Agenda item

To provide an update to the Health and Wellbeing Board on the Kirklees Health and Wellbeing Strategy (KHWS) priority of ‘Mental Wellbeing.’

 

Contact:  Rebecca Elliot, Public Health Manager and Paul Howatson, Programme Manager – Mental Health and Learning

Rebecca Elliot, Public Health Manager and Paul Howatson, Programme Manager provided an update on the Kirklees Health and Wellbeing Strategy priority on Mental Wellbeing. In summary, the Board was advised that the aim of the discussion will be to highlight the commitments made, highlight the success indicators, discuss the delivery on the ‘I statements’ and the local partner actions, touch on the recent successes and challenges currently being faced, and discuss the contribution that this priority makes to other top tier strategies, including the Kirklees outcomes and the ten ambitions of the Integrated Care Board.

 

Referring to a set of slides, the Board was reminded that the vision for the KHWS is:

 

“People who live, work or study in Kirklees live their best lives with good health and wellbeing, free from inequality, stigma, discrimination and barriers, so they can do and enjoy the things that matter to them.”

 

The information presented showed the links between the three main priorities of the KHWS and how they help to achieve the outcomes for Kirklees. In relation to mental wellbeing, a summary of the information presented is as follows:  

 

-      Best Start Outcome - there is an important link between parental mental health and the impact that has on a child’s mental health. It is also important to support family wellbeing even before conception. It is recognised that half of lifetime mental illness starts before the age of 14.

 

-      Well outcome - people with a diagnosed mental health condition, die on average 15 years earlier than those without, and protective factors such as being in good employment and being connected to other people and your place, plays and important part in keeping people with mental health conditions well.

 

-      Independent Outcome – the aim is to overcome in Kirklees, the unfortunate shame and stigma that people with mental health conditions still experience, and to enable people with mental health conditions to live well and thrive, and that their mental health condition does not hold them back.

 

The commitment that was made and outlined in the KHWS for mental health in respect of the ambition, is that “everyone in Kirklees achieves good mental health and has a good quality of life with purpose and fulfilment throughout their lives.”  The Board was directed to a list of the success indicators to be used throughout the duration of the KHWS to be able to monitor progress.

 

The success indicators are a mix of qualitative and quantitative indicators which is particularly important when it comes to the mental health priority. The aim is to be able to not only look at numbers, trends, and data, but also to be able to understand the stories behind the data.

 

Success indicators include:

 

-        % of people feeling happy

-        % of people feeling life is worthwhile

-        % of people feeling lonely*

-        Self-reported mental health

o    Adult emotional wellbeing*

o    Emotional wellbeing of 13/14 year olds*

-        Self-harm rate

-        Suicide rate

 

Qualitative

-        News stories

-        Testimonies with people with lived experience

 

(*bold = shared outcome headline indicator)

 

The Board was informed that a number of ‘I statements’ were agreed for mental wellbeing priority including:

 

-        “I would like support to help me take control of my own mental health”

-        “I would like mental health care and support to be available with my own local community”

 

The Board was informed that much of the work is already being undertaken round the mental wellbeing priority, for example the development of training packages called ‘Mental Health for You and Others,’ which is being developed with Public Health and wellness colleagues. The aim is to promote the fact that “you can’t help people with their own mental health unless you are able to recognise and support your own mental health and self-care.” There is the Primary Care Community Health transformation work in Kirklees, aimed at increasing resources to communities and the integration of mental health into other social support, for example financial support and foodbanks.

 

There is the development of the ‘Live Well Kirklees’ website which also includes access to a mental health microsite for Kirklees and this is aimed at making access to knowing what is available as easy as possible for Kirklees residents. There is the mental health 24/7 support line, in addition to the recent development of the social prescribing link workers in Kirklees.

 

There are also mental health support teams in schools and whole school approaches that are being delivered across Kirklees schools which aims to provide easier access to children across the school network. There are other resources available for children and young people such as ‘Kooth,’ which is an online anonymous mental health support chat health, and senior mental health training being rolled out across schools in Kirklees.

