Agenda item

Purpose: To review the system approach to adult mental health in West Berkshire. Including a review of how mental health services are delivered to the rural population in West Berkshire, the community mental health transformation programme and the preventative approach.

Rachel Johnson (Senior Programme Officer, Public Health and Wellbeing) presented the report on Public Mental Health in West Berkshire (Agenda Item 6). During the presentation the following points were highlighted:

·         It was noted that everyone had mental health, and the Public Health role was not only regarding ill health, but also about people looking after their own mental health, how to improve it and prevent mental illness.

·         Rachel Johnson shared with the Committee a number of examples of initiatives relating to improving mental health. These included: a guide to local mental wellbeing services, wellbeing bags in libraries and the Five Ways to Wellbeing approach. A number of leaflets were shared in relation to these initiatives which were included in the minutes.

·         It was advised that there were a number of national campaigns including Mental Health awareness week, world mental health day and Every Mind Matters. NHS campaigns were also promoted by the Public Health team.

·         Many areas of West Berkshire Council were also involved in improving public mental health and these included the family hubs, leisure centres, green spaces, and the museum.

The mental health leaflets shared by Rachel Johnson were reviewed by Members who raised questions regarding the accessibility of the leaflets for members of the public as well as how they were shared with parish councils and councillors. It was noted that the z-card format (information sheet folded to credit card size) was useful but incurred an additional cost to produce. It was advised that the information in the leaflets were on the West Berkshire Council website, taken to events with a public health presence, shared with partner organisations and were on social media.

Action: Rachel Johnson to feedback if leaflets could be made available in reception at Market Street and email the documents to all West Berkshire Council Councillors.

Colin Edwards (Head of Joint Commissioning, Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (BOB ICB)) gave an overview of the report on West Berkshire Community Adult Mental Health (Agenda item 6). Dr Garyfallia Fountoulaki (Clinical Director Community Mental Health Services, Berkshire Healthcare NHS Foundation Trust) then gave an overview of the report on Community Mental Health services (Agenda item 6). Dr Fountoulaki noted the following in addition to the contents of the report:

·         The One Team development launched a few months ago and was a new model for Berkshire. This was to ensure all services worked together to reduce transition points which led to delays.

·         When discussing context and challenges, it was noted that there were no opportunities to train in West Berkshire and so staff needed to be attracted to this area. There was a national workforce shortage due to the ageing population and demand increasing.

·         The MHICS teams were based in GP surgeries and sometimes struggled to find space. Online appointments were offered but were not always appropriate.

·         It was noted that West Berkshire was a large area which meant that transport times and access issues made it harder to offer face to face appointments. This was due to both staff travel times and the rural population accessing services centrally located.

Adrian Barker (Chair of the Mental Health Action Group – sub-committee of the Health and Wellbeing Board) highlighted the work of the Mental Health Action Group (MHAG) in supporting the implementation of the Health and Wellbeing Strategy Delivery Plan on adult mental health. Members of the MHAG included Berkshire Healthcare NHS Foundation Trust (BHFT), West Berkshire Council and voluntary organisations. It was a whole system approach including services supporting mental health as well as the wider perspective and all that impacted on mental health. The MHAG were working through the Delivery Plan which was agreed two to three years ago. It was due to be revised shortly to look at new ways of delivering elements of the Health and Wellbeing Strategy.

Adrian Barker noted there were two key areas to look at. The first area was partnership. It was highlighted that both the One Team approach by BHFT and the MHICS service involved a wide range of stakeholders. The MHAG had also been involved with the BOB ICB Place Board for Berkshire West. However, it was noted that to be successful in Mental health across the whole system, active commitment and buy in from all the players was needed to support the strategy. A conversation with BHFT and their involvement with the MHAG were needed. It was noted this was a constant challenge for everybody. Secondly the wider approach needed to be considered. It needed to be more about the big picture of where they were trying to get to in five to ten years and how the various pieces fitted together and were leading towards change.

Action: Adrian Barker and representative from BHFT to discuss partnership working and the MHAG.

It was advised that part of the Public Health budget was allocated for public mental health initiatives. A new mental health fund with Greenham Trust was due to be launched soon to provide funding for voluntary sector organisations to bid for funding to support peoples’ mental health.

Matt Pearce (Director of Public Health) added that public health funding was essential to focus upstream to tackle the causes of mental ill health. However, focussing on maximising the levers we had in all our different organisations, agencies and communities was key. Poor mental health was very complex for instance due to poor housing, unemployment or trauma in childhood. It was not always about money but about how people were supported with good mental health across the whole of their life course. Matt Pearce agreed that the whole system approach was essential. Mental health was embedded in all that we did and so focus needed to be on how to lever opportunities across partner agencies and communities to maximise how best to improve peoples’ wellbeing.

It was noted that in West Berkshire, the under 75 excess mortality rate in adults with serious mental illness was very high compared to the rate for England. In addition, there was concern related to mental health amongst young people since COVID and about how parents were supported more generally.

Dr Fountoulaki noted difficulty finding appropriate spaces for meeting with patients, particularly in rural areas. Medical activities could take place at Hillcroft House in Thatcham, or in patient’s homes. Some activities could take place in the community such as wellness groups. There were some constraints for the MHICS service in finding space in some GP Practices and so patients may be asked to go to Hillcroft House. This may delay or make access slightly more difficult, but they would always work to meet the patients needs. There was work ongoing to highlight the benefits of the MHICS service within primary care and embedding it in surgeries.

Clarification was given around the One Team development. It was confirmed that the model did not involve large changes to teams, but some leadership and boundaries of teams were reconsidered. This was to bring together teams so that decisions were made jointly. High quality initial assessments were made by senior members of staff to avoid referring people between teams.

Finance and mental health was highlighted in terms of difficulties accessing benefits. It was noted that a report into financial problems and mental health wen to the Health and Wellbeing Board in 2023. This involved a number of stakeholders. There was no one answer, but a number of recommendations were made. There was a workshop recently involving Citizens Advice Bureau and the Department for Work and Pensions. It was noted that benefits applications could be complicated and took time due to the number of checks and processes needed. BHFT also provided opportunities to work with people on other things such as housing.

RESOLVED to note the reports.