What we are doing - mental health
Prevention, wellbeing and inequality
There are some good examples in south east London of preventative mental health care, particularly focused on children, young people, families and the wider determinants of mental health. However, most mental health services are treatment rather than prevention focused and we do not have a consistent way making sure everyone gets the same advice and support to stay mentally and emotionally well.
We are addressing this by collaborating across south east London to develop a consistent approach to recognise and support people with mental health needs.
There is good evidence to suggest that those people who have depression, anxiety and severe mental illness, are less able to engage in diet and lifestyle aspects that help them to stay well. Hence they are more likely to develop physical health conditions too. Identifying by screening and then ensuring timely access to good evidence-based care, which are known to improve outcomes for people, is essential.
We know that the mental health needs of people living in south east London are higher than average. There are many reasons for this including, deprivation, population mobility, sexuality and ethnicity. People from black and minority ethnic communities are more likely to be diagnosed with a serious mental illness. South east London also has a large lesbian, gay, bisexual, transgender (LGBT) population, who also experience poorer mental health outcomes than the general population. Other people at higher risk of mental illness are those with long term physical health conditions, older people, pregnant women or new mothers who are socially isolated and people who are unemployed or in poor housing.
We want health and care services to target those most at risk of developing a mental health problem, provide preventative care, identify issues early, and give timely access to specialist assessment and advice when needed. Currently, access to certain evidence based treatment, needs to be significantly improved and needs to be available across all boroughs.
Making changes such as stopping smoking, improving diet, increasing physical activity, losing weight and reducing alcohol consumption can help people to reduce their risk of poor physical health significantly and can improve mental health too. This means making every contact with health and care services count, as it is an opportunity to use day-to-day interactions to support behaviour change.
Many of the initiatives within our community based care, urgent and emergency care and maternity projects are focused on preventative care and making sure everyone has the same experience when accessing services.
Integrating mental health services
Thirty per cent of people with a long-term condition also suffer from poor mental health. People with severe mental illness do not always get the best care for their physical health needs.
We are working to improve this by integrating mental health services in all health and care services.
An example of the work we are doing in this area includes an initiative to improve the mental health of people with diabetes through the ‘three dimensions for diabetes’ pilot. The overall aim is to integrate medical, psychological and social care for people with persistent and poorly controlled diabetes, reducing the number of people who go to A&E and meaning fewer cases of long term health complications like kidney dialysis, blindness and amputation.
Urgent and emergency care
We want access to crisis mental health services to be easier and faster. We are working to make sure there is access to mental health support and liaison teams for people of all ages in all our A&E departments 24 hours a day, 7 days a week – known as the ‘core 24’ standard.
We are also committed to making it easier for south east London residents to access community based crisis response teams and intensive home treatment as an alternative to hospital based care.
Adult mental health
Better access to talking therapies
Talking therapies can help people with a range of mental health conditions such as mild to moderate depression, anxiety, panic attacks, obsessive compulsive disorder, anger, eating and relationship difficulties. In south east London they are part of Improving Access to Psychological Therapies (IAPT) services.
We want to make sure that by 2020/21 more people can access talking therapies, so that at least 25 per cent of people with common mental health conditions are supported in this way each year.
People who need inpatient mental health care
We want to make sure that if someone is in crisis, they can access a health-based place of safety. The police can use the law to take people from a public place to a ‘place of safety’ or ‘136 suite’ if they seem to have a mental illness and are in distress and in need of immediate care. This is a place where mental health professionals can assess a person’s needs and work out the best next steps.
Unless someone is need of specialist care that is only available outside of the borough they live in, we also want to stop sending people out of the area and provide inpatient mental health care closer to their homes.
Perinatal mental health
Nationally, one in five mothers suffers from mental health problems during pregnancy or in the first year after childbirth. Yet fewer than 15% of areas have the necessary perinatal mental health services and more than 40% provide none at all.
In south east London we want all women to have access to perinatal mental health services. This is already underway in Lambeth, Southwark & Lewisham after funding was secured to expand specialist perinatal services.
Children and young people’s mental health
Half of all mental health problems have been established by the age of 14, rising to 75 per cent by the age of 24. It is essential that they receive timely access to evidence-based care in order to improve their life chances. Many of the initiatives within our community based care and urgent and emergency care projects are focused on minimising the need for children and young people to be admitted to hospital through illness or mental health crisis.
We want to be better at supporting families to keep children and young people physically and mentally well, and out of hospital. Offering advice on things like healthy lifestyles, better access to talking therapies and more health and care staff being trained to recognise mental ill health at an earlier stage.
If a child or young person does need treatment for a mental health condition, we want them to have better access to intensive home treatment and support from mental health liaison services, and crisis care if necessary.