 

Referring to a set of slides the Board was informed that local partners had agreed a number of actions as follows:

 

-      “We will work together to promote the protective factors for mental health for all ages: connection to others, learning, being in work, good housing, physical activity, giving back and purpose,” - individual placement and support and social prescribing offer

 

The Kirklees Employment Service, is for people with mental health problems to encourage and support them back into work, however for those with a more severe mental health problem, the individual placement and support service is commissioned through Southwest Yorkshire Partnership Foundation Trust (SWYFT). The  Trust recently scored highly in their fidelity audit of the success of the placements and the success of the work they were undertaking. It was positive for a new service to score highly in their audit.

 

The social prescribing offer working out of Primary Care in GP surgeries, where people are encouraged to go for other activities. Supporting good mental health is not just about a prescription or some time off work, it is also encouraging people to overcome social isolation and loneliness. Another scheme is the ‘Get Set Goal Scheme,’ that is championed through the Health and Wellbeing Academy at Huddersfield University. There are many initiatives that are happening.

 

-      “We will work together to raise awareness about mental wellbeing, create a positive culture, reduce stigma, and promote prevention, early intervention, and recovery throughout all we do across Kirklees” – celebrating and supporting experts by experience to shape services and say what has been helpful to them

 

Within the Kirklees Mental Health Alliance, it is recognised that service users stories are important to really focus activities. During Covid, service users stayed away from meetings and some of that connection was lost. Since then, the alliance has developed a recruitment pack to promote service users to come and tell their story, not just their own story, to have that collective view regarding what is good about services locally and what could be improved. Work is currently being undertaken to get that lived experience voice back into meetings to help shape thinking.

 

-      “We will provide opportunities to increase protective factors for children’s mental wellbeing, being active, eating well, connecting with peers and friends, learning a new hobby,” - Family Together Model, Our Space, holiday activities and food programme

 

Colleagues from the Integrated Children’s Commissioning Team shared information on the ‘Families Together Model,’ ‘Our Space,’ holiday activities and food programme. At this time with the current economic crisis the food programme, it is important that children and young people are eating well, eating healthily, and eating regularly.

 

The Board was informed that with regard to suicide prevention, undertaking training and reducing stigma, there is now a local training offer and increasing awareness of how to respond, in addition to the development of community conversation guides. There is a great deal of training available, and it is ensuring that as many people as possible have access to it and utilise the techniques from ‘Safe Talk’ or the suicide assist models which are nationally recognised. Experts in mental wellbeing, ‘Touch Stone,’ is one of the voluntary and community sector agencies for advocacy and there are also peer support workers that are working with the community teams in SWYFT helping people on discharge from hospital to build their personal resilience and help them back into communities.

 

It is important that services are where they can intervene early and are accessible and available to local communities. A programme of work, jointly being worked on by the Integrated Care Board and local authority is the Primary Care Community Mental Health Transformation Programme, which aims to recruit mental health specialist roles into Primary Care, to ensure that these workers are available in local communities.

 

The Board was informed that some of the recent successes include:

 

Inequalities -  through the mental health programme, inequalities has always been a key theme to work towards,  working across the different partner organisations within the Kirklees Mental Health Alliance to deliver inclusion across the mental health portfolio. Through a recent suicide prevention wave of funding and community grants project, it is ensuring that all projects focus on those who suffer inequity of access or inequalities by virtue of protected characteristics or other reasons.

 

Within Primary Care, there is the Physical Health and Wellness Team that are helping to undertake the annual health checks for people with severe mental illness. The team has had good success working with primary care colleagues to get people in for their annual screening and making sure they are doing all right and have a conversation with them which is just as important.

 

Shaped by People – Kirklees Mental Health Alliance is undertaking a recruitment exercise for new service user representatives

 

Poverty – foodbanks, tackling poverty partnership and grant funded projects (taking a joined up approach to wellbeing and poverty, local welfare team)

 

Digital – embracing the technology, expansion of ‘Kooth,’ grief and loss service, and 24/7 mental health helpline

 

Housing – specialist accommodation strategy and review of specialist accommodation for people with mental health needs. The mental health training for housing staff has been well received

 

Climate emergency – opportunity for learning from raised anxiety and low mood from the Covid years, understanding the children and young people view

 

The Board was informed that the relevant ambitions from the Integrated Care Board Strategy (ICB), which are still key include:

 

-      increasing the years of life that people live in good health in West Yorkshire

-      achieving a 10% reduction in the gap in life expectancy between people with mental health conditions learning disabilities and/or autism

-      reducing suicide by 10% across West Yorkshire by focusing health inequalities, achieving a greater understanding of impact of inequality on suicide, so that suicide prevention becomes everyone’s business

 

Embedding the ‘I statements’  within the Kirklees Mental Health Alliance (MHA) terms of reference and asking all partners to review these within their respective organisations, to ensure collective ownership of those statements. It is important to agree within the MHA, a systematic way of routinely monitoring delivery against the KHWS priority. Agree periodic check-ins with the Health and Wellbeing Board as a mechanism to monitor implementation and potentially looking towards a mental health inequalities event for Autumn 2023.

