Improving Population Mental Health and Well-being: Living Well with Mental Health

1
Improving Population Mental Health and
Well-being Living Well with Mental Health

• Gregor Henderson
• National Mental Health
• Development Unit
• www.nmhdu.org.uk

2
Some questions

• Where have we come from and what has been
  achieved?
• The new national policy context and what this may
  mean for mental well-being?
• What are some of things we are learning?
• What might we need to keep in mind as we go
  forward from here?

3
Some Context

• POVERTY - 13.5m, 22 of people in UK live below
  the low income threshold. 4m children, 13 of all
  older people, 33 of all people with a disability
  and 20 of bme population, with 5 of people
  living in overcrowded housing..
• INEQUALITY over the last 10 years the poorest
  10 have got poorer whilst the richest 10 have
  got richer. Inequalities persist in educational
  attainment, employment, health, participation and
  living standards.
• WELL-BEING? rising GDP, rising material wealth
  and living standards for the majority, but life
  satisfaction and measures of wellbeing flat or
  declining..
• ECONOMIC DOWNTURN reduced job prospects, higher
  level of redundancies and unemployment, house
  repossessions, less infrastructural development,
  public sector spending cuts, low paid and low
  skilled at greatest risk, increased uncertainty,
  distress, stress and anxiety, higher frequency of
  physical and mental illness. lower levels of
  mental well-being

4
Some definitions

• Poor mental health or poor mental well-being
  leads to poorer physical health, higher rates of
  health care use, harmful behaviours (excessive
  drinking, drugs) increased mortality and reduced
  life expectancy, poorer educational performance,
  increases in crime, anti-social behaviour, lower
  levels of employability and productivity
• levels of mental distress among communities
  need to be understood less in terms of individual
  pathology and more as a response to relative
  deprivation and social injustice, which erode the
  emotional, spiritual and intellectual resources
  essential to psychological well-being
• (WHO 2008)

5
The recent past

• National service framework for mental health
  better but not well
• Focus on individually focused service solutions,
  important but not the whole picture
• Low levels of investment in promotion and
  prevention
• Lack of attention to wider social determinants
• Insufficient engagement with the wider system
  public health and well-being, community life,
  education, employment and working life, culture,
  arts, sport, leisure

6
The emerging new policy picture

• Twin and complementary aims of New Horizons
• Guiding values and principles
• Providing a vision and direction of travel
• Authorising and supporting a broader agenda,
  including but going beyond mental illness, to a
  wider partnership agenda with greater local
  determination

7
www

• FORESIGHT REPORT Mental Capital and Well-being
• www.foresight.gov.uk
• NEW HORIZONS Towards a shared vision for mental
  health
• www.dh.gov.uk/mentalhealth

8
What are we learning? - strategically

• Importance of population approaches to health
  and well-being for ALL
• Importance of integrated thinking and acting
  benefits ALL
• Different levels of population focus
• Universal and targeted approaches
• Pushing for the next stage of development
  small steps towards a cultural shift or social
  movement

9
What are we learning? - practically

• The developing evidence base
• Wider health improvement gains (physical
  activity, food and nutrition, behaviour change)
• Early years, schools, youth work, employment,
  later life
• Community approaches work
• Wider contributions to health and well-being
• Health, social, community and economic benefits
  (your work)

10
More learning

• There is good enough evidence of benefit
• Importance of local data, indicators, measures
• Evaluation, review, monitoring and learning -
  adjusting, adapting
• Local partnership approach local shared
  development, ownership, leadership, commitment,
  building on early action.

11
Commissioning

• Joint assessment of need - physical and mental
  health
• Continual community engagement, case making and
  local learning
• Balancing investments towards health and
  well-being (using the evidence)
• Going further upstream, towards longer term
  returns
• Engaging with providers and the importance of
  well-being outcomes

12
Challenges

• Is the evidence good enough?
• Who will do the commissioning for mental
  well-being?
• What will happen to mental health services and
  the most severely ill?
• How can we find the resources?
• How will we know we are making a difference?

13
Some things to keep in mind?

• QuIPP or QP? demonstrating the case
• Local Authority Powers of Well-being
  community health and well-being
• Innovation at a time of reducing funding
• Part of something bigger, and guarding against
  exceptionalism
• The upside of down
• The power of relationships and co-creation

14
Co-creating our future

• The future is not some place we are going, but
  one we are creating.The paths to it are not
  found but made, and the activity of making them
  changes both the maker and the destination.
• John Schaar, Science Advisor to
• President Richard Nixon

15
THANK YOUNational Mental Health Development
Unitgregor.henderson_at_nmhdu.org.uk
www.nmhdu.org.uk
16
Kotters Eight Steps to Achieving
Transformational Change

• Phase One
• 1.Establishing a sense of Urgency and Making
  the case
• 2.Forming a guiding coalition
• 3.Creating a Vision

17
Eight Steps to Achieving Transformational
Change

• Phase Two
• 4.Communicating the Vision
• 5.Empowering Others to Act on the Vision
• 6.Planning for and Achieving Short Term Wins

18
Eight Steps to Achieving Transformational
Change

• Phase Three
• 7.Consolidating Improvements and Producing Still
  more Change. (implementing, acting, visible
  change)
• 8.Institutionalising New Approaches (sustaining
  and mainstreaming)