P
& Dr
D Karen Tocque
T
Carola Peck
April 2010
Salfford Mental
M
Wellb
being
N
Needs
s Asse
essmen
nt
Keyy messagges • There is real co
ommitmen
nt from seervices to develop the mentaal wellbein
ng agenda in Salfford and ssome very effective services o
on the gro
ound supp
porting it • Creatiing good m
mental health and w
wellbeing is everyon
ne’s business • Partneership wo
orking between orgganisationss, commu
unities and
d people in Salford
d will m
make positiive mentaal health and well‐being a reaality There is n
need to: • Strenggthen strrategic pllanning between b
the men
ntal wellb
being and
d mental health
h/illness agenda • Ensuree all operational paartners gain a bette
er understtanding off mental w
wellbeing, the im
mpact of mental m
wellbeing on o service
e provision and wh
here it fitss into thee broader health agenda • Acceleerate the sshift in foccus from ttreatmentt to prevention servvices • Impro
ove data collection ggenerally and develop an und
derstanding of how
w contactss with communit
c
ty services can enh
hance existing systtems for monitorin
ng mentall wellbeeing • Measu
ure the reeal need w
where gapss in service provisio
on have beeen identiffied • Betterr understaand copingg mechanisms and resilience in individuals and comm
munities th
hat might alleviate ttheir need
d for servicces • Demand moree compreehensive evaluatio
ons and effective service delivery; includ
ding a greaater emph
hasis on th
he value aadded of iinterventions that impact on
n mentaal wellbein
ng • Develo
op a clear strategy for co
ommunicaating the mental wellbeingg agenda includ
ding a directory of seervices an
nd compre
ehensive m
map of serrvice provvision Mental Wellbeing in Salford
Headline Statistics 36,500 adults (20% of people aged 16+) Around
1
6,000 children (12% of people aged 0‐18) and 2
living in Salford might have some kind of mental wellbeing need. Of these: • 7,900 adults are likely to have extreme anxiety or depression • almost 7,700 claimed benefits in 2009 due to mental health or nervous reasons • over 6,500 were in contact with community mental health teams in 2008/09, of which around 3,500 were with outpatient psychiatrists • nearly 7,000 adults and children were treated as outpatients in 2008/09 for all mental and behavioral disorders or in psychiatry departments • over 3,500 were treated as inpatients in 2008/09 for mental and behavioural disorders, 1,500 related to psychoactive substance use • around 650 people were treated as inpatients for self hard in 2008/09; • 60 people died from suicide or undetermined injury from 2006 to 2008 (20 per year) which contributes 3.2% to the gap in male life expectancy between Salford and the England average • The most deprived populations are currently identified as having the greatest need for services, however there are also gaps within the data sources that prevent assessment of whether services (particularly community services) are meeting levels of need 1
estimate calculated from the deprivation gradient published in the 2009 NW Mental Wellbeing Survey www.nwph.net/nwpho/Publications/Forms/DispForm.aspx?ID=208 2
Nixon B, Warburton H (2009). Child and Adolescent mental Health: North West Needs Assessment. 2 Mental Wellbeing in Salford
Contents Page Numbers Section 1: Background to Assessment 4 Section 2: Framework for Developing Wellbeing 5 Section 3: Review and Collation of Mental Wellbeing Statistics for Salford 6 ‐ 21 Section 4: Consultation with Stakeholders 22 ‐ 37 Incl: Examples of Existing provision 23 ‐ 28 Gaps & Unmet Needs 29 ‐ 37 Section 5: Recommendations – Priority & General 38 ‐ 45 46 ‐ 67 Appendices: Appendix 1: Documents Supporting Mental Wellbeing Agenda Appendix 2: The Population of Salford Appendix 3: P2 People & Places Descriptions Appendix 4: The Mental Health Minimum Data Set Appendix 5: Map of Service Provision Appendix 6: Services & Individuals Consulted Appendix 7: Training Needs Identified 3 Mental Wellbeing in Salford
1. Background to Assessment This mental wellbeing needs assessment is aligned to the principles and ideas expressed in the New Horizons Strategy programme3 and its Framework for Developing Wellbeing4. New Horizons has provided an opportunity for Salford to look at the way it is approaching service provision and commissioning services ‐ giving recognition to a new perspective which supports the shift towards community based services and supports the mental wellbeing agenda, which in itself gives greater emphasis on prevention. 1.1. Terminology There are numerous definitions of mental wellbeing; this report supports the meaning used within the New Horizons document5 which recognises mental wellbeing as: A positive state of mind and body, feeling safe and able to cope, with a sense of connection with people, communities and the wider environment 1.2. Project Focus The needs assessment included 3 main pieces of work: Section 3: Review and collation of existing epidemiological and service data to highlight possible unmet needs Section 4: Consultation with key stakeholders to improve understanding on the way their services affect mental wellbeing and explore ways of enhancing the mental wellbeing of their clients. Identifying unmet need / gaps in service provision and opportunities for improvement Section 5: Recommendations 3
Department of Health (November 2009) New Horizons – A shared vision for mental health Department of Health (March 2010) New Horizons – Confident Communities, Brighter Futures. A Framework for Developing Well‐being. + A Summary of (March 2010) 5
Department of Health (March 2010) New Horizons 4
4 Mental Wellbeing in Salford
2. Framework for Developing Wellbeing This mental wellbeing assessment takes as a base the Framework for Developing Well‐being6; the latest document from the Department of Health which supports the New Horizons Strategy. The framework provides a suggested structure to facilitate partnership working that will enable communities to promote wellbeing across their populations. It summarises effective approaches that include universal measures for the wider population, combined with intensive and early interventions targeted at high‐risk groups’. It is based on public health principles and follows a life course approach within the context of the family and community from early to later years ‐ addressing wider determinants of mental health and well‐being across different domains. The headings in the framework target different audiences with key messages on how to achieve greater population well‐being. The analysis of the consultation ‐ provision of services, gaps and unmet needs follows this framework and uses the domains to help set the scene for developing mental wellbeing in Salford. A Framework for Developing Well‐being (from: New Horizons – Confident Communities, Brighter Futures) As well as New Horizons, there are a number of other documents which provide an excellent base to work from to support taking forward the mental wellbeing agenda in Salford (see Appendix 1). 6
Department of Health (March 2010) New Horizons 5 3. Mental Wellbeing statistics for Salford 3.1.
Overview of the estimated numbers of people with wellbeing needs and those in contact with various tiers of service (details for each are illustrated in the numbered sections)
Number of people dying from suicide and undetermined casues
21
Months of life lost
2006‐2008 average across all people
5.5 (M); 1.1 (F)
Possible attempted suicides
if 0.5 ‐ 2% succeed
1050 ‐ 4200
Number of people on Care Services Approach
Enhanced CPA
2008
2,510
2008/09 MHMDS
1,553
957
Standard CPA
Number of people treated in hospital for mental & behavioural disorders (F00 ‐ F99)
Due to psychoactive substance use (F10 ‐ F19)
3,576
2008/09 SUS
1,508
1,328
Schizophrenic, mood and neurotic disorders (F20 ‐ F48)
Number of people treated in hospital for Self Harm (X60‐X84 )
649
People attending outpatients for Mental and behavioural (F00 ‐ F99) or Psychiatry treatment
6,983
People attending outpatients for Specialist Psychiatry
5,631
Number of contacts with community mental health team and outpatients
2008/09 SUS
6,576
2008/09 MHMDS
3,474
Consultant psychiatrist contact (Outpatients)
2,871
Community psychiatry nurse contact
Claiments of benefit for mental or nervous disorders
Number of people who have mental wellbeing needs
7,685
6,000
36,500
young people 0‐18
adults aged 16+
32,300
People with below average mental wellbeing
extreme depression / anxiety disorders
moderate depression / anxiety disorders
Nervous trouble or depression (in last 12 months)
August 2009
2009 estimates
7,900
28,600
19,250
2007 estimate
Menta
al Wellbeing in Salford
S
3.2.
Wellb
being in the com
mmunity (below
w average) The Norrth West wellbeing survey found that living in more deprrived communities iis stronglyy associated with lo
ower levels of menttal wellbeing; 20% o
of people here havee below aaverage wellbeing ccompared with 11%
% in more affluent aareas. The datta above were repro
oduced from the su
urvey (Table 5, pagee 39) and measuress for below aaverage wellbeing w
were applied to eacch Lower Super Outtput Area in Salford.7 The map sho
ows where the greaatest proportion off the Salford populaation has below aveerage wellbein
ng (by Middle Supeer Output Area, MSO
OA) and whilst this increases as deprivvation increasees across wards thee gradient is not verry strong. mental wellbeing weere more than threee The survey also found thatt people with low m
mental wellbeing to
o be moderately anxious times ass likely as those witth higher levels of m
or depressed (see 3.3) and
d 3.6 times more likkely to never speak to any neighbours. be determined from
m this survey. Overall wellbeing of youngg people could not b
7
estim
mate calculated from
m the deprivation grad
dient published in the
e 2009 NW Mental Weellbeing Survey www.nwph.net/nwpho/Pu
ublications/Forms/DisspForm.aspx?ID=208 7 Menta
al Wellbeing in Salford
S
3.3.
