Agenda item

The Scrutiny Committee is invited to consider what conclusions it wishes to make from the information provided at earlier meeting.

In particular, the Committee is asked to consider:-

·         What are the key messages from the presentations received?

·         Where are there significant gaps in the services provided?

·         What actions can be taken to address those gaps or unmet needs?

Copies of the Minutes of previous review meetings and the relevant chapter on Mental Health and Wellbeing from the 20^th Annual Public Health Report for Stockport are enclosed for information.

The Chair invited members and officers to discuss the issues that had arisen to date as part of the Mental Health review and to identify any areas where the Scrutiny Committee may wish to make recommendations.

Copies of the minutes of previous meetings were submitted as was a copy of the chapter on mental wellbeing from the 20^th Annual Report of the Director of Public Health (copies of which had been circulated).

The following general comments were made/ issues discussed:-

·         All presentations had identified the importance of mental health and the impact of ill-health on various aspects of society but also on service delivery and resources. It was encouraging that conversations were taking place about addressing these issues and that collaboration was being considered between public sector partners.

·         Overcoming stigma and ‘normalising’ issues around mental illness may help to encourage early intervention as sufferers may be more willing to seek help. It was important to shift the focus to early intervention/ prevention. There needed to be a change in the approach to wellbeing and emotional health.

·         There was a danger in the current approach to mental health that service users became dependent of the services, particularly intensive services, and this would impede their long term improvement.

·         The challenge in widening access to services was hampered because the overall level of resources for mental health services was lower than it should be for the population, and there was not capacity within the acute sector that could be decommissioned to release resources.

·         Although the take up of personal budgets was lowest for those with mental health conditions, the anecdotal evidence was that it had a significant impact.

·         Addressing underlying mental health would assist with patients also suffering physical ill-health, and thereby impact on hospital admissions. Tackling this would unlock resources that could be used to broaden access to services for mild to moderate conditions.

·         A range of emotion problems that were not medical conditions, such as loneliness and isolation, and these were a significant factor in a person’s wellbeing.

The following ‘gaps’ or areas for improvements were discussed:-

·         There were a range of services on offer, such as counselling, talking therapies and Improving Access to Psychological Therapies, but there were questions about whether there was sufficient capacity, whether they were being used correctly, and whether the emphasis was right.

·         Much of the activity of the large public sector employers was to be welcomed, but the example of Stockport Homes was particularly useful in demonstrating the benefits of investing in the wellbeing of employees. Improving links with mental health services to provide advice and support would be welcomed.

·         There would be value in improving the support offered outside of treatment to provided better emotional support. There was a challenge for acute

providers, local authority and the third sector to provide an all-round service. There was increasing focus on pooling services to allow for a wrap around service.

·         There was clear benefit highlighted in the presentations in contact and talking with patients. This was the case for those with mental health problems and those with complex medical care needs. There was a case for greater emphasis on these elements of basic nursing care.

·         What more could be done to assist public sector colleagues, such as the Police, who were not specialists to signpost and refer concerns to appropriate services?

·         The changes to the compulsory age for education or training provided opportunities to extend support for young people entering adult-hood and providers needed to be adequately prepared to provide this support.

·         Improving health literacy had been discussed in other contexts by the Scrutiny Committee, but the importance of people understanding and taking steps to improving their mental health would be beneficial.

It was recognised that the Review had not considered directly the issues surrounding mental health and young people. It was noted that many of the concerns around early intervention, signposting and training could be applied to young people and those who worked with them. The Committee recognised that the topic of young people and mental health was a significant piece of work in its own right and not wholly within the remit of this Committee. However, the Committee also noted that there were pressures on the CAMH Service and that this should be highlighted in the final report.

The Chair highlighted the following issues that had featured in the discussions had by the Committee during the course of the Review:-

·         importance of the mental health to a variety of public sector organisations and activity;

·         the impact mental health had on individual’s in work, maintaining employment and seeking it;

·         increasing recognition of the need to address mental health, both in terms of its impact on physical wellbeing and as an integral element in overall wellbeing (noting the emphasis placed on mental health within the NHS Mandate);

·         the key role played by GPs in diagnosis, treatment and referral for mental health problems and the variability of this across GP practices;

·         examples of good practice from Stockport Homes which should be encouraged in other employers, both public and private, recognising the benefits this investment would bring;

·         sickness absence recording captured statistics about mental health, but there were concerns that this artificially aggregated a wide variety of conditions and hampered identification of work-related stress;

·         the value of simple, relatively inexpensive interventions and support delivered through and by the community was a fruitful area for expansion.

RESOLVED – (1) That all those involved in the Mental Health review be thanked for their contribution.

(2) That the Democratic Services Manager be requested to prepare a final report for circulation to members and contributions prior to submission to the meeting on 7 March 2013.

(3) That contributors wishing to provide further information to support the production of the final report be requested to provide this to the Democratic Services Manager as soon as possible.

(4) That the Democratic Services Manager be requested to cancel the meeting scheduled for 19 February 2013.