The Board received a presentation from Shakila Ali (Women’s Inclusive Team); Safia Jama (Women’s Inclusive Team); Jamie Stafford (East London NHS Foundation Trust); and Phil Warburton (Rethink Mental Illness & Citizens UK) on the Adult Mental Strategy 2019-2024 that has identified three themes:

1. To raise awareness and understanding of the importance of mental health and wellbeing
2. To ensure early help is available particularly in times of crisis
3. To ensure the provision of high-quality mental health care and treatment

The main points of the discussions on this presentation may be summarised as follows:

The Board:

v  Noted that the pandemic has impacted adversely on levels of mental health issues in the Borough.

v  Noted details of the Community Connector programme commissioned by East London Foundation Trust from the Women’s Inclusive Team as an example of the strategy in action.

v  Noted that Community Connectors provide person-centred support, working alongside clinical and other statutory and voluntary sector services to support people in achieving better mental health and wellbeing.

v  Noted that the service cross cuts all three themes of the adult mental health strategy and is presented as a case study of an approach to addressing health inequalities through the engagement of local people to improve access to mental health services and achieve better outcomes.

v  Agreed that to refer to people from ethnic minorities as Black, Asian, or Minority Ethnic (BAME) does not fully do justice to the diverse range of cultural experiences like fear, stigma and lack of culturally sensitive treatment can function as barriers to accessing mental health care for people from BAME backgrounds (e.g., parents claiming that their children have been possessed as opposed to admitting that they have mental health issues)

v  Agreed that there is no 'one size fits all' when talking about race and identity as group labels bundle many identities and experiences together. This obscures the fact that people in these groups do not all have the same experience of race and they do not all face the same challenges.

v  Commented that (i) residents from a BAME background, may experience different rates of mental illness than the rest of the population; and (ii) mainstream mental health services are not equipped to fully understand the needs of BAME groups due to a lack of training and a lack of staff diversity.

v  Felt that there was a lack of lack of knowledge about different cultures that was thought to perpetuate stereotypes and reduce compassion and empathy. That can potentially marginalise people from mental health services (e.g., staff do not take the time to ask about people about their culture and traditions).

v  Agreed that whilst it is a very difficult thing to achieve it was important to move towards a culture of care where referrals to mental health services are an important part of the continuum of mental health services.

v  Agreed that when staff members are proactive about referral processes, it can lead to consistent access to and use of services that help to identify, treat, and reduce the effects of mental illness for many.

v  Noted that “Talking Therapies” (i) is a type of therapy which involves a patient talking to a trained professional about their thoughts, feelings, and behaviour. It provides a safe and confidential space to talk to someone who will not be judgemental; (ii) can help those referred make sense of things and understand themselves better. The therapists will help to discuss the next steps and any changes to make the patient feel more positive about their life.

v  Noted that individual therapy may consist of telephone, face to face and online sessions. The length of sessions, number of sessions and frequency of sessions will vary depending on the main presenting problem and the level of severity of difficulties. The first stages of individual therapy usually involve an assessment and creating a shared understanding between client and therapist of the client’s difficulties and maintaining factors. The treatment plan is then discussed and agreed upon. Tower Hamlets Talking Therapies offers short term evidence-based interventions, based on Cognitive Behavioural Therapy principles.

v  Noted the formation of Neighbourhood Mental Health Teams which will mean: (i) organising core community mental health teams around four neighbourhoods (which align to social care localities and Primary Care Networks); and (ii) introducing new ways of working which will bring together professionals daily to collaborate in providing care, and shift focus on population health across the neighbourhood.

v  Noted that there would be additional investment into Voluntary, Community and Social Enterprise sector to tackle inequalities (e.g., Grant schemes to tackle inequalities and build resilience and new partnerships and projects to improve access, experience, and outcomes for local communities).

v  Noted the reimagining mental health by the co-designing new rapid access to help resolve distress in people’s lives through the living well systems of support which are distinguishable by a set of key features (e.g. accountability for people centred outcomes that promote choice, recovery, and citizenship; sees people as citizens within communities, rather than ‘patients’ or ‘professionals’ and puts the voice of lived experience at the centre of services and the system to provide timely access to support where it is needed).

v  Noted that World Mental Health Day will take place on the 10th of October 2022 and the theme for World Mental Health Day is ‘Mental Health in an Unequal World’. Reflecting on the Covid-19 pandemic, advocates will focus on how people with long-term health conditions for people living deprived communities and experiencing racial discrimination were disproportionately impacted.

v  Agreed that it was important to develop a wider understanding of these issues throughout those communities that it seeks to serve (e.g., how mental health issues are being addressed in Tower Hamlets).

v  Noted that LBTH has combined a broad spectrum of services into a single program operated by Age UK East London. The Tower Hamlets Connect portal asks questions to guide users toward relevant health and wellbeing services. This website includes a calendar of in-person events and guides about health issues throughout life. Residents in need of one-on-one consultations with social care staffers and physicians can contact the Tower Hamlets Connect helpline.

v  Noted that LBTH is running a pilot “Residents” Hub that will guide people through available resources for housing, healthcare, employment, and social services.

v  Noted that LBTH will model a permanent Residents' Hub at the new Town Hall on lessons learned during the pilot.

v  Agreed that whilst more people than ever are talking about their mental health, there is still a stigma in society attached to being open and honest about how you feel. This stops people from reaching out for help, as they may feel shame or embarrassment. To tackle this:

(i)    Schools should organise a guided workshop for the students to process and express their feelings; raise money for mental health charities with a fundraising event; and hire a mental health speaker to share their story with the students.

(ii)  Businesses need to ensure that mental health support is central to their employee benefits scheme

(iii) Communities could organise a community-wide fundraising event for a mental health charity; create a space where members of the community can talk about their feelings; and ensure that residents have access to local and affordable mental health support.

The Chair thanked Shakila Ali; Safia Jama; Jamie Stafford and Phil Warburton and the contribution of Board Members to the discussion on this item.