Wellb
being in the com
mmunity (anxietty and depressio
on) In the m
most deprived fifth of areas, 1 in 20 meen and 1 in 16 wom
men say that they haave extremee anxiety or depresssion and 1 in 5/6 have moderate anxieety or depression. Data ab
bove were reproducced from the North West Mental Wellbeing Survey (Tablee 107, page 16
60) and were applieed to each Lower Su
uper Output Area in
n Salford. Estimated
d numberrs of people sufferin
ng from extreme an
nxiety and depressiion were calculated
d for each MSOA and ward. Thee pattern across Salfford is illustrated in
n the map. n across wards in Saalford increases as The estimated gradient of anxiety/depression
being deprivation increases. Thiss gradient is much sstronger than for beelow average wellb
he community that require support fro
om mental wellbein
ng suggestting that needs in th
servicess are greater in the most deprived areas. However, somee wards with higher deprivation measures havee slightly lower than expected anxietyy and depression: Winton, Ordsall, Blackfrierrs and Pendleton. d with age such thatt people over 40 haad Having some anxiety or deepression increased
mes higher rates thaat people aged 16‐2
24. The prevalence o
of extreme wellbeing two tim
needs o
of children and adollescents has been rreviewed elsewheree.8 8
Nixoon B, Warburton H (2009). Child and Adoleescent mental Health: North West Needs A
Assessment. 8 Menta
al Wellbeing in Salford
S
3.4.
Incap
pacity Claims du
ue to mental and
d nervous disord
ders (at August 2009)9 In the m
most deprived fifth of areas, where 50%
% of Salford’s popu
ulation live (see Append
dix 2), over 80 in eveery 1000 people of working age claim benefits for mentaal or nervouss reasons. A total o
of 90‐120 in a 1000
0 people of workingg age claim benefitss for mental or nervvous reasonss in the communitiees with the greatestt need: Broughton aand Langworthy waards and Urb
ban Challenge areass (see Appendix 3 fo
or descriptions). 9
Dep
partment for Work and Pensions. http://83.244.183.180//NESS/BEN/ibsda.httm 9 Mental Wellbeing in Salford 3.5.
Contacts with Community Services – Mental Health Minimum Dataset (MHMDS), 2008/09 The mental health minimum dataset collates information on adults over 18 years of age receiving treatment in a specialist mental health care service and statistics are published annually (see Appendix 4 for Salford summary).10 The 2008/09 dataset is no longer considered experimental and record level data were accessed to enable analysis by individuals.11 The only geography available was wards. Over 6,500 people aged over 18 living in Salford had one or more contacts with community and outpatient mental health teams in 2008/09. In the more deprived wards, 14 in 1000 people had at least one contact with community or outpatient mental health (CMH) teams in 2008/09 and half of these (7 in 1000) had at least one contact with a Community Psychiatry Nurse (CPN). There is a very strong gradient with increasing deprivation but some areas show lower than expected numbers of people treated by CMH teams than would be expected from their level of deprivation: Kersal, Irwell Riverside, Little Hulton and Ordsall. On the other hand, Eccles appears to have more than expected numbers of people in contact with CMH teams. The table below shows the number of people in Salford having one or more contact with CMH staff in 2008/09. 10
11
The Information Centre. Mental Health Minimum dataset. www.mhmdsonline.ic.nhs.uk Provided by NHS Salford Commissioning Business Support 10 Mental Wellbeing in Salford People in contact with community &
outpatients mental health team
Psychiatrist (OP) contacts
CPN contacts
Social worker contacts
OT contacts
Psychologist contacts
6,576
3,474
2,871
1,235
1,094
1,192
Physio contacts
279
MHMDS ‐ Data gaps 1.
Only records information on adults aged over 18 (and for young people aged under 18 who are treated in adult service) 2.
The definitions are related to server and enduring mental health problems and not for common mental health issues. As such the numbers presented here do not exactly match numbers of people attending hospital as outpatients or for admitted patient care 3. The dataset is not provided with postcode of residence or other small areas geography, only by ward. Therefore population sub‐groups with the greatest need cannot be analysed further
11 Menta
al Wellbeing in Salford
S
3.6.
Peop
ple treated in ho
ospital as outpattients for all me
ental and behavioural (F00 – F99) or specialist p
psychiatry treattment Hospitaal statistics contain records of all N
NHS outpatient ap
ppointments in England and these weree extracted12 wherre a person had any diagnosis for mentall and behvioural d
disorders (MBD) o
or attended psych
hiatry specialty. Nearly 7,000 people atteended outpatientts for MBD or specialist psychiatry on at least one occasion in 2008/09, 5,600 of w
who attended for specialist psychiatry treatment. To ensu
ure robust numbeers, the figures heere for different p
population sub‐gro
oups show the average annuaal rate of attendance per 1,000 pop
pulation over the period 2005/06 to December 2009. In the m
most deprived fiftth of areas, nearlyy 27 of every 1,00
00 people living in
n Salford
d attended outpattients for MBD or specialist psychiaatry each year, compared with less than
n 10 per 1,000 in tthe more affluentt parts of Salford. 12
by NHS Salford Commisssioning Business Suppport 12 Menta
al Wellbeing in Salford
S
In geneeral, the most deprrived wards show aa higher rate, with
h around 30 in a 1,000 people attended outpatieents for MBD or sp
pecialist psychiatryy: Langworthy, Weeaste & Seedley. However, thiss is not a clear patttern and some more deprived areas have nd some relativelyy more affluent areeas lower rrates (Irwell Riverside and Ordsall) an
have higher rates (Eccles,, Swinton South, W
Weaste & Seedley aand Barton). pulation segmentaation system P2 Peeople & Places13 also shows the geneerally The pop
higher rates in more deprrived communitiess in Salford called U
Urban Challenge aareas, nt communities called Blossoming comparred with lower rates in more affluen
Families and Mature Oakks. However, Weathered Communitiees also show a high
h rate of attendance at outtpatients for MBD or specialist psych
hiatry. Full descripttions of thesee People & Places categories are in A
Appendix 3 and these characteristicss can be used
d to target interventions aimed at different population
n groups. MBD or specialist p
psychiatry was twicce as The rate of attendance att outpatients for M
high in older people (aged 60 and over) living in Salford, at 35
5 per 1,000, than in 15 per 1,000.
youngeer people (aged under 30) – around 1
Unfortu
unately, there wass no ethnicity codin
ng within the outp
patients dataset an
nd therefo
ore levels of attend
dance across cultural groups could not be determined.. Outpattients ‐ Data gapss •
•
Unfortunately, theree was no ethnicityy coding within th
he outpatients dattaset and
d levels of attendance across cultural groups could n
not be determineed. Atttendance rates for different diagno
oses were not posssible because ICD
D 1014 is n
not often recorded. 13
14
P² P
People & Places © Beeacon Dodsworth 200
04 – 2010. www.beacon‐dodsworth.co.uk//site/products/peoplee_classification Inte
ernational Statistical C
Classification of Diseaases and Related Health Problems. 10th Reevision. http://apps.w
who.int/classificationss/apps/icd/icd10onlin
ne 13 Menta
al Wellbeing in Salford
S
3.7. Peop
ple admitted to hospital fo
or inpatient caare 3.7.1. For all mental an
nd behavioural d
disorders (F00 –– F99) Hospitaal statistics contain
n records of all adm
missions to NHS ho
ospitals in England
d and 15
these w
were extracted w
where a person had
d any diagnosis forr mental and behviioural disordeers (MBD). n in Over 3,,500 people were aadmitted to hospittal for MBD on at lleast one occasion
2008/0
09, 1,500 were treaated for psychoacttive substance use and 1,300 were treated
d for schizophreniaa, mood or neurotiic disorders. To ensu
ure robust numberrs, the figures heree for different pop
pulation sub‐groups show th
he average annual rate of admission
n per 1,000 populattion over the perio
od 2005/0
06 to December 20
009. In the m
most deprived fifth
h of areas, nearly 1
18 of every 1,000 p
people are admitteed to hospitaal each year for meental and behaviorral disorders. 15
by NHS Salford Commisssioning Business Suppport 14 Menta
al Wellbeing in Salford
S
Higher raates for MBD are seeen in the most dep
prived wards of Salfford, Langworthy and Broughto
on with over 20 peo
ople are admitted tto hospital for everyy 1,000 residents. Howeverr, other wards also have similarly high rates, Weaste & Seeedley, Barton and Eccles. o outpatient attend
dances, the populattion segmentation ssystem P2 People &
& Similar to
Places16 also shows the gen
nerally higher rates in more deprived U
Urban Challenge areeas 000 population), com
mpared with lowerr rates in the more (over 20 admissions per 1,0
hered Communitiess also show a high rrate of affluent Blossoming Familiees. However, Weath
on to hospital and M
Mature Oaks might have a higher rate than the level of admissio
deprivation would suggest. Rates of admission
n are seven times higher in people ageed 60+ 30. (30‐35 per 1,000) than in peeople aged under 3
Levels o
of admission acrosss cultural groups could not be determined because there was insufficient data on eth
hnicity, with the maajority of non‐whitee records ‘not stated’ or ‘blank’.
16
P² P
People & Places © Beeacon Dodsworth 200
04 – 2010. www.beacon‐dodsworth.co.uk//site/products/peoplee_classification 15 Menta
al Wellbeing in Salford
S
d to Hospital for self harm (X60 – X84) 3.7.2. People admitted
Around
d 650 people weree admitted to hosspital for self harm
m in 2008/09. To ensure robust numbers,, the figures here for different population sub‐group
ps show the average annuaal rate of admissio
on per 1,000 popu
ulation over the period 2005/06 to December 2009. In the m
most deprived fifth of areas, nearly 4 in
n every 1,000 people are admitted to hospital each year for self harm, which is 4.7 times higher than iin more affluent areeas. 16 Menta
al Wellbeing in Salford
S
In generaal, the most depriveed communities show a higher rate, w
with 4‐5 people adm
mitted to hospittal for every 1,000 rresidents: Langworrthy Ward and Urbaan Challenge areas. Howeverr, Winton ward and
d Weathered Comm
munities also show h
high rates of hospittal admissio
on for self harm. wer levels of self haarm than might be eexpected from Some waards show much low
deprivation alone: Kersal, Irrwell Riverside, Little Hulton and Ordsall. within females aged
d 16‐29 but both seexes aged 16‐44 and The highest rates are seen w
ow high rates of ad
dmission for self harrm. females aged 45‐59 also sho
Levels o
of admission acrosss cultural groups could not be determined because there was insufficient data on eth
hnicity, with the maajority of non‐whitee records ‘not stated’ or ‘blank’.
