Mental health in adults (health and wellbeing needs in South Tyneside)

Almost two thirds of people who will need mental health support already have existing mental health needs, including severe mental illness, with the majority of people needing support for depression or anxiety, or both.

Others will need help for trauma symptoms and a range of other difficulties including complicated grief arising from bereavement and loss.

Awareness and understanding of mental health and wellbeing has increased significantly over the past decade.

Government and NHS policies have made significant commitments to improve support for people with mental health difficulties.

Since 2012, a number of important national policy documents have focused on improving mental health outcomes, preventative approaches, reducing inequalities, reforming services and mental health legislation and preventing deaths by suicide.

Long Term Plan

The NHS Long Term Plan outlines the key priorities and outcomes for health post the 70^th anniversary of the organisation.

In terms of support for people with mental health, it highlights additional spending at least £2.3 billion more a year on mental health care, helping 380,000 more people get therapy for depression and anxiety by 2023 / 24 and delivering community-based physical and mental care for 370,000 people with severe mental illness a year by 2023 / 24.

Long Term plan funding is being used to support the ambition in relation to transforming community mental health provision, with an additional £1 billion new Long Term Plan funding per year by 2023 / 24 to ultimately transform the provision of community mental health care for adults and older adults with severe mental illnesses. 

Within the context of this JSNAA, area of scope include: 

• Specialist community perinatal mental health
• Adult common mental illnesses (IAPT)
• Adult severe mental illnesses (SMI) community care
• Mental health crisis care and liaison
• Suicide reduction and bereavement support

Mental health transformation funding

South Tyneside was awarded funding, which became operational from April 2022, to develop a range of services that support community based mental health transformation.

Community based services are best placed to help reduce the need for clinical interventions (unless needed) and can offer support that helps to people that are discharged from hospital.

Third sector organisations are also well placed to offer support around housing, skills, employment, benefits that would not form part of the approach from a clinical perspective, helping to reduce stress and anxiety. Services cover all adults from 18.

In the Five Year Forward View for Mental Health the NHS outlines it's approach to the development of mental health services, which includes support for people with dementia.

This includes the need to ensure good quality, seven day per week commissioned services, and the need to ensure appropriate staff training offered. 

Both the NHS Long Term Plan and the Mental Health Five Year Forward View recognise the need to involve local people in designing and ensuring mental health services are fit for purpose.

The NHS Mental Health Implementation Plan 2019 / 20 to 2023 / 24 outlines this as:

• Ensuring engagement and co-production with local communities
• Involving people with lived experience of mental ill health and mental health services and their families and carers
• Involving people in the long term, such as in governance structures

Suicide Prevention Strategy for England 2023 to 2028

The need to develop local suicide prevention strategies and action plans that engage a wide network of stakeholders in reducing suicide, is set out in the government's 2012 national strategy for England: Preventing Suicide in England: a cross-government strategy to save lives (objective 1) and Public Health England's (PHE), Local Suicide Prevention Planning guidance developed in 2015 (objective 2).

The national strategy outlines 2 objectives:

1. To reduce the suicide rate in the general population.
2. And to provide better support for those bereaved or affected by suicide.

NICE published updated guidelines on the community engagement to improve health and wellbeing and reduce health inequalities in 2016.

These include:

• Working to empower communities in decision making in relation to planning and regeneration has been shown to increase resilience within communities.
• Community development approaches, like public health interventions more generally, are an opportunity to support empowerment.
• Addressing mental health equity for those that carry the highest risk of poor mental wellbeing, efforts to support this group to engage fully is a priority.

The 2014 Care Act introduced new duties on local authorities, which support primary users of social care services, including people with mental illness and their carers.

The act is about promoting wellbeing, setting out how care and support should be provided to adults with eligible care needs, it supports the personalisation of support services, putting the person at the centre of the process.

Local context

The South Tyneside Vision is:

"A place where people live healthy, happy, and fulfilled lives".

There is a need to ensure that the any changes to services contribute to the Council's vision for residents with dementia to live happy healthier and fulfilled lives, specifically the ambitions of being:

• Financially secure.
• Healthy and well.
• Connected to jobs.
• Part of strong communities.
• Targeting support to make things fairer.
• (and seek to reduce inequalities)

South Tyneside's Adult Social Care Strategy 2022 to 2026 outlines the Council's approach to delivering its statutory responsibilities in terms of wellbeing.

It also outlines the need to safeguard adults at risk of abuse or neglect and ensuring that local people get the information and advice that they need to make informed choices.

The approach aims to develop a place-based system of care, support by placing people, families, and neighbourhoods at the very heart of its work to achieve the best outcomes.

The 6 objectives include:

• Objective 1: Prevention and early intervention.
• Objective 2: Support people tom remain in control.
• Objective 3: Keeping people at risk of harm and abuse safe and well.
• Objective 4: Working in partnership to improve health and care.
• Objective 5: Working together with our communities.
• Objective 6: Have a sustainable and skilled workforce.

The South Tyneside Mental Health Strategy 2022 to 2026 outlines that being a mentally healthy borough means that we all feel normal to talk about mental health and that everyone, whoever they are, wherever they live and whatever they need, will be able to access good quality mental health support when needed.

The priority areas identified in the strategy are closely aligned to that of the national direction of travel to:

• Target mental health promotion and prevention within our community; with particular focus on those most at risk of poor mental health, suicide and self-harm.
• Reduce over representation of people from black, asian and minority ethnic communities admitted to hospital with a mental health crisis.
• Ensure education, training and employment is more accessible to people with mental health problems.
• Improve transition support for 14 to 25 year olds.
• Ensure all services recognise the impact that trauma or psychological and social adversity has on mental health. This includes an understanding of how to respond to adverse childhood experiences and embedding a 'Think Family' approach in all service models.
• Improve timely access to mental health crisis services and support and ensure that people receive a compassionate response.
• Help raise awareness of mental health issues with older people and ensure that they are able to access information, support and appropriate treatment that meet their needs.
• Improve the physical health of people with serious mental illness.

Carers

Whilst not specifically related to mental health, Carers Strategy 2022 to 2027 examines the needs of carers and the support available. The strategic priorities include, recognising and supporting carers, increasing access to stable and supportive employment, keeping carers connected and improving the health and wellbeing of carers.