isolation, health fears and financial concerns are causing new mental health problems for many of whilst making existing ones worse. There are significant levels of mental health need in the Borough across the whole pathway from serious mental illness (SMI) to common mental health disorders (CMD), such as anxiety and depression and general mental wellbeing. With (i) self-reported levels of anxiety and depression are the highest in London; (ii) the rate of diagnosis for all mental health conditions is significantly higher for residents in the most deprived groups compared to the least deprived, particularly for post-natal depression and SMI; (iii) the rate of diagnosis for schizophrenia, is three times higher than for residents in the least deprived group; (iv) women in Tower Hamlets are twice as likely to be diagnosed with clinical depression than men, and this risk increases when factors such as low-income and social housing are considered. The rates of SMI are at least twice as high for BAME residents; (v) children and young people are estimated as having a higher prevalence of mental health problems than in London or England; (vi) Tower Hamlets has the lowest proportion in London of residents over 65. Mental health problems in older adults are common and often undiagnosed.

v  Noted with concern that this significant increase is believed to have been caused by factors including people returning to work; schools re-opening; the negative impact of lockdown measures on the mental well-being of local populations; increased public awareness of crisis lines; and reduced opportunities for community mental teams to engage face to face with all service users during the lockdown.

v  Noted that Covid-19 could leave the Borough with an epidemic of mental ill-health that will last much longer than the virus itself e.g. Community Mental Health Teams report that they have noticed an increase in complexity of people being referred and that people are often presenting with multiple social issues such as debt, risk of losing their jobs and home, relationship problems.

v  Was concerned to note that as an alternative to A&E (i) the Crisis Line had, had to set up an extra line to respond to increase demand; (ii) a Crisis Café had been established by Hestia to support for those support people in crisis out of hours across the Borough. Hestia it was noted is working in collaboration with LBTH and partner agencies to ensure that everyone within their care is equipped with the tools necessary for a life beyond this crisis.

v  It was noted that the Crisis Café was unable to provide a “drop in” offer, however, referrals are triaged via the Crisis Line and it provides an alternative space for people in crisis, with access to clinicians, therapists and support staff at evenings and weekends. Finally it was noted that the Crisis Line and Café will be maintained after the pandemic.

v  Agreed that given the above-mentioned it is really important for residents to take care of their mental wellbeing and there are lots of simple steps they can take to stay positive and build resilience. For example: (i) stay connected with others and talk about how they feel rather than bottle things up; (ii) undertake physical activity as it can play an important role in regulating mood; and by eating well and getting enough sleep as feeling tired and run down will affect mental health.

v  Commented that they wished appropriate support for those Afghan families who have fled to the UK to escape the Taliban and that health centres need to be prepared with sufficient mental health counselling support.

Following a full and detailed debate, the Chair thanked all those in attendance for their contributions to a very useful deliberations on this important matter.

Accordingly, the Sub-Committee resolved to note that the key points for the Committee are to receive more information on the:

1)    recruitment and retention of mental health service staff.

2)    development of the community mental health services and the referral pathways.

3)    work being undertaken to tackle loneliness and social isolation during the COVID-19 outbreak and beyond that will help to prevent more costly health and care needs from developing, as well as aiding community resilience and recovery; and

4)    work being done to improve the safety of refugees during the COVID-19 pandemic.