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


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

Improving Population Mental Health and
Well-being Living Well with Mental Health
  • Gregor Henderson
  • National Mental Health
  • Development Unit

Some questions
  • Where have we come from and what has been
  • 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?

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
  • 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

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)

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
  • 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

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

  • FORESIGHT REPORT Mental Capital and Well-being
  • NEW HORIZONS Towards a shared vision for mental

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

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)

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.

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

  • Is the evidence good enough?
  • Who will do the commissioning for mental
  • 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?

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
  • The upside of down
  • The power of relationships and co-creation

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

THANK YOUNational Mental Health Development
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

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

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