NIMHE slide guidelines

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Promoting the mental health of our children and
young people
The Crossmead Centre, Exeter 14 October 2005
Jeremy Voaden Public Health and Mental Health
Promotion Specialist, National Institute for
Mental Health England South West
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Contents

• Mental health? Finding a common, shared language
• Promoting mental health How?
• The strategic drivers
• Securing mental health Partnerships
• Promoting mental health What?
• Placing children at the heart of improvement

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WHO European Declaration on Mental Health 2005

• There is no health without mental health. Mental
  health is central to the human, social and
  economic capital of nations and should therefore
  be considered as an integral and essential part
  of other public policy areas such as human
  rights, social care, education and employment

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Finding a shared common language

• ..is an important element of successful
• partnership working and is essential to
• provide a framework for communicating
• goals and outcomes to the widest
• possible audience

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Mental Health

• mental health is the emotional and spiritual
• resilience which allows us to enjoy life and to
• survive pain, disappointment and sadness. It is
• a positive sense of well-being and an underlying
• belief in our own, and others dignity and
  worth.
• HEA 1997

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The Mental Health of Children and Young People
in Great Britain 2004

• Office Of National Statistics August 2005
• This report first describes the prevalence of
  mental disorders among 5- to 16-year olds in 2004
  and notes any changes since the previous survey
  in 1999. It then provides profiles of children in
  each of the main disorder categories (emotional,
  conduct, hyperkinetic and autistic spectrum
  disorders) and , where the sample size permits,
  profiles subgroups within these categories.

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Public Mental Health

• Takes a population wide approach to
• understanding and addressing risk and
• protective factors for mental health. It may
• involve
• Reducing the incidence and prevalence of mental
  health problems
• Improving quality of life for someone with a
  mental illness diagnosis
• Increasing mental well-being

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Promoting Mental Health How?

• Mental health promotion aims to
• Promote mental health and well-being for all e.g.
  Supporting parents, health promoting schools
• Prevent mental health problems through increasing
  protective factors (e.g. social support, infant
  attachment) and reducing risk factors (e.g.
  bullying, school exclusion, racism)
• Improve the quality of life for people with
  mental health problems e.g. reducing
  discrimination social exclusion

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Promoting Mental Health How?

• Mental Health Promotion works at 3 levels
• Strengthening Individuals Increasing emotional
  resilience through interventions designed to
  promote self-esteem, life and coping skills
• Strengthening Communities Social inclusion
  participation, improving neighbourhood
  environments, workplace health, community safety,
  childcare, self-help networks
• Reducing Structural Barriers to Mental Health
  Reducing discrimination inequalities, promoting
  access to education, meaningful employment,
  housing, services and support for the vulnerable

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Promoting mental health Why?

• A valuable goal in itself
• A means of achieving wider goals
• Improved health behaviour physical health,
• educational attainment, productivity, decreased
• anti-social behaviour, behavioural disorders and
• criminal activity
• i.e. Mental health contributes to the social
• spiritual and economic capital of society

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The Strategic Drivers

• The National Service Framework
• (NSF) for Mental Health (Dept. of Health 1999)
• Standard One The development of a strategy that
  will
• Promote mental health for all, working with
• individuals and communities
• Combat the discrimination against and promote the
  
• social inclusion of people who experience mental
  
• distress
• Includes children young people. Traditionally a
  Settings
• Approach

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2. Mental Health and Social Exclusion (ODPM, 2004)

• Activity across 6 life domains
• Employment
• Education
• Housing (Home Neighbourhood)
• Leisure (Arts, Culture Sport)
• Community activity (volunteering faith groups)
• Personal finance (income, welfare benefits, debt,
  financial services)
• Contributes to delivery of a number of Public
  Service
• Agreement Targets

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e.g. Action in Schools

• Department for Education Skills
• Resources to raise awareness of stigma
• and discrimination towards people with
• mental health problems (including a focus
• on ethnicity and gender) on Teachernet
• for use in Personal, Social Health Education

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e.g. Better support for parents and their
children

• Social Care Institute for Excellence
• Systematic review of evidence on
• supporting parents with mental health
• problems on their parenting needs
• DfES Encourage Sure Start programmes,
• childrens centres, early years settings other
• statutory/voluntary services e.g Home Start to be
  
• accessible and reach out to support parents with
  mental
• health problems

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3. From Here to Equality 2004-2009

• A 5-year Strategic Plan to Tackle Stigma
• Discrimination on Mental Health Grounds
• Ref http//www.shift.org.uk/
• Programmes of activity
• Employment recruitment, retention, mental
  health promotion
• Media Coverage
• Football
• Young People
• Physical Health

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4. Choosing Health Public Health White Paper
(Dept.of Health 2005)

• 6 Priorities
• Tackling health inequalities
• Reducing the number of people who smoke
• Tackling obesity
• Improving sexual health
• Improving mental health and well-being
• 6. Reducing harm encouraging sensible
• drinking

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• Transforming the NHS from a sickness service to
  a health
• service is not just a matter of promoting
  physical health.
• Understanding how everyone in the NHS can promote
  
• mental well-being is equally important
• We will ensure that Standard One of the NSF for
  mental
• health, which deals with mental health promotion,
  is fully
• implemented (p.131)
• Mental Health is the only priority that does not
  include a
• specific range of initiatives designed to reduce
  prevalence in
• the context of inequalities.

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Choosing Health Mental Health Delivery Plan

• Big Wins include New services to improve
  mental emotional well-being
• e.g.
• We will publish guidance to help carers engage
  looked after children
• in creative activity to improve their
  self-esteem, social skills and
• emotional well-being
• Initiatives with Sure Start Healthy Schools
  every school to be a Healthy
• School by 2009.
• ENABLE-a CD-ROM designed to help schools identify
  and address the emotional
• health needs of children with emotional and
  behavioural difficulties.

