Agenda item

For the Board’s guest, Richard Benyon MP, to address the Board on the subject of mental health and for the Board to respond by outlining some of the activity which is ongoing at Berkshire-wide, Berkshire West and West Berkshire levels.

Berkshire-wide activity:

• Brighter Berkshire Campaign
• Berkshire Suicide Prevention Strategy

Berkshire West activity:

• Berkshire West Mental Health Strategy

West Berkshire activity:

• Mental Health Collaborative Action Plan
• West Berkshire Suicide Prevention Action Plan

Dr Bal Bahia opened discussion of the item by stating that the Board had planned to choose particular areas of interest on which to focus meetings of the Health and Wellbeing Board. It was timely that the Board should focus on mental health in this meeting, considering the launch of the Brighter Berkshire campaign. Richard Benyon MP was invited to make a statement to open the discussion.

Richard Benyon MP thanked the Board for the opportunity to speak about mental health and expressed the view that a step change was needed in the way the statutory, voluntary and community organisations worked together to improve the way that people with mental health issues were supported.

One in four people experience mental health issues at some point in their lives, demonstrating how common mental health disorders were. The predicted economic cost to society of mental health problems was £105 billion which was equivalent to the entire NHS budget. Mental health problems were more likely to effect young people and people on low to medium incomes.

In the workplace, one in five working adults is effected by mental health issues and nearly one in seven experience mental health problems in the workplace. In 2015 the estimated cost to employers was estimated to be around £9 billion.

2017 was the Year of Mental Health and Brighter Berkshire was a fantastic campaign looking to fund mental health projects and reduce duplication with its mantra ‘do once for Berkshire’.

‘Making Every Adult Matter’ was an ambitious campaign which sought to end rough sleeping and tackle homelessness. The connection between homelessness and mental health was somewhat obvious as mental health problems could be exacerbated or caused by homelessness and vice versa. Thanks were owed to Lindsey Finch from Thames Valley Police who had agreed to take forward the work to make every adult matter.

The Government had recently announced that £11.7 billion would be made available for preventing and treating mental health issues. The Prime Minister, in a speech to the Charity Commission on 9^th January 2017 had outlined plans to offer further support for mental health and Richard Benyon wanted to ensure that residents in West Berkshire would benefit from these plans. The government planned to pilot new approaches such as offering mental health first aid training for teachers and staff to help them identify and assist children experiencing mental health problems and ensure that schools and colleges worked closer together with local NHS services to provide dedicated children and young people’s mental health services. In the workplace, the government wanted to strengthen links with employers to support people with mental health problems back into work. In communities the government would make up to £15 million of extra funding available for community clinics, crisis cafes, and alternative places of safety. There would be investment in digital mental health services which would be of particular benefit to residents in West Berkshire who experienced rurality and isolation.

Locally, there were three particular issues which Richard Benyon asked the Board to consider how they might help: first, the Friends in Need needed continued funding if it was to continue its good work. Second, no mental health charities had received CCG funding. Thirdly, from his casework, Richard Benyon advised that people were not always discharged from Prospect Park with the appropriate support.  He concluded by saying that the Brighter Berkshire campaign offered an opportunity to create a step change in the way that mental health services were provided.

Ali Foster, on behalf of the Brighter Berkshire campaign, addressed the Board. Brighter Berkshire was a year long, volunteer lead campaign which wanted to raise awareness about mental health. It sought to encourage organisations and individuals to understand that everyone had a role in improving mental health. Mental health services often felt disjointed, with no one person being responsible for oversight of mental health in Berkshire.

The Brighter Berkshire campaign had launched a website and a logo, a song writing competition and had held a Walk and Talk event. They would be broadcasting a regular programme on BBC Radio Berkshire to raise awareness of the campaign and try to reduce the stigma around discussing mental health openly.

Ali Foster expressed the view that CCG funding had halved and had been prioritised towards children and family services rather than adults only mental health services. The Suicide Prevention Strategy for Berkshire did not include children. It was difficult to acquire information from professionals via informal channels and there was a disconnect between decision-makers and service users. She encouraged all the organisations represented at the Health and Wellbeing Board to make a pledge to outline how they would support the Brighter Berkshire campaign.

Councillor Lynne Doherty noted that the CCGs had given some funding to HomeStart to support perinatal mental health. She accepted that more could be done to raise visibility of West Berkshire’s mental health ‘offer’.

Rachael Wardell advised that the Adult Social Care service was open to people with mental health problems, as was the Social Care Information Point; she suggested that better links could be made between those service and Brighter Berkshire. 

Andrew Sharp expressed the view that the Health and Wellbeing Board might have a role to give some structure to the Mental Health Forum to ensure that the communication between different services was improved.

Shairoz Claridge noted that the way different services worked together was not always perfect but the other speakers would pick up on the ways that integrated working was being pursued. Regarding the specific point about the Friends in Need service, Shairoz Claridge explained that the group did not meet the CCG’s strict criteria.

Darrel Gale presented the Board with the draft Berkshire Suicide Prevention Strategy. The NHS Five Year Forward View for Mental Health set a target on all NHS agencies and partners to reduce the current level of suicide by 10% by 2020. To achieve this, the Department of Health recommended, in the National Suicide Prevention Strategy, that all top tier local authorities produce suicide prevention actions plans. In Berkshire, this has been coordinated by a multi-agency suicide prevention group who have drafted a strategy which includes a Berkshire-wide action plan, and local action plans responding to the unique needs and circumstances of each of the six unitary authorities in Berkshire. The action plans would be reliant on multi-agency working and partners across the health and public sectors are in the process of endorsing the strategy.