17 Mental Wellbeing in Salford 3.7.3. Details of and other reasons for admission to hospital related to poor mental wellbeing 3,576
Number of people treated in hospital each year for mental & behavioural disorders (ICD 10 ‐ F00 ‐ F99)
i
F00‐F09 Organic, including symptomatic, mental disorders
ii
F10‐F19 Mental and behavioural disorders due to psychoactive substance use
iii
F20‐F29 Schizophrenia, schizotypal and delusional disorders
iv
F30‐F39 Mood (affective disorders)
v
F40‐F48 Neurotic, stress‐related and somatoform disorders
iii ‐ v
vi
837
1,508
248
771
396
1,328
Mental Health Conditions (F20 ‐ F48)
F50‐F59 Behavioural syndromes associated with physiological disturbances and physical factors
vii
F60‐F69 Disorders of adult personality and behaviour
viii
F70‐F79 Mental retardation
ix
F80‐F89 Disorders of psychological development
x
F90‐F98 Behavioural and emotional disorders, onset usually occurring in childhood and adolescence
xi
F99 Unspecified mental disorder
xii
F10, K70, K73, K74 & X45 Alcohol Specific Conditions [from NWPHO]
xiii
X60‐X84 Self Harm
xiv
Z61.4 ‐ 61.6 Child abuse and neglect; Z63 Bereavement and loss *
32
36
10
216
40
13
948
649
89
* numbers for Z63 (bereavement and loss) were <5 but have been included in the total Sub‐conditions (mental and behavioural disorders due to psychoactive substance use (F10‐F19) and mental health conditions17 (F20‐F48) show very similar geographic patterns across Salford as for all mental and behaviorual disorder (F00‐F99) illustrated above. 17
NWPHO definition 18 Mental Wellbeing in Salford 3.8.
Mortality from suicide and undetermined injury In Salford, there are around 20 deaths each year from suicide and injury undetermined.18 Since 2001 there has been a gradual increase in male deaths but not in females. The majority of these deaths are in people aged 15‐44 (55%) with none under the age of 16 and a very small proportion in the elderly. Age
<16
15‐44
45‐74
75+
total
Number
0
33
24
3
60
%
0
55%
40%
5%
Deaths in Salford from suicide and undetermined injury, 2006‐2008.20 The total years of life lost (YLL)20 from these deaths is 1,876 and this equates to 5.5 months lost for every man and 1.1 months lost for every woman living in Salford (2006‐2008 aggregate).19 For females in Salford the months life lost (MLL) is no different to the England average but for males it is higher and contributes 3.2% of the gap in life expectancy between Salford and the England average.21 18
19
Compendium of Clinical and Health Indicators (www.nchod.nhs.uk or nww.nchod.nhs.uk) Contribution to life expectancy in North West local authorities www.nwph.net/life‐expectancy 19 Mental Wellbeing in Salford 3.9.
Summary: mental wellbeing needs across populations The populations who are at greatest need of support either within the community or from health and social care services can currently only be determined from those people who are already in contact with these services. All the data sources accessed independently showed that the groups at greatest need were: • Those living in the more deprived areas20 of Salford (see Appendix 2): rates of benefit claims, contacts with and mental health teams or treatment in hospital were 3 to 6 times higher in the more deprived localities than in more affluent areas. The maps throughout this report illustrate the geographical consistency in poor levels of mental wellbeing across Salford. • Particular wards consistently have higher rates for all indicators relating to mental wellbeing need. These are, Langworthy, Broughton and Eccles and in the case of Eccles this was not directly related to the average level of deprivation (which for Salford is relatively low). • Other wards stand out as having higher than expected rates (for the given level of deprivation) for particular indicators: Weaste & Seedley and Barton have relatively high rates of admission to hospital and contact with community mental health teams. • By contrast, there are wards that have lower than expected measures of mental wellbeing treatment for the given level of deprivation: Irwell Riverside, Little Hulton, Ordsall and Kersal. From the analysis here, it is not possible to determine whether this reflects a true lower level of need in these communities or whether it reflects a gap in access to services. • In general, rates of wellbeing needs were much higher in people aged 60+ than in other age groups, which might explain some of the differences across wards where the proportions of older people vary. The exception here is for self harm, where rates are highest in persons aged 16‐44. This higher rate in self harm is reflected in the number of suicides in the younger age groups. • Measures across other populations segments, P2 People and Places, also shows the gradient of increasing mental and wellbeing needs as deprivation increases but too highlights anomalies that are likely to be due to locations with a higher elderly population. • There are no direct measures of wellbeing in the Salford community so estimates of need were generated from the recent North West Mental Wellbeing Survey. These show that below average wellbeing increases as increases deprivation but that this gradient is not as steep as that seen in rates of contact with services. Similarly, there is a stronger gradient for estimates of severe anxiety or depression but more affluent wards would still be predicted to have higher estimates of need than the service level data might suggest. 20
Census based Lower or Middle Super Output Areas (LSOA or MSOA). www.statistics.gov.uk/geography 20 Mental Wellbeing in Salford • It is not possible to determine whether these differences in gradient actually reflect an identified gap in service needs because it is possible that: •
o
A greater level of resilience exists within more affluent individuals or more affluent communities that enables people to cope with below average wellbeing / severe anxiety or depression without the need for services. o
Other mechanisms of ‘treatment’ are accessed in more affluent communities that are privately paid for – this might be private healthcare or it might be investment in social activity that alleviates low wellbeing or enhances coping mechanisms. o
The gradients of low wellbeing / anxiety or depression in Salford are not actually similar to that in the North West as a whole. Whilst this is not very likely since other independently‐measured wellbeing gradients (ie. for benefit claims or hospital admission) are almost identical21 without undertaking a local wellbeing survey, this cannot be validated. Wellbeing needs across cultural groups could not be determined because there was insufficient data collected on ethnicity. Despite many systems being set up to collect this information, the majority of records in people who were not ‘White British’ were ‘not stated’ or ‘blank’. 3.9.1. Gap analysis Despite the different definitions of mental wellbeing needs between population estimates and across various services, a very rough attempt to identify gaps in service provision has been undertaken here. This shows differences between wards in relation to where people with estimated wellbeing needs are accessing services. Except for the two most deprived wards (Broughton and Langworthy), people living in the more affluent wards appear to be obtaining more treatment within the community setting than people living in the more deprived wards. More work is needed to understand the interrelationships between the different service‐level datasets and ideally a collation of data on individuals accessing a broader range of community services before an accurate needs assessment can be undertaken. 21
North West Health Profiler. www.nwph.net/healthprofiler 21 Mental Wellbeing in Salford 4. Consultation with stakeholders The consultation covered a sample of 34 different and diverse services across Salford that impact on mental wellbeing. Services to interview were proposed by the Mental Wellbeing Strategy group. The aim was to include a sample of services covering the NHS, Salford City Council and 3rd Sector organisations. Additional services were interviewed where it was felt they would add value to this consultation. Full details of all those interviewed are given in Appendix 1. This report is based upon the findings from the face to face and telephone interviews that took place with these particular services. Areas explored in each consultation: ¾ Their understanding of Mental Wellbeing and the impact their service has on mental wellbeing ¾ The main activities they provide which have an impact on mental wellbeing through delivery of their core services ¾ How their policies, programmes and projects affect mental wellbeing ¾ Ways of enhancing the mental wellbeing of their clients / staff ¾ Gaps in service provision ¾ Training needs There is clearly commitment from some services across Salford to look at the mental wellbeing agenda and to integrate it into the strategic planning process: • There is commitment to develop a mental wellbeing strategy • The Public Health department had 2 stakeholder events during 2009 to look at mental wellbeing, where approx 35 participants from NHS / Salford City Council & 3rd sector were represented, giving a good basis for the mental wellbeing needs assessment • A shift from treatment to prevention has begun to take place, although this clearly needs accelerating • There is a positive emphasis in Salford on the worklessness agenda and its impact on mental wellbeing Many services, however, do not always see mental wellbeing as an integral part of their work. They often lack a general understanding of mental wellbeing and how it fits into their work agenda, even though they may be offering services that have a huge impact on the mental wellbeing of the people with which they work. 22 Mental Wellbeing in Salford Examples of Existing Provision
The following tables offer an overview of existing provision identified from the consultation; giving examples of both projects and services provided within Salford which impact on mental wellbeing. A broad range of projects and services were found to be provided throughout Salford, many of which target the most vulnerable populations. There are some excellent examples of partnership working between the public sector and 3rd sector organisations; e.g. the Neighbourhood and Health Improvement Teams, Salford Foundation, Salford Carers, The Angel Healthy Living Centre and Unlimited Potential. There are projects targeting specific mental wellbeing issues; e.g. Skills and Work, Salford Moneyline, MIND and IAPT and there are also projects targeting particular groups; e.g. Day Opportunities, START, Progress 2 Work, BEST, and Big Life / Energise Centre. The document takes as a base The Framework for Developing Wellbeing summary document
22
, taking each domain in turn and for ease of reference, colour coding the work with the same colours used in the framework. 22
DoH (March 2010) New Horizons – Confident Communities, Brighter Futures. A Framework for Developing Well‐being ‐ Summary 23 Mental Wellbeing in Salford Examples of Existing Provision
A Life Course Approach – Ensure a Positive Approach Half of all mental health problems, excluding dementia, start by the age of 14. Childhood and early adulthood are key periods in the development of personal resilience and educational and social skills that will provide the foundations for good mental health across the whole life course. Examples of Existing Provision (including projects & services) Promote good parental mental health – identify and treat poor parental mental health and risk factors antenatally and in later years Promote good parenting skills ‐ universally as well as targeting high‐risk families Develop social and emotional skills – for example, via mental health promotion in schools Develop violence and abuse prevention skills – with programmes in schools and colleges Intervene early with mental health problems – including psychosis and emotional and conduct disorders Enhance play and outdoor activity – to promote physical and mental health and social skills • Parent support advisors • Family support team • Joint protocols and working between children’s services and adult mental health services • Targeted antenatal parent preparation • Webster Stratton – incredible Years • Promoting Positive Parenting – Triple P • Speakeasy • 2/3rds of primary schools and all secondary schools signed up to Social & Emotional Aspects of Learning (SEAL) • Think Family Services • Restorative Justice programmes • MEND / Mini MEND programmes • Healthy Schools programme • Pyramid Clubs • Behavioural & Emotional Support Team, (BEST) • Early Detection & Intervention Team • Grumpy ‐ Play Development Officers ‐ supporting and developing play provision across the city. • 42nd Street • MEND / Mini MEND programmes • Eco schools Other: Excellent links between CAMHS & Children’s Services Directorate / Healthy Schools (incl. Directory of Emotional Wellbeing). Well resourced specialist CAMHS Service 24 Mental Wellbeing in Salford Examples of Existing Provision
