Mental health: How do you know your council is doing all it can to improve mental health?

Local Government Association| July 2018 | Mental health How do you know your council is doing all it can to improve mental health?

Local government  contributes to promoting good mental health in individuals and communities. This happens through:

  • system-wide leadership through health and wellbeing boards (HWBs)
  • public health responsibilities to promote mental wellbeing and prevent poor mental health throughout the life course
  • statutory duties and powers related to mental health for children and young people and for adults
  •  the overview and scrutiny of mental health provision.
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Image source: local.gov.uk

Even with the extremely poor financial situation, many local areas are maximising their opportunities by working smartly and imaginatively with partners to promote mental wellbeing (Source: Local Government Association).

The briefing includes questions for commissioners to consider when planning services, and key points for good practice.

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Transforming care- the challenges and solutions

Voluntary Organisations Disability Group | June 2018 | Transforming care- the challenges and solutions

VODG (Voluntary Organisations Disability Group), have produced a report that identifies the learning from the Provider Taskforce’s project.  The primary aim of the pilot was to develop support assessment and proposals for 27 people originally from London who have been in inpatient settings for longer than five years.

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Image source: vodg.org.uk

This report sets out the work carried out, the learning and recommendations for
next steps both in London and nationally.  Its purpose is to share learning. It is not a formal evaluation, nor a proposition for the provision of services, but offers insight into the challenges and solutions in delivering the “transforming care” agenda. VODG acknowledges that there are improvements that need to be made across the system, including for community-based providers (Source: VODG).

Two thirds of patients with serious mental health problems placed in rehab far from home and local support

Care Quality Commission | People in rehab for serious mental health problems more likely to face lengthy stays far from home and local support | 2018

The Care Quality Commission (CQC) sent information requests to 54 NHS and 87 independent healthcare providers that manage mental health rehabilitation inpatient services.  CQC, working in collaboration with NHS England and NHS Improvement, asked providers for information about the mental health rehabilitation inpatient services that they manage. This included information about the number of locations and wards providing mental rehabilitation services, and the average daily cost of a bed on those wards, the length of each patient’s stay, funding authority and the mental healthcare provider responsible for aftercare. university-2540603_1920They found nearly two thirds (63%) of placements in residential-based mental health rehabilitation services are ‘out of area’, which means they are in different areas to the clinical commissioning groups (CCGs) that arranged them.

CQC estimates that £535 million is spent on residential mental health rehabilitation annually, with ‘out of area’ placements accounting for around two thirds of this expenditure.  The review shows that people in residential mental health rehabilitation services provided by the independent sector are, on average:

  • More likely to be further from their homes than those staying in NHS services – 49km compared to 14km.
  • More likely to stay there for longer – 14.5 months on their current ward compared to 7.5 months on their current ward in a NHS service.
  • At a greater risk of having their aftercare compromised because the managers there are less likely to know which NHS trust would care for them following discharge – 99% of managers of NHS rehabilitation services were able to name the NHS trust that would provide their patients’ aftercare, in comparison to 53% for independent services.

CQC recommend that the Department of Health and Social Care, NHS England and NHS Improvement agree a plan to engage local health and care systems in a programme of work to reduce the number of patients placed in mental health rehabilitation wards that are out of area. (CQC)

Press release available here 

Briefing can be read on the CQC website 

Latest figures for finished admission episodes with a primary or secondary diagnosis of ‘eating disorder’ published

NHS Digital has released the latest figures for finished admission episodes (FAEs) with  a primary or secondary diagnosis of ‘eating disorder’ by:

  1. a) area team of treatment and by age and gender and type of ‘eating disorder’,
  2. b) by clinical commissioning group of treatment from 2010/11 to 2016/17.

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The supplementary information data  can be accessed from NHS Digital 

The following news stories may also be of interest:

Daily Telegraph Eating disorder hospital admissions double in six years, figures show

The Guardian Long NHS delays can be ‘devastating’ for patients with eating disorders

Commissioning mental health services in primary care

Of primary importance: commissioning mental health services in primary care  | NHS Clinical Commissioners

This report highlights projects where CCGs and their partners are delivering better care for patients, working across the boundaries between physical and mental health, as well as health and social care, while at the same time reducing pressure on GPs and hospitals.

Developed by NHS Clinical Commissioner’s Mental Health Commissioners Network, the report aims to share learning and good practice from these projects to help support others looking to implement projects across primary care.

Case studies in the report include:

  • Community Living Well in West London which helps those with long-term mental health conditions and covers a full range of psychological therapies from guided self-help, through to sessions of short-term psychodynamic or CBT, carers therapy and a wellbeing service.
  • Work in Sheffield where IAPT workers are attached to each of the CCG’s individual 85 practices, and are incorporated as part of the practice multidisciplinary team.
  • The Well Centre, a primary care health centre in Lambeth for young people aged 13 to 20 offering support with all areas of health including mental wellbeing.

Full report available here

Depression in children and young people

NICE has published a guideline on identifying and managing depression in children and young people aged between 5 and 18 years.

This guideline covers identifying and managing depression in children and young people aged between 5 and 18 years. Based on the stepped care model, it aims to improve recognition and assessment and promote effective treatments for mild, moderate and severe depression.

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Image source: www.nice.org.uk

This guideline includes recommendations on:

Full guideline: Depression in children and young people: identification and management

Children and Young People’s Mental Health and Wellbeing Profiling Tool

This tool has been developed to support an intelligence driven approach to understanding and meeting need| PHE

It provides commissioners, service providers, clinicians, services users and their families with the means to benchmark their area against similar populations and gain intelligence about what works.  It collates and analyses a wide range of publically available data on: prevalence, protective factors, primary prevention (adversity and vulnerability) and finance. It provides commissioners, service providers, clinicians, services users and their families with the means to benchmark their area against similar populations and gain intelligence about what works.

Tool structure – indicators are presented in 5 domains:

  • Identification of need
  • Protective factors
  • Primary prevention: Adversity
  • Primary prevention: Vulnerability
  • Finance

Within this domains, indicators are grouped by geography (predominantly county and local authority but also Clinical Commissioning Group) and then ordered by topic (e.g.adversity associated with poverty, abuse and neglect, family difficulties and parental difficulties).

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