Berkshire Authorities had not published a suicide prevention action plan at the time of the 2015 All Party Parliamentary Group inquiry into local suicide prevention plans in England. Action plans were a recommendation of the England Suicide Prevention Strategy published in 2012. Since 2015, a high-level multi-agency steering group met in Berkshire to plan a local audit of suicides and to work together on a strategy and action plans for the local authorities. This draft strategy was the result of this work and a recommendation of the strategy was that all six local health and wellbeing boards endorse the strategy and their local action plans.

The strategy included a target to reduce suicides by 25% as the steering group had expressed the view that it would be possible to be more ambitious than the national recommendation.

Darrel Gale outlined the recommendations of the strategy and summarised that the strategy would be formally published in September 2017 on World Suicide Prevention Day.

Rachael Wardell expressed the view that unless there was an evidence base for the 25% reduction target it would be more ambitious to set a zero- target to demonstrate that no suicides would be deemed to be tolerable.

Councillor Quentin Webb noted the good work of the Charlie Waller Memorial Trust and enquired whether there had been any decrease in the number of suicides as a result of their work. Darrel Gale responded that it would be difficult to tell due to a lag in the data but supported the charity.

Darrel Gale gave a warning that although suicide among children was extremely rare, the internet offered easy access to material which promoted suicide and thought was being given nationally to what could be done about it.

Dr Bal Bahia noted that the Berkshire Healthcare Foundation Trust and Royal Berkshire Healthcare Trust promoted a zero-suicide target. He concluded that the Health and Wellbeing Board approved the Berkshire Suicide Prevention Strategy with the advisory that they would like to see a zero suicide target.

Bev Searle, on behalf on the Berkshire Healthcare Foundation Trust, presented the Berkshire West Mental Health Strategy which had been developed with the unitary authorities and commissioners. In Berkshire West there was a good foundation to meet the targets in the NHS Five Year Forward View as services such as Talking Therapies and the Child and Adolescent Mental Health Service (CAMHS) performed well despite below-average funding. Over 20,000 responses to the consultation had been received from service users, which had been used to guide the development of services.

Overall the aim was to deliver ‘safer, improved services with better outcomes, supported by technology.’ Joint working between GPs, Local Authorities, the acute hospitals and the voluntary and community sector would be vital to the success of delivering the strategy.

Jason Jongali and Angus Tallini, on behalf of the Berkshire West CCGs, provided an overview of the services which were commissioned by the CCGs. The priorities were to improve access to psychological therapies, ensure early intervention in psychosis, reduce the number of suicides, reduce CAMHS waiting time invest in perinatal mental health and achieve a better crisis support service.

Andrew Sharp commented that the successes of local services were fantastic but the uplift in funding for mental health was not proportionate to the overall uplift in NHS funding. There were some gaps and with support, the voluntary and community sector would be able to provide more services.

Councillor Mollie Lock noted the excellent work of the Emotional Health Academy and asked by how much waiting times had been reduced. Angus Tallini advised he would provide that information.

Rachel Johnson and Adrian Barker, on behalf of the Mental Health Collaborative (MHC), addressed the Board. The MHC was established in 2014 as a group of professionals from a variety of organisations who had an interest in mental health. The MHC was writing a strategy for West Berkshire and would report progress of actions to the Board. The strategy would take into account the whole complex system and require interventions at different levels. Particularly, preventative interventions could release resources previously used for treatment.

Councillor Hilary Cole expressed the view that a local mental health strategy should not duplicate the work and actions already identified in the other strategies which had been presented to the Board.

Rachael Wardell noted that West Berkshire was a place that was better resourced than many others but the resource was not necessarily in the traditional places.

Richard Benyon stated that fantastic things were going on in West Berkshire and many speakers had mentioned raising awareness of mental health issues. Awareness would only be helpful if it lead to action. Across the different organisations who supported mental health in West Berkshire, timescales should be shortened to ensure pace and momentum. There was often a gulf between strategies and resources, national campaigns and local needs. Richard Benyon advised that he was encouraged to see so much activity and mentioned that Garry Poulson was coordination a suicide action group to be attended by representatives from the local farming and racing industries. Some lateral thinking would benefit everybody to be more effective.

Dr Bal Bahia agreed that organisations could link together better and expressed the view that service users experience was sometime missing from plans. The Mental Health Collaborative and the Board’s Steering Group would pick up on the themes discussed.

RESOLVED that

The West Berkshire Health and Wellbeing Board pledge to develop and implement an action plan to build on the commitment it has made in its refreshed Strategy to support mental health and wellbeing throughout life.

The Health and Wellbeing Board approve the adoption of the Berkshire Suicide Prevention Strategy with an advisory that they would prefer a zero suicide target.

The Health and Wellbeing Board note the information presented on the Berkshire West Mental Health Strategy 2016-2021.

The Health and Wellbeing Board note the progress of the Mental Health Collaborative to support the aim in the Health and Wellbeing Strategy to ‘support mental health and wellbeing throughout life’.