Build Strength, Safety and Resilience Improve the resilience and safety of individuals and communities to help guard against some of the factors that can damage people’s well‐being or lead to mental health problems and suicide, through interventions that prevent violence and reduce poverty, debt, unemployment, homelessness and the impacts of climate change. Examples of Existing Provision (including projects & services) Community‐based violence prevention – community approaches to reduce e.g. alcohol‐related violence and disorder •
•
•
•
Reduce unemployment and debt reduce unemployment, financial exclusion and debt – improve income and financial capability •
•
•
•
Prevent homelessness and improve built environment – intervene early to prevent homelessness, reduce community noise, litter, graffiti, improve street lighting •
•
Reduce fuel poverty – insulate homes, improve central heating and increase benefits to create affordable warmth Suicide prevention – restricting access to lethal methods including local suicide hot spots, sensitive media reporting at national and local levels and targeted support for high‐risk groups such as young men and prisoners Reduce effect of flooding and Heat waves – target heat wave and flooding •
Think Families Service Neighbourhood Management Teams Anti social behaviour teams Community Safety partnership work – working with local courts Working Neighbourhood Teams Skills and Work START Salford Foundation • Witness outreach teams • Independent domestic Abuse Services – Women’s Aid •
•
•
•
•
•
Progress 2 Work The Angel Healthy Living Centre Salford Moneyline River Valley credit union Enhanced Housing Options ASSFAM ‐ Salford Assisted Families Project New Deal for Communities – Charlestown & Lower Kersall Improving local environment via Local projects through the Neighbourhood Environmental Services Management Teams / Working Neighbourhood Teams • Housing Advice Service • Bond guarantee scheme AWarm Scheme ‐ Affordable Warmth Access Referral Mechanism – incl. one‐stop‐shop of housing / social care / 3rd sector offers for older and vulnerable people Not in scope of study Not in scope of study 25 Mental Wellbeing in Salford Examples of Existing Provision
Develop Sustainable Connected Communities Reduce social exclusion by addressing stigma and discrimination. Enhance sustainable communities by promoting social and environmental engagement to develop connected inclusive communities. Examples of Existing Provision (including projects & services) Reduce stigma and discrimination – workforce development and media campaigns on well‐being and mental health literacy Develop social networks – community participation and social prescribing to increase social capital and networks • Equality & Cohesion Service ‐ LA • Equality, Diversity & Cohesion work ‐ NHS • Princess Royal Trust ‐ Support to carers • MIND • Age Concern • Books on Prescription • Neighbourhood / Community Development working (incl Delivering Racial Equality scheme) • Health Improvement Teams • Princess Royal Trust ‐Salford Carers Centre • Unlimited Potential •
•
•
•
•
•
•
Enhance safe green community spaces – •
develop and increase access to safe green •
community spaces •
Sustainable interventions – for example, •
insulating homes, healthy eating and •
active transport, to improve health and •
reduce energy use Age Concern The Angel Healthy Living Centre Life Centre for young people Way to Wellbeing Salford Time Bank LINk project SSTAR Environmental Services Parks & Green Spaces – Salford City Council Rangers Community Allotments Neighbourhood / Community Development working Health Improvement Teams AWarm Scheme Other: Carers ‐ Specialist worker for young adult carers 16‐24yrs – supporting transition / Carers to get a band rated personal budget. Buile Hill Garden Centre Project – has a focus on training, work experience and volunteering and aims to help service users access employment opportunities Signposting Salford –being developed through The Angel Healthy Living Centre. The beginnings of a networking site (currently on Facebook) for professionals working across Salford 26 Mental Wellbeing in Salford Examples of Existing Provision
Integrate Physical and Mental Health Physical and mental health are interconnected. To ensure good overall health, approaches to promoting physical and mental health need to be integrated to reduce health risk behaviours, reduce inequalities and improve health outcomes. Examples of Existing Provision (including projects & services) Incorporate mental health and well‐being literacy within health improvement programmes – including: smoking, alcohol, drug misuse, obesity and healthy eating, physical activity and sexual health Target those with mental health problems – for physical health checks and health improvement programmes such as smoking cessation Physical exercise – an effective component in the treatment of mild to moderate depression Integrated healthcare pathways – integrate physical and mental health assessments and treatment (including psychological therapies) into healthcare pathways • Many local projects through the Neighbourhood Management Teams / Working Neighbourhood Teams • Health Improvement Teams • Health Trainers • Health Trainers • Health Improvement Teams • Community Mental Health Teams • MEND & Mini MEND programmes • Re‐energise • Way to Wellbeing • Health Walks • Health Trainers • Service users delivering Tai Chi Classes • GMWMH Day Opportunities • Community Mental Health Teams • IAPT 27 Mental Wellbeing in Salford Examples of Existing Provision
Promote Purpose and Participation Positive well‐being is enhanced by a balance of physical and mental activity, relaxation, generating a positive outlook, expressing creativity, and purposeful community activity. Examples of Existing Provision (including projects & services) Work can play a vital role in improving everyone’s well‐being and mental health – people generally enjoy better mental health when they are in work; the longer individuals are absent or out of work, the more likely they are to experience depression or anxiety Balance physical and mental activity – including physical activity, continued learning and rest Positive psychology and mindfulness interventions – psychological therapies and approaches that promote positive thoughts and emotions Participation in the arts and creativity – arts programmes, for example, that enhance individual and community engagement Purposeful community activity – enable volunteering • Working Neighbourhood Teams • Working Well • Progress 2 Work • Skills & Work • Mental health advocacy • Salford Foundation •
•
•
•
•
• Health Improvement Teams • Community Mental Health Teams •
•
•
•
•
•
•
Fit City Walks for Life Health Walks MEND & Mini MEND Improving Access to Psychological Therapies ‐ IAPT Computerised Cognitive Behaviour Therapy ‐ cCBT Core Arts Arts on Prescription Youth Arts inclusion Creative Start GMWMH Day Opportunities / SSTAR The Angel Healthy Living Centre • MIND • 42nd Street • START • Big Life / Energise Centre • The Angel Healthy Living Centre • Big Life Centre • Unlimited Potential Other: GMWest Mental Health NHS Foundation Trust Day Opportunities – work within a framework of recovery – supporting an ethos of social inclusion and recovery; treating service users holistically within a life context Salford Royal NHS Foundation Trust / SCC & NHS Salford are exploring a more proactive Occupational Hlth Service – reinvesting £ into one service 28 Mental Wellbeing in Salford Gaps & Unmet Needs
The consultation identified gaps and unmet needs across service provision throughout Salford. The following provides an overview of these. Where there is a reference to ‘Provision lacking vs. Need’ this refers to the strong suggestion from those interviewed that there is lack of provision for these services / groups; however, it is not possible to measure this fully. The first 2 pages are generic and cover more than 1 of the domains referred to in The Framework for Developing Wellbeing. There then follows a page on each of the domains referred to in the Framework using the same colour codes. 29 Mental Wellbeing in Salford Generic Gaps & Unmet Needs Identified (that cover more than one domain)
Area •
•
•
•
Strategic
•
•
•
•
•
•
•
•
Commissioning Services Generic Gaps / Unmet Need Some major strategies not fully embracing the mental wellbeing agenda Lack of strategic planning between the mental wellbeing and mental health/illness agenda Little evaluation of service delivery and effectiveness of interventions Limited understanding of the value added of mental wellbeing and how it impacts on different aspects of work programmes Lack of common understanding re the terms mental wellbeing, mental health & mental illness Potential pockets of deprivation within wealthier areas not classified as needing support and therefore overlooked for provision of dedicated services that impact on mental wellbeing Universal lack of understanding of social return on investments Lack of added value in contracts Gap in expectations of multiple outcomes from services Lack of specific reference to mental wellbeing within SLAs No true pooled budgets Mental wellbeing services not clearly joined up with the specialist services – gaps in service provision between the two areas • An imbalance in the focus of tertiary vs. preventative services resulting in lack of community based services • Services not consistently looking at emotional resilience and workplace health as a tool to support mental wellbeing within the workplace • Mental wellbeing not being integrated into routine assessments of health workers 30 Mental Wellbeing in Salford Generic Gaps & Unmet Needs Identified (that cover more than one domain)
Area Communication Gaps / Unmet Need Identified
• No strategy for communicating the whole mental wellbeing agenda Lack of links and communication between services from strategy to operational levels particularly between the Public and 3rd Sector; including: • Lack of full engagement, i.e. consistent consultation and feedback opportunities, between the NHS and 3rd Sector • Lack of networking opportunities between NHS & 3rd Sector • Ineffective networking of services. Services on ground unsure what others projects are doing – resulting in disjointed projects and unnecessary duplication of delivery Directory of services / Map of service provision: • No comprehensive & up to date central Directory of all services impacting on mental wellbeing (many different directories being developed across Salford – duplication / inconsistencies / lack of joined up thinking) • No complete map of service provision (see Appendix 5 for existing map) Other
Understanding the concept of mental wellbeing • General gap in understanding the broader concept of mental wellbeing • Clear model of mental wellbeing not being used consistently across the borough Care Pathways • Care pathways not clearly defined leading to lack of agreement across services re where issues should be raised and where staff should signpost clients Thresholds • Threshold levels for assessment re mental wellbeing / mental health unclear 31 Mental Wellbeing in Salford Generic Gaps & Unmet Needs Identified (that cover more than one domain)