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Potential where mental health not specified
Health Champions

• we will develop a network of health champions
  to offer short term consultancy support to local
  councils and community partnerships to share good
  practice and assist them in developing local
  action for health p.94

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Potential where mental health not specified
Health Trainers

• In keeping with a shift in public health ..from
  advice from on high to support from next door,
  health trainers will often come from local
  communities. They will be people who are in touch
  with the lives of the people with whom they
  work. P106
• e.g. dealing with stress, tackling social
  isolation

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Potential where mental health not specified
Child Health Guides

• the foundation for personal health guides
  (PHGs) for life. In a childs early lifewill be
  developed and held by their parents or
  carers..As they grow up, each child will take on
  responsibility for developing their own health
  goals with help from their parents, school staff
  and health professionals

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5. NSF for Children, Young People Maternity
Services (DoH 2004)

• Standard 9 The mental health and psychological
• well-being of children young people
• The promotion of childrens mental health is an
  investment for life. Good mental health is a
  vital foundation for childrens emotional, social
  and educational development, enabling them to
• Achieve at school
• Form supportive relationships
• Move successfully into adult and working life

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6. Every Child Matters (DfES 2004)

• Cross government strategy for ensuring
• that all children are
• Healthy
• Safe
• Enjoy and achieve
• Make a positive contribution
• Achieve economic well-being

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7. Young Peoples Green Paper (DfES 2005)

• Strategy for providing opportunities, overcoming
• challenges and support to young people, helping
• all teenagers achieve the 5 ECM outcomes.
• Strong focus on making volunteering the norm.
• Ref A National Framework for youth action and
• engagement-report of the Russell Commission
• (2005)

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And there are many more

• e.g.
• Work and families choice and flexibility
• consultation paper (DTI 2005)
• Balancing work and family life enhancing
• choice and support for parents (DTI 2003)
• Living Life to the Full Dept for Culture,
• Media Sport 5-Year Plan (DCMS 2005)

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Securing mental health promotion-Integration in
strategic partnerships

• Local Implementation Teams (LITs) Primary Care
  Trusts
• (PCTs) Mental Health Promotion Strategy
• Child Adolescent Mental Health Service (CAMHS)
  Partnerships Mental Health Promotion Lead
  membership to secure effective Tier 1 Programmes?
• Local Strategic Partnerships Community
  Strategies
• Healthy Schools Partnerships
• Learning Disabilities Partnership Boards

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Local Area Agreements

• LAA3 Year agreement. Sets out priorities for
• local areas agreed between central
• government (represented by Government
• Office of the South-West) local area
• represented by local authority, Local Strategic
• Partnership other key partners (including
• community and voluntary sector)

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• Priorities grouped around 4 blocks
• Children and Young People
• Safer and stronger communities
• Healthier communities older people
• Economic development enterprise
• 1st Round Pilots Devon
• 2nd Round Swindon, Poole, Somerset,
• South Gloucestershire, Cornwall

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Promoting mental health What?

• Increasingly robust evidence base for
• effective interventions. Major systematic
• reviews. Key areas include education,
• nutrition, housing, economic security,
• parenting, relationships, schools,
• workplace, unemployment, physical activity
• substance misuse
• http//www.nelh.nhs.uk/nsf/mentalhealth/whatworks/
  intro/risk.htm

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Case Study- Mental Health and the
Under-5sHealth Education Board for Scotland
Evidence into Action Initiative

• 3 main types of factor which affect mental
  health
• Risk FactorsCharacteristics statistically
  associated with poor outcomes.
• Protective FactorsPromote positive mental health
  and help shield child from difficulties.
• Resilience FactorsEnable some children to do
  well even though they have experienced adversity
  in early life.
• Of particular interest are Protective
  Resilience Factors that are malleable i.e. Can be
  added to a childs life through services or
  teaching. Include support, educational
  opportunities and problem-solving skills.

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Social Environmental Factors
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Parental Family Factors
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Child Factors
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Placing children at the heart of service
improvement

• Healthy Care National programme developed by
  National Childrens
• Bureau (NCB) funded by Department for Education
  Skills. Provides
• framework to tackle inequalities of health
  experienced by looked after
• children. Implement National Healthy Care
  Standard (NHCS)
• South-West Dec 2003 Regional Steering Group-3
  Local
• Authorities Full Status, 2 Associate Sites
• Gloucestershire-gained the views of children
  young people
• South Gloucestershire encourage young peoples
  active participation
• Torbay young people wanting to be actively
  involved
• Can young people communicate effectively about
  their emotional health.?

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Recovery

• Im not recovered like old cushions
• With their floral, delicate display,
• But Ive rediscovered old emotions,
• No longer dark, no longer Dismay,
• Emotions that Ive not felt for an age,
• Happiness, positive abstract nouns,
• After so long with my mind in a cage,
• My life feels whole, not just frowns,
• Then fragmented moments of pleasure,
• But a moving picture, full of life,
• The future..things to treasure.
• For in a world, full of strife,
• Your gentle words helped me to recover,
• Thank God we can care for each other.
• Will Higgs (14), Chipping Campden

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Contact details

• Jeremy Voaden
• Public Health Mental Health Promotion
  Specialist
• NIMHE-South West
• E-mail Jeremy.voaden_at_nimhesw.nhs.uk
• Tel [phone]
• Correspondence address
• Churchdown Innsworth Community Project
• 35 Coriander Drive
• Churchdown
• Glos GL3 1LD