 

The Board was informed that in terms of some of the challenges:

 

-              workforce and recruitment challenges

-              impact of the pandemic

-              cost-of-living crisis

-              central funding coming to an end, suicide prevention funding coming to an end

-              integrated partnership working efficiently

 

The Health and Wellbeing Board was asked to comment on, and help shape the direction of delivery against the mental wellbeing priority, and consider how board members can support the delivery against the mental wellbeing priority.

 

In response to the information presented the Board made comment and asked a number of questions including some of the following:

 

-          recruitment and retention is an issue across health and social care, and it is an area that needs to be worked hard on to promote these types of roles within the communities and ‘grow our own’ talent. By working with the universities, it may be possible to introduce training and courses which is needed in the community. In primary care, the Primary Care Networks (PCN) have been recruiting mental health workers, however for the past year they have struggled to get those that are trained and therefore there needs to be a workstream between the PCNs, SWYFT, the university and Kirklees Mental Health Alliance.

 

-          Is work being undertaken with ‘Core Twenty plus Five’ who have allocated some funding for suicide prevention?

 

-          Central funding for suicide will cease, and the statistics around Kirklees suicide rates have shown a reduction because of the focused work that has been undertaken compared to other areas across West Yorkshire and Kirklees is the only area where it had gone down. Where was the central funding coming from for example the government, or health and how can that programme continued to be supported?

 

-          Do colleagues have a sense of what areas are not being achieved or delivered because of workforce challenges and has any thought been given in the MHA to how to work differently to attract and retain staff?

 

-          With regard to the ‘Get Set Goal’ and the work on that initiative, work is being undertaken partnering with Kirklees around supporting the workforce, particularly in social care, the independent sector, and the voluntary and community sectors where they don’t have large organisations to support them. It is good that there is partnership and working together and there will be a ‘We care for you’ roadshow, which will begin in March 2023.

 

-          Poverty is often mentioned; however, it is not often mentioned about people who are working, yet living in poverty because of the inequalities that are across the system. The challenge is to ensure that the people working across the system who are not necessarily in the statutory sector or NHS are being treated equally around their conditions and pay.

 

-          Good quality, affordable housing is important because of the impact on people’s health. There is work that housing providers do to support their residents with health and wellbeing and there is a lot of work going on across the West Yorkshire Housing Partnership around how we are supporting people through the cost-of-living crisis. Work is also being undertaken around condensation, damp and mould, and this work has been ongoing for 12 months not prompted by the findings of a recent inquest. There is a lot of good work going on within housing that supports good mental and physical health

 

-          Nursing vacancies currently stands at approximately 47,000 nationally, and across the region there are approximately 6300 vacancies in the North-eastern Yorkshire region, and the  mental health shortage rate is higher. It is good to see the strategy relying on other factors rather than just the statutory service, increasingly drawing on community resources will be vitally important. The other aspect is to do with expectations and the university has a responsibility to manage people expectations coming into the profession. Professional groups tend to be siloed and compartmentalised and it is important to continue to have creative discussions with partners on how to rethink professions and professional groups, and how to make them more adaptive.

 

-          In response to this priority, Calderdale and Huddersfield Foundation Trust has undertaken a lot of work on inequalities within the waiting lists to ensure that people from different population groups receive their care within the same time frame. It has been successful regarding people living with learning disabilities and ensuring they get their care in an appropriate time frame. A mental health lead nurse has recently been appointed, to ensure that people living with mental health conditions receive their care in a timely way.

 

-          It would be useful if each Councillor in Kirklees and Board members were provided with further information on the Crisis Café and the Grief and Loss Service.

 

 

RESOLVED

 

That Rebecca Elliott and Paul Howatson be thanked for providing an update on Kirklees Health and Wellbeing Strategy priority, mental wellbeing.