Area Data Gaps / Unmet Need Identified • A gap in data / evidence collection generally – ad hoc and intermittently collected. Mental wellbeing not being seen as a priority as lack of hard evidence to support it and consequently lack of funding to go with it • Inability to reconcile definitions for wellbeing means that accurate assessment of mental wellbeing need (especially for specific needs such as psychosis, dementia or for younger age groups) is problematic • Contacts with mental wellbeing services is not collated systematically so only measures for severe mental wellbeing needs are currently recorded • Insufficient collection of data on equity and diversity; even ethnicity data is still poorly recorded • Gap in understanding the overlap and uniqueness of various systems for collection data on contacts with treatment services (e.g. Inpatient, Outpatient, MHMDS, IAPT and CAMHS) and how contacts with community services could enhance these systems. • Data currently show that more affluent groups are not in contact with services but do have mental wellbeing needs; a greater understanding of what ‘coping’ provision these groups utilise would be beneficial to help target or enhance existing mental wellbeing services 32 Mental Wellbeing in Salford Gaps & Unmet Needs Identified
A Life Course Approach – Ensure a Positive Approach Half of all mental health problems, excluding dementia, start by the age of 14. Childhood and early adulthood are key periods in the development of personal resilience and educational and social skills that will provide the foundations for good mental health across the whole life course. Gaps / Unmet Needs Promote good parental mental health – identify and treat poor parental mental health and risk factors antenatally and in later years Promote good parenting skills – universally as well as targeting high‐risk families Develop social and emotional skills – for example, via mental health promotion in schools Develop violence and abuse prevention skills – with programmes in schools and colleges Intervene early with mental health problems – including psychosis and emotional and conduct disorders
Enhance play and outdoor activity – to promote physical and mental health and social skills Services • Getting mental wellbeing message across to families esp. re grief • Lead professional for every vulnerable child • Mentoring services for young people. Provision lacking vs. Need • Services to help young people express emotions and cope with the past. Provision lacking vs. Need • Specialist/dedicated workers for young carers in schools. Provision lacking vs. Need 33 Mental Wellbeing in Salford Gaps & Unmet Needs Identified
Build Strength, Safety and Resilience Improve the resilience and safety of individuals and communities to help guard against some of the factors that can damage people’s well‐being or lead to mental health problems and suicide, through interventions that prevent violence and reduce poverty, debt, unemployment, homelessness and the impacts of climate change. Gaps / Unmet Needs Community‐based violence prevention – Services / Worklessness Agenda (Cross reference Promote Purpose & Participation)
community approaches to reduce alcohol‐
• Support for those unable to read & write particularly ex‐offenders. Plus lack of 1:1 basic related violence and disorder skills for those with dyslexia. Provision lacking vs. Need Reduce unemployment and debt reduce • Outreach for those wanting to support individuals re worklessness. Provision lacking vs. unemployment, financial exclusion and Need debt – improve income and financial • Shortage of social enterprise schemes for those ready to work/in transition stage of moving capability
to full work. Provision lacking vs. Need Prevent homelessness and improve built Housing environment – intervene early to prevent • Work with private landlords to support those that have damp issues and are not living in homelessness, reduce community noise, social housing litter, graffiti, improve street lighting • Understanding level of need re supported tenancies for low level mental wellbeing Reduce fuel poverty – insulate homes, Funding improve central heating and increase • Shortage of funding in pre‐education / learning for skills benefits to create affordable warmth • Long term investment missing in social enterprise projects Financial Wellbeing • Lack of enough advice on debt / financial literacy • Support for people re loan sharks who are preying on the most vulnerable Suicide prevention – restricting access to lethal Not in scope of study methods including local suicide hot spots, sensitive media reporting at national and local levels and targeted support for high‐risk groups such as young men and prisoners Reduce effect of flooding and Heat waves – target heat wave and flooding 34 Mental Wellbeing in Salford Gaps & Unmet Needs Identified
Develop Sustainable Connected Communities Reduce social exclusion by addressing stigma and discrimination. Enhance sustainable communities by promoting social and environmental engagement to develop connected inclusive communities. Gaps / Unmet Needs Reduce stigma and discrimination – workforce development and media campaigns on well‐being and mental health literacy Develop social networks – community participation and social prescribing to increase social capital and networks Enhance safe green community spaces – develop and increase access to safe green community spaces Sustainable interventions – for example, insulating homes, healthy eating and active transport, to improve health and reduce energy use Services • Local services for local cultures – i.e. culturally based services to compliment existing general ones. Provision lacking vs. Need • Support services for refugee and asylum seekers. Provision lacking vs. Need • Advocacy / appeal work for carers. Provision lacking vs. Need • Specialist carer interventions e.g. for parent carers / young carers in schools /alcohol abuse Æ needs scoping • Parent carer support – need for clear pathways for parent carers • Support to reduce isolation for older people. Provision lacking vs. Need • Services offering initiatives for older people impacting on mental wellbeing – particularly outdoor / active ones. Provision lacking vs. Need Social prescribing (Cross reference Integrate Physical & Mental Health) • Lack of understanding re the breadth of Social Prescribing project • Gap in developing ties with services around Social Prescribing project and integrating it into the broader health agenda Enhancing safe green community spaces • Lack of formal links between mental wellbeing and the environment agenda 35 Mental Wellbeing in Salford Gaps & Unmet Needs Identified
Integrate Physical and Mental Health Physical and mental health are interconnected. To ensure good overall health, approaches to promoting physical and mental health need to be integrated to reduce health risk behaviours, reduce inequalities and improve health outcomes. Gaps / Unmet Needs Incorporate mental health and well‐being literacy within health improvement programmes – including: smoking, alcohol, drug misuse, obesity and healthy eating, physical activity and sexual health Target those with mental health problems – for physical health checks and health improvement programmes such as smoking cessation Physical exercise – an effective component in the treatment of mild to moderate depression Integrated healthcare pathways – integrate physical and mental health assessments and treatment (including psychological therapies) into healthcare pathways Understanding the concept of mental wellbeing / Services • Lack of understanding by services re physical health and potential impact on mental wellbeing • Services actively engaging families into physical activities to support their mental wellbeing • Potential lack of congruency between Working Neighbourhood Teams / Health Improvement Teams and Community Mental Health Teams • Mental wellbeing not being integrated into routine assessments of health workers Æhealth care pathways 36 Mental Wellbeing in Salford Gaps & Unmet Needs Identified
Promote Purpose and Participation Positive well‐being is enhanced by a balance of physical and mental activity, relaxation, generating a positive outlook, expressing creativity, and purposeful community activity. Gaps / Unmet Needs Work can play a vital role in improving Services everyone’s well‐being and mental health • Limited choices of therapy interventions offered to people in Salford. Provision lacking vs. – people generally enjoy better mental Need health when they are in work; the longer • Intensive support services to build confidence in those that are struggling at lower end of individuals are absent or out of work, the spectrum (links to above). Provision lacking vs. Need more likely they are to experience • Limited breadth of socially inclusive services for the most vulnerable. START excellent art depression or anxiety based service but insufficient diversity of other services providing other activities. Balance physical and mental Provision lacking vs. Need activity – including physical activity, • Evidence for more implementation of Holistic therapies. Provision lacking vs. continued learning and rest Positive psychology and Worklessness Agenda (cross reference Develop Sustainable, Connected Communities) mindfulness interventions • Lack of pre‐educational / learning for skills projects – psychological therapies and approaches • Child care for young mothers – as an early intervention to avoid being on at risk register. that promote positive thoughts and Provision lacking vs. Need emotions Participation in the arts and creativity – arts programmes, for example, that enhance individual and community engagement Purposeful community activity – enable volunteering 37 Mental Wellbeing in Salford
Recommendations
5. Recommendations Analysis of the gaps and unmet needs has led to the following recommendations, which have been split into ‘Priority’ and ‘General’ areas. The priority recommendations will support the delivery of an effective mental wellbeing strategy across Salford and help partners more fully integrate and embed mental wellbeing into the broader health agenda. The more general recommendations will start the process of ensuring that mental wellbeing is everybody’s business and should also be incorporated into the mental wellbeing strategy action plan. 38 Mental Wellbeing in Salford Priority Recommendations
Area Strategic
• Develop a common agreement across Salford, in line with national thinking, on meaning and usage of the terms mental wellbeing, mental health & mental illness • Continue to ensure a greater shift in focus from specialist mental health services to more community based services. This should be clearly identified in any new mental wellbeing / mental health strategies developed • Establish clear strategic planning and a more integrated and seamless approach between the mental wellbeing and mental health/illness agenda from commissioning to provision, with a visible partnership approach to the whole agenda • Establish a shift to demand more comprehensive evaluations and effectiveness of service delivery and the value added of interventions that impact on mental wellbeing • Where services have identified gaps / unmet needs particularly in relation to ‘Provision lacking vs. Need’ the real need should be measured and service commissioning tailored accordingly Services • Develop joint outcomes for the Health Improvement Teams and Working Neighbourhood Teams / Community Development Workers to ensure better integrated working and to ensure sustainability of programmes that impact on mental wellbeing • Ensure better integrated working re mental wellbeing between the Public and 3rd Sector ensuring the 3rd Sector feel listened to and fully contribute towards influencing practice • Scope the need for a broader range of choices of therapy interventions that clearly support and impact on mental wellbeing 39 Mental Wellbeing in Salford Priority Recommendations
Area • Identify the direction that commissioning bodies want to take re mental wellbeing Commissioning • Ensure mental wellbeing is more visible in the commissioning process and is specified in SLAs • Encourage a thinking of multiple outcomes & support the added value concept by asking for evidence of additional social, environmental & economic impact in every contract commissioned Communication • Consider an outcomes focused performance management approach re mental wellbeing and mental health ‐ which is embedded throughout the commissioning and procurement process through to contract management (See Sustainable Commissioning Model)23 • Develop a clear strategy for communicating the mental wellbeing agenda • Strengthen communication re mental wellbeing between services from strategy to operational levels across Public and 3rd Sector organisations through: ¾ Better engagement between commissioners (particularly NHS) and 3rd sector organisations – with more inclusive consultation and feedback opportunities ¾ Operational teams effectively feeding into policy development & delivery ¾ Development of clearer communication channels between partners ¾ More effective networking on the ground creating a better understanding of projects and services Service Directory / Map of service provision • Develop a central Directory of services impacting on mental wellbeing to support signposting for professionals. This will ensure quality and consistency and to avoid duplication. Consider how best to categorise these agencies so that appropriate referrals cab be made. Senior partners should drive this • Develop a map of service provision to support the directory (see Appendix 5 for existing map) 23
