This is an online synopsis of the topic which shows the executive summary and key contacts sections. To view the full document, please download it.
|Topic title||Adult mental health (2016)|
|Topic owner||Mental Health Joint Commissioning Group|
|Topic author(s)||Liz Pierce and Helene Denness|
|Topic quality reviewed||January 2016|
|Topic endorsed by||MH JCG 21st January 2016|
|Current version||March 2016|
|Replaces version||April 2011|
|Linked JSNA topics|
|Insight Document ID||63575|
Mental health problems are common, disabling and costly.
In 2014, Nottingham Health and Wellbeing Board approved the Nottingham City Mental Health and Wellbeing Strategy, Wellness in Mind. Wellness in Mind brings together the vision for improved mental health and social inclusion across the life course under five priorities.
1. Promoting mental resilience and preventing mental health problems
2. Identifying problems early and supporting effective interventions
3. Improving outcomes through effective treatment and relapse prevention
4. Ensuring adequate support for those with mental health problems
5. Improving the wellbeing and physical health of those with mental health problems.
The use of the term ‘mental health problem’ mirrors that used in the National Strategy (DH2011) and is therefore used in this chapter as an umbrella term to describe the full range of diagnosable mental illnesses and disorders, including personality disorder.
There are many factors that influence mental health and wellbeing including personal relationships, childhood experience, employment, housing, safety, built and natural environment and experience of discrimination. At a personal level, the ‘five ways to wellbeing’ (NEF 2008) identified key messages for mental health promotion: be physically active, connect with other people, keep learning, take notice ( based on mindfulness) and give time to other people ( e.g. volunteering). There is a Wellness in Mind training programme which aims to Increase awareness and understanding of mental health and wellbeing across Nottingham. Mental wellbeing is measured each year in Nottingham and the groups with the lowest levels of wellbeing are the unemployed and those with long term health problems.
Mental health problems are very common and it is estimated up to one in two adults will experience problems at some point in their lives (Kessler 2007). Mental health problems range from severe mental illness, such as schizophrenia to common mental health problems such as anxiety and depression. All these conditions can be highly disabling and affect family, working and social life.
Adults with enduring mental health problems can be one of the most socially excluded groups in society, experiencing stigma and wide ranging social disadvantage as well as poor physical health outcomes. Under the Equality Act people with long term mental health problems may be considered to be disabled, with requirements of all services to make reasonable adjustments to enable them to benefit.
Mental health and physical health are interlinked. People with mental health problems experience higher rates of physical illness and a lower life expectancy (De Hert 2011), and those with chronic or long term physical health problems are more likely to experience mental health problems, often unrecognised and untreated. (Naylor 2012).
Mental health problems impact on individuals, families, communities, and society as a whole, with immense social and financial costs. Mental illness is an important cause of social inequality as well as a consequence. Mental health problems contribute a higher percentage of total ‘disability adjusted life years’ in the UK than any other long term illness (14%, or 23% with drug and alcohol abuse included, compared to cardiovascular disease 12%, cancer 13% and respiratory illnesses 8%) (WHO 2009). Estimates put the full cost of mental health problems in England at £105.2 billion (Centre for Mental Health 2010), and mental illness accounts for about 13% of total NHS spend (Parsonage et al 2012). In Nottingham the largest proportion of ESA claimants (50.8%) are recorded as having ‘mental and behavioural disorders’, which accounts for over 8,000 adults of working age (Nottingham City Health and Wellbeing Board 2015)
Mental health service improvement is a national priority ( DH 2016), particularly focussing on crisis care, perinatal mental health, ending inappropriate use of police intervention, better access to psychological therapies and parity of esteem (giving equal value to mental and physical health). Building on the NHS Mandate, NHS England has published the Five Year Forward View for Mental Health, an independent report by the Mental Health Taskforce that sets national aspirations to 2020.In Nottingham, mental health urgent care is included as a local NHS vanguard, there is a Crisis Concordat partnership, and in 2015 Nottingham City HWBB agreed a Suicide Prevention Strategy .
Citizens reported finding the system of mental health services confusing and difficult to navigate and were not always clear where to first turn for support. It is anticipated that the newly commissioned mental health and wellbeing service will serve to meet this need.
Ensure all commissioned mental health services:
Commissioners of other services that impact upon mental health and wellbeing should:
Liz Pierce, Insight Specialist Public Health, Nottingham City Council,
Helene Denness, Consultant in Public Health, Nottingham City Council
Ciara Stuart, Head of Commissioning - Mental Health, Nottingham Clinical Commissioning Group
Bobby Lowen, Lead Commissioning Manager, Commissioning and Insight, Nottingham City Council