New Economics Foundation http://www.procurementcupboard.org/ 40 Mental Wellbeing in Salford Priority Recommendations
Area Other Understanding the concept of mental wellbeing • Develop tools to ensure that mental wellbeing is more visible and integrated into the thinking, planning, commissioning and implementation processes Worklessness & supporting access to employment • Scope the perceived gap in service provision for 1:1 basic skills training particularly those with dyslexia, ex offenders and those needing more support at home • Provide more social enterprise schemes for those that are ready to work / in transition stage of being ready to work are developed • Provide more pre‐educational / learning for skills projects Training • Develop a clear training strategy and training programme, which embeds the training needs identified and is integrated into the mental wellbeing strategy. Ensure the programme is offered to all relevant partners, including 3rd Sector organisations (See Appendix 6 for training needs identified) • Develop a robust joint training programme re mental wellbeing for the Health Improvement Team and Working Neighbourhood Teams – supporting a team led approach • Ensure any training developed is done so in consultation with other providers e.g. the Mental Wellbeing THRIVE course being developed between MIND and The Angel – supporting joined up approach to service delivery 41 Mental Wellbeing in Salford Priority Recommendations
Area • Ensure routine analysis from systems currently recording data on mental wellness is undertaken and circulated to provide evidence of a realistic picture of Salford’s issues re mental wellbeing Data • Work on a common understanding of the definitions of mental wellbeing and mental ill health / diagnosis to help the understanding of needs across all agencies involved in this agenda • LA and NHS should work jointly on what additional data should be being collected / collated from community services • Implement strategic data collection to enable better monitoring evaluation and research • Clarify for services what information is required, at what level and by whom • Strengthen the ability to measure a social return on investments • Invest more in evidence gathering and analysis of equality data and integration of this into service planning and delivery • Improve quality of ethnicity data collection within existing systems • Need for hard evidence of anecdotal information that provision does not meet needs • Develop understanding of the overlap and uniqueness of various systems for collection data on contacts with treatment services (e.g. Inpatient, Outpatient, MHMDS, IAPT and CAMHS) and how contacts with community services could enhance these systems • Added value would be gained from measuring the distance travelled by people that are accessing services 42 Mental Wellbeing in Salford General Recommendations
Area
Strategic
• Ensure all services know mental wellbeing is their business and all major strategies clearly define their role within the mental wellbeing agenda and integrate it into their planning process • Ensure all services sign up to the recovery model and embed it into their service delivery so enhancing the mental wellbeing agenda • Use the teams on the ground more fully to jointly bridge the gap between the mental wellbeing and mental illness agenda (Working Neighbourhood Teams and Health Improvement Teams are good examples) • Develop a greater understanding of the ‘value added’ of mental wellbeing and how it impacts on different aspects of work programmes • Consider pockets of deprivation within wealthier areas not classified and possibly in need of dedicated services for mental wellbeing • Scope congruency between Working Neighbourhood Teams / Health Improvement Teams and Community Mental Health Teams Services
• Develop joint outcomes for both the Health Improvement Teams and Working Neighbourhood Teams / Community Development Workers to ensure better integrated working and to ensure sustainability of programmes that impact on mental wellbeing • Broaden Services’ thinking re mental wellbeing and ensure they offer more projects that impact on it • Ensure services integrate the emotional resilience model of wellbeing into their workplace health agenda to support employee wellbeing 43 Mental Wellbeing in Salford General Recommendations
Area Commissioning • Shift emphasis to joint funding of projects that impact on mental wellbeing – e.g. The Health Trainers Project / Rangers • Develop / support an independent website re mental wellbeing as a mechanism for people in a community development role to increase communication, joint working, signposting. This could be commissioned through a 3rd sector organisation Communication Other Understanding the concept of mental wellbeing and its indicators • Share indicators developed for mental wellbeing with all partners (See CSIP Toolkit 200724 & NEF work 2008)25 • Integrate mental wellbeing into routine assessments of health workers Worklessness & supporting access to employment • Introduce a grace period for those newly employed who struggle paying their own rent – so supporting them back to work ‐ a revision of how to pay. Press for action from the Dept for Work & Pensions if not feasible • Consider provision of child care for those mums that need a break /respite from caring Care Pathways • Develop a whole systems approach to identify and deliver clear care pathways for different levels of mental health & mental wellbeing. Senior managers should drive its implementation Thresholds • Clarify threshold levels for mental wellbeing / mental health assessments to ensure better signposting to / accessing of appropriate services 24
CSIP ( March2007) Mental Well‐being Impact Assessment : A Toolkit / Local Steuer N & Marks N / NEF (2008) Local Wellbeing: Can we measure it? 25
44 Mental Wellbeing in Salford General Recommendations
Area Other Housing / Homelessness • Work with private landlords to support those that have real damp issues and not living in social housing • Ensure housing providers develop a more co‐ordinated approach on tenancy sustainability and promotion of mental wellbeing • Scope need of supported tenancies for low level mental wellbeing Financial Wellbeing • Scope need to develop more services to provide advice on debt / financial literacy Social Prescribing • Provide better marketing of the Social Prescribing project to services on the ground and give more opportunities to services that could make a contribution to its success • Ensure SCC Leisure Services strengthens links with Day Care Opportunities particularly re Exercise on Prescription Scheme Enhance safe green community spaces • Make more formal links between mental wellbeing and the environment agenda Research / Evaluation • Give full support to any research being undertaken that might help to support the mental wellbeing agenda e.g. MIND’s mapping exercise to assess gaps in provision / The Big Life Centre’s work with Salford University to strengthen data evidence and improve ability to measure the distance travelled for people coming in and accessing services • Evaluate the carers’ personal budget to see what impact it has had on carers and whether it has improved their mental wellbeing
45 Mental Wellbeing in Salford Appendices
APPENDICES Appendix 1: Documents Supporting Mental Wellbeing Agenda Appendix 2: The Population of Salford Appendix 3: P2 People & Places Descriptions Appendix 4: The Mental Health Minimum Data Set Appendix 5: Map of Service Provision Appendix 6: Services & Individuals Consulted Appendix 7: Training Needs Identified 46 Mental Wellbeing in Salford Appendix 1
Documents Supporting Mental Wellbeing Agenda
As well as the New Horizons publications, there are a number of other documents which provide an excellent base to work from to support taking forward the mental wellbeing agenda in Salford providing support for strategy development and also looking critically at how we might measure mental wellbeing. These are a few we have come across but it was not in the scope of the assessment to systematically review all those available. 1. Working our way to better mental health26 published in 2009 – a cross government framework designed to improve well‐being at work for everyone 2. The recently published National Advisory Council CAMHS review one year on27 which looks at examples of progress of the review but also at the many challenges that need to be tackled if the CAMHS Review recommendations are to be achieved. 3. The recently published DCSF guidance for promoting the emotional health and wellbeing of children and young people28 which clearly sets out recommendations in relation to leadership, vision, strategy and action planning. 4. The North West’s Mental Wellbeing Survey 200929 which found that ‘an individual’s connection and interaction with their community is critical; in particular having a sense of belonging to the neighbourhood and feeling one can influence decisions about the local area, make a big difference to mental wellbeing’. 5. The Young Foundation’s report on looking at measuring wellbeing which admits there is no single, agreed definition of wellbeing currently in use at central or local government level and measuring people’s ‘subjective wellbeing’ often requires asking people about their feelings and experiences, typically through surveys and/or questionnaires.30 6. On the European Happy Planet Index (HPI)31, the UK trails well behind, coming 21st in the league of 30 nations. It has a series of self‐assessment questions that enable a personal HPI index to be calculated. 7. The New Economics Foundation (nef) has set out a radical proposal to guide the direction of modern societies and the lives of people who live in them. It calls for governments to directly and regularly measure people’s subjective well‐being: their experiences, feelings and perceptions of how their lives are going, as a new way of assessing societal progress.32 The outputs from nef include a guide to measuring children’s wellbeing.33
26
Joint Govt (December 2009) Working our way to better mental health NAC (March 2010). One Year On. The first report from the NAC for Children’s Health & Psychological Wellbeing 28
DCSF (January 2010) Promoting the Emotional Health of Children & Young People – Guidance for Children’s Trust Partnerships, including how to deliver NI 50 29
NWPHO (June 2009). Health Profiles North West Summary 30
Steuer N Marks N. Local Wellbeing: can we measure it? (September 2008) http://www.youngfoundation.org/files/images/YF_wellbeing_measurement_web.pdf 31
www.happyplanetindex.org 32
www.nationalaccountsofwellbeing.org 33
www.neweconomics.org/sites/neweconomics.org/files/Backing_the_Future_Measuring.pdf
27
47 Mental Wellbeing in Salford Appendix 2: The Population of Salford
The mid‐2008 population34 of Salford is estimated to be around 221,000 and this is fairly equally split across broad aged groups. Of these, the majority (46%) is resident in the most deprived fifth of areas nationally; this varies slightly by age, with 50% of children and young people and 43% of people aged over 60 living in the most deprived areas. Distribution of the Salford population living in areas of different levels of deprivation (national quintiles). Data 35
experimental population statistics. Source National Satistics. The map below shows the different levels of deprivation across Salford and its neighbourhood areas by small area geography.36 All the maps in this report present data at Middle Super Output Areas (MSOA). Index of multiple deprivation (IMD 2007) as the average score by Middle Super Output Area.
36
34
Population estimates for UK, England and Wales, Scotland and Northern Ireland. www.statistics.gov.uk/statbase/Product.asp?vlnk=15106 35
Estimates of Household Population for England and Wales www.statistics.gov.uk/statbase/Product.asp?vlnk=10755 36
National Statistics. Census Geography. www.statistics.gov.uk/geography 48 Mental Wellbeing in Salford Appendix 2: The Population of Salford
The population is fairly evenly distributed across wards in Salford, although fewer people live in Ordsall than in any other ward. Over 20% of the population is aged 60+ in Weaste and Seedley, Swinton North, Eccles, Walkden South and Worsley. Over 20% of the population is aged under 16 in Cadishead, Winton, Little Hulton, Broughton and Kersal. Distribution of the Salford population across wards. Data experimental population statistics. Source National 35
Statistics. The types of P2 People and Places37 (see Appendix 3) that predominate within the Salford population are ‘Urban Producers’ (22%) and ‘Suburban Stability’ (21%); there are no areas classified as ‘Qualified Metropolitans’ or ‘Multicultural Centres’ in Salford. 37 Distribution of the Salford population across P2 People and Places lifestyle groups. Data experimental population 35 statistics. Source National Statistics.
37
P² People & Places © Beacon Dodsworth 2004 – 2010. www.beacon‐dodsworth.co.uk/site/products/people_classification 49 Mental Wellbeing in Salford Appendix 3: P2 People and Places Descriptions
P2 People & Places 37 P2 name 1 Mature Oaks % Salford Population 4.2% 2 Blossoming Families 5.6% 3 Country Orchards None 4 Rooted Households 5.9% 5 Senior Neighbourhoods 3.4% 6 Qualfied Metropolitans 0.0% Description Wealthy, highly qualified, older working people living in large detached houses. • tend to have two or more cars • read broadsheet newspapers such as the Daily Mail and Express • have a keen interest in politics • are the least likely group to smoke • prefer to shop at Sainsbury's but are not afraid to buy online on their home computers • are unlikely to move. Well qualified, and well paid, young professional families with infants buying their detached houses. • generally own two cars • read black top newspapers, such as the Mail and the Express • have some interest in politics • tend not to smoke • do their shopping predominantly in Sainsbury’s, with Tesco also being popular • have some adults who move, but only over short distances. An older group, working in skilled manual jobs, with quite high incomes and living in semi‐
detached houses. • often have two cars • chose to read black top newspapers such as the Express and Mail • are not interested in politics • are unlikely to smoke • do their grocery shopping at Tesco • are relatively unlikely to move. Mostly retired, or late middle age, quite affluent adults living in their owner occupied detached houses; quite likely to own a second home. • own one car • read broadsheet and black top newspapers, such as the Mail and the Express • are very interested in politics • varied grocery shopping patterns, shop at supermarkets such as Aldi and Lidl or at Tesco and Morrisons, Safeway and Somerfield • are relatively unlikely to move.
Highly qualified professional young commuters, and large numbers of students, living in small single households concentrated in city centres. • have little need for a car • are heavy readers of broadsheet newspapers • are extremely interested in politics • have fewer than average smokers • mostly shop at Sainsbury’s • are the second most mobile group. 50 Mental Wellbeing in Salford Appendix 3: P2 People and Places Descriptions
P2 name 7 Suburban Stability % Salford Population 20.7% 8 New Starters 6.4% 9 Urban Producers 21.8% 10 Weathered Communities 12.9% 11 Multicultural Centres None 12 Disadvantaged Households 8.5% 13 Urban Challenge 9.2% Description Adults of varying ages, not highly qualified and mainly working in routine or skilled manual jobs and living in semi‐detached and terraced housing that they are buying. • tend to own one car • read red top tabloids such as the Sun and the Mirror • are not interested in politics • are more likely to smoke than average • generally shop at Asda, though Aldi and Lidl as well as Morrisons, Safeway and Somerfield are also frequented • are a relatively stable group in terms of population migration. Mainly students and highly qualified but low income young adults living in single or cohabiting bedsits or flats mostly privately rented. • do not have a car • read broadsheet newspapers to keep up with world affairs • are very interested in politics • are very likely to smoke • do grocery shopping as cheaply as possible, at chains such as Aldi and Lidl • are the most mobile population of all groups, being twice as likely to move as others. Lone parent, low income families, living in terraced council housing, working in routine manufacturing, unskilled, semi‐skilled or skilled jobs. • do not have a car • tend to read the tabloids • are not interested in politics • are very likely to be smokers • like to do their grocery shopping at Asda • are unlikely to move. Mostly adults past retirement age, living in council and housing association homes. Those still of working age are employed in routine or skilled and semi‐skilled jobs. • rarely have a car • are likely to read tabloid newspapers, such as the Sun and the Mirror • are uninterested in politics • tend to be smokers • tend to shop at supermarket chains such as Asda, Aldi and Lidl • are a mainly settled and very stable group. Low income, poorly qualified young families or lone parents living in council or housing association homes, high rates of unemployment. • tend not to have a car • tend to read tabloid newspapers, such as the Sun and the Mirror • are not interested in politics • are more likely to smoke than any other group • do their shopping at Asda • have an above average numbers of movers. Elderly, often retired people in council or housing association flats, with the highest unemployment rate of any group. • do not have a car • read tabloid newspapers, like the Sun and the Mirror • are interested in politics • have an above average number of smokers • like to do their grocery shopping at Asda • have a below average numbers of movers. 51 Mental Wellbeing in Salford Appendix 4: The Mental Health Minimum Data Set
The Mental Health Minimum Dataset (MHMDS)38 contains record level data about NHS services delivered to over a million people with severe and enduring mental health problems each year between 2003 and 2009. This website accompanies the Mental Health Bulletin publication and provides trust‐level breakdowns for the national statistics presented in the Bulletin. These are shown in as graphics with year on year comparisons. One of the main purposes of this web site is to enable provider trusts to review and improve their MHMDS data as part of a wider programme of work to develop mental health data that is fit for a range of management and planning purposes. NHS commissioners are encouraged to discuss the trust‐level results with their providers. The Mental Health Bulletin is available at: www.ic.nhs.uk/statistics‐and‐data‐collections/mental‐health Understanding the statistics The statistics are presented as eight separate reports. All England and individual organisation‐level figures are provided for each report and, for the organisation‐level statistics, the underlying data tables are available to download from the each screen. What this site can tell you This site aims to answer, in some cases for the first time, the following: •
the number of people using NHS mental health services •
the rate of access to NHS mental health services by 100,000 population •
the number of people detained in hospital •
the number of people on the Care Programme Approach (CPA) •
information about how long people spend in hospital •
information about the number of beds, patient admissions and discharges •
number of contacts with different professional staff groups •
information about types of clinical teams coordinating patient care Information about MHMDS: www.ic.nhs.uk/services/mental‐health/mental‐health‐minimum‐dataset‐mhmds What this site cannot tell you The site does not cover the services for people with common mental health problems that are provided in primary care, for example through GP surgeries. Nor can it tell you about specialist mental health services delivered by independent hospitals or through specialist services for children and adolescents. Information about the prevalence of mental disorders can be found in Adult Psychiatric Morbidity in England, 2007: results of a household survey at: www.ic.nhs.uk/pubs/psychiatricmorbidity07. 38
The Information Centre www.mhmdsonline.ic.nhs.uk 52 Mental Wellbeing in Salford Appendix 4: The Mental Health Minimum Data Set
NHS COMMISSIONER: SALFORD PCT ‐ 5F5 1. Number of people using NHS mental health services The number of people in contact with NHS adult and elderly secondary mental health services by the highest level of care they received during the year. The report shows the number of people who used NHS adult and elderly secondary mental health services during the year. Many of these people will have had more than one episode of care during the year or received care from more than one provider, but each person is only counted once. The numbers are divided into those whose care during the year included at least one day as an inpatient (admitted), those for whom there are records of contact with outpatient or community services or a CPA review, but who did not spend any time as an inpatient (only non admitted) and those for whom no kind of contact, attendance or time in hospital was recorded during the year (no care). Each person is counted in one category only, with ‘admitted’ ranked first and ‘no care’ last. 53 Mental Wellbeing in Salford Appendix 4: The Mental Health Minimum Data Set
2. Number of inpatients detained in hospital Number of people who spent time (at least one day) as an inpatient and the proportion who spent time detained under the Mental Health Act 1983. This report shows the number of people who spent time formally detained in an NHS hospital under the Mental Health Act 1983 during the year. This number is shown as a proportion of all people who spent time as inpatients in mental health services. Each person is counted only once and in one category with ‘formal’ ranked before ‘informal’, so if a person spent time as a formally detained patient and time as an informal patient, they are counted once only in the ‘formal’ category. Legal status was not recorded for some inpatients and it is assumed that this is because they were never formally detained during the year. Although they are assumed to be in the informal category these people are grouped separately. 54 Mental Wellbeing in Salford Appendix 4: The Mental Health Minimum Data Set
3. Number of people on Care Programme Approach (CPA). The highest level of CPA
recorded for every person in contact with mental health services during the year. For
2008-09, values for the employment status and settled accommodation indicator for
people on CPA aged 18-69 are shown for the first time. This report shows the number of
people who spent days on the CPA during the year. CPA supports people with long term
mental health needs. People with more complex needs are on enhanced CPA and others are
on standard CPA. By showing the highest CPA level (with no CPA being the ranked lowest)
recorded for each person during the year the statistics show the proportion of patients that
had more complex mental health care needs. Each person is counted only once and in one
category with enhanced ranked before standard, so if a person spent time on standard CPA
as well as on enhanced CPA, they are counted in the enhanced category.
55 Mental Wellbeing in Salford Appendix 4: The Mental Health Minimum Data Set
4. Average length of stay in hospital per record [Not considered reliable by Commissioner, so only presented by provider] The average length of stay per record for people who spent time as inpatients during the year. This report gives the average length of an inpatient stay in the current year per record in days. The statistics are classified into: up to 30 days, 31‐60 days, 61‐90 days, 91 days to one year, over 1 year. NHS PROVIDER: GREATER MANCHESTER WEST MENTAL HEALTH NHS FOUNDATION TRUST – RXV 56 Mental Wellbeing in Salford Appendix 4: The Mental Health Minimum Data Set
NHS PROVIDER: MANCHESTER MENTAL HEALTH AND SOCIAL CARE TRUST – TAE 57 Mental Wellbeing in Salford Appendix 4: The Mental Health Minimum Data Set
5. Inpatient activity The total number of admissions to and discharges from mental health inpatient services. The report shows details of inpatient activity by counting the total number of admissions to and discharges from inpatient services during the year. 6. Rates of access to NHS mental health services The rate of access to NHS adult and elderly secondary mental health services per 100,000 population. The report shows the rate of access to NHS mental health services per 100,000 population separately for adults of working age and those over the age of 64 who live in this PCT area. Rates of access are only given by NHS commissioner (PCT) as provider trusts offer services to people from many different areas. 58 Mental Wellbeing in Salford Appendix 4: The Mental Health Minimum Data Set
7. Outpatient and community activity Number of contacts with members of different professional staff groups This report counts contacts with members of the community mental health team and attendances at outpatient clinics (shown at contacts with a consultant psychiatrist). 59 Mental Wellbeing in Salford Appendix 4: The Mental Health Minimum Data Set
8. Type of clinical team coordinating patient’s care Type of team responsible for patients on CPA at the end of the year. This report gives an indication of the number of people on CPA at the end of the year by the type of clinical team responsible for their care. 60 Mental Wellbeing in Salford Appendix 5: Map of Service Provision
Mental Wellbeing – Indirect Services Map This map was produced for the Mental Wellbeing Strategy Group by integrating existing directories of services collated by the Primary Care Trust and Salford City Council. It does not yet give a complete picture as other service directories exist39 and more work is required to ensure that a single central directory and map of services is produced and maintained. 39
For example: MIDAS Directories for Dual Diagnosis Services. www.midastrial.ac.uk/ddds.asp 61 Mental Wellbeing in Salford Appendix 6: Services & Individuals Consulted
Services from NHS
Name Contact details Tel & Email Job title / Service Anthony Ainsworth [email protected]
077660 26561 Health and Wellbeing Officer – Public Health
Assumpta O’ Connell Assumpta.o’[email protected]
0161 212 4945 Carmen Martinez
[email protected]
0161 212 4938 David Herne
[email protected]
0161 212 5693 [email protected]
0161 212 5635 Healthy Schools Scheme Co‐ordinator
Health and Wellbeing Manager – Public Health
Acting Director Public Health
Debbie Yates
Eejay Whitehead
[email protected]
0161 603 4109 // 07799113402 Fiona Reynolds
[email protected]
0161 212 4953 Janet Roberts
[email protected]
0161 212 4839 [email protected]
0161 212 4953 Janice Lowndes
Maggie Maudsley [email protected]
0161 603 4283 Mental Health Commissioning
Emotional & Wellbeing Provider – Hlth Improvement Manger –
Community Consultant in Public Health
AD Commissioning Modernisation / Chair Older people Mental Health Health Improvement Manager – Public Health
CAMHS Commissioner 62 Mental Wellbeing in Salford Appendix 6: Services & Individuals Consulted
Services from Salford City Council Name Contact details Tel & Email Job title / Service Brian Wroe
[email protected]
[email protected] 0161 793 2287 [email protected]
0161 793 3596 Community Services
Matthew Ainsworth [email protected]
0161 793 2546 Employment Services
Mike Wright
[email protected]
0161 922 8703 AD Housing Connections Partnership /Homeless
Phil Martin / Zahrah Mir [email protected]
0161 793 2812 Equality & Cohesion Team
Shaun Clydesdale
[email protected]
0161 793 3178 Social Inclusion
Wayne Priestley
[email protected]
0161 925 1399 AD Environmental Services
Don Brown
Community Safety
63 Mental Wellbeing in Salford Appendix 6: Services & Individuals Consulted
Services from 3rd Sector Name Contact details Tel & Email Job title / Service Bernadette Conlon 0161 351 6000
Clare Mayo
[email protected]
0161 793 3832 // 07971495526 [email protected]
0161 833 0271 Chief Executive START / Basis rep
Promotes emotional wellbeing & recovery by providing creative arts based activities & training opportunities for people who are or at risk of mental hlth difficulties User Development Worker – Representing Users
Dawn O’Rooke
Louise Bell
Marcus Greenwood Nicky Hutchings
[email protected]
0161 212 5701 / 5820 [email protected]
0161 839 3030 Scott Daraugh
[email protected]
0161 736 7644 [email protected]
0161 833 0495 // 07906000920 Tom Griffiths
[email protected]
0161 237 5908 Centre Manager ‐ Princess Royal Trust Salford Carers. Providing support & advocacy for carers. Based in The Angel Centre Manager ‐ Big Life Centres. Work with people who have been excluded from mainstream society due to health, housing, education or skill. Manager – Mind based at The Angel. Promote positive mental health & wellbeing. Advocate and campaign. Fight stigma & discrimination Manager ‐ LifeCentre for young people – Seedley & Langworthy. Providing opportunities for young people 11‐25 Centre Manager ‐The Angel Healthy Living Centre
A social enterprise providing art, music, creative learning, health & wellbeing for local people Community Development Officer‐ White Minority Communities ‐
SEVA 64 Mental Wellbeing in Salford Appendix 6: Services & Individuals Consulted
Services from 3rd Sector / NHS Name Contact details Tel & Email Job title / Service Alan Rosser
0161 787 8500 & Mob: 07903 942389
Belinda Roach
0161 603 6860
belinda.roach@work‐solutions.org.uk Chris Dabbs
07834646345 // 0161 734 0088
Janet Cunningham 0161 736 6500
Deputy Chief Exec ‐Salford Foundation. Provides a wide range of emotional support services for young people in Salford Foundation. Service Manager ‐Skills and Work. Connects people to jobs & training – for 18+. Supporting economically inactive Salford residents into employment or onto training ‐ giving assistance in building up confidence & skills Chief Executive ‐ Unlimited Potential. A social enterprise which aims to help people fulfil all of their rich potential through leading healthier, happier lives Loan Officer ‐ Salford Money Line. Providing affordable loans to individuals John Dickinson
0161 737 5500 Phil McEvoy
0161 212 4982
Ronnie Lloyd 0161 772 4381
Shellie Nelson
0161 707 5007
Manager ‐ Progress 2 Work. Engaging with those who have had substance misuse problems & on benefit. Offering information, advice, guidance, support & training to help get back to work Manager ‐ IAPT. Improving Access to Psychological therapies based at The Angel. Head of Day Opportunities ‐ GMWest Mental Health NHS Foundation Trust. Work within a framework of recovery; supporting an ethos of social inclusion and recovery. Treating service users holistically within a life context SSTAR Manager – Cavendish House. Salford Support Time & Recovery Network part of Salford Day Opportunities GMW MH 65 Mental Wellbeing in Salford Appendix 7: Training Needs Identified
Awareness Focussed ‐ General An Understanding of:
•
•
•
•
•
•
•
•
•
•
Mental wellbeing generally and how it fits into the broader agenda of health and wellbeing The framework for developing wellbeing The different terms – mental wellbeing, mental health & mental illness What services are out there that support mental wellbeing Signposting to different services that support mental wellbeing and also mental health / illness services Why it’s important to build confidence and personal relationships in clients Issues around alcohol and mental health / wellbeing Evidenced based programmes for effective signposting Indicators for mental wellbeing Dementia and Alzheimer’s – How these illnesses affect the individual’s health & wellbeing & how they impact on service provision • The Working Neighbourhood Teams and how they link into the overall mental wellbeing agenda 66 Mental Wellbeing in Salford Appendix 7: Training Needs Identified
Skills focussed ‐ Specific • The mechanics of behavioural change and mental wellbeing • The emotional resilience model and its implementation into practice • Diagnostic training to identify early stages of mental health; where mental wellbeing fits into this and when to intervene or not Æ towards the mental illness spectrum • Understanding of thresholds for mental wellbeing & mental health and where to signpost in response to different threshold levels + Referral points to services – i.e. when and who to refer to • Development of a brief interventions and mental wellbeing package • Enhancement of the BEST programme to build on existing TAMHS (Targeted Adolescent Mental Health in Schools) Specific for Senior • How mental wellbeing fits into the overall health agenda and impacts on their staff managers: Other more specific Reverse needs based planning identified Re‐visit the whole training philosophy to see training as ‘learning and development’. Offer courses on: • How to plan on the basis of strengths not needs • How to get people to talk about hopes and aspirations • Helping people and communities to set their own goals 67 Salfford Mental
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Prroduced by:
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[email protected]