First Steps Adult Mental Health Promotion Service Concept Day 3 March 2016

Mental Health Need - Surrey Lower levels of most risk factors for MH than Eng. (deprivation, unemployment, homelessness, overcrowding, DA, relationship breakdown, Long Term Conditions) Higher loneliness & isolation in adult carers/social care users than Eng. Higher levels of wellbeing than Eng. (happiness) Similar levels of higher risk drinking as Eng. & S.E Similar rate of suicide to Eng & S.E : –Relationship –Financial –Health

Estimated % Adults (2012) Mixed anxiety & depression7.76% Generalised anxiety3.7% Depressive episode1.93% All phobias1.14% Obsessive Compulsive Disorder0.72% Panic0.73% Source: PHE Fingertips Adult Psychiatric Morbidity Survey (2007) results applied to Surrey age population estimate (ONS) Estimated % of adults with common mental health disorders (2012)

Areas with highest Indicator of Common Mental Illness scores

Evidence of What Works Socio-economic: housing support, social support/ prob.solving/CBT for unemployed, debt/welfare advice Social inclusion/connection/support: incl. volunteering Environment: green spaces, cultural/social facilities Education: adult & community learning prog.s Workplace: MH literacy,CBT/stress mgt, ↑ job control, NICE,early referral to support, supported employment

Evidence of What Works Physical Health: self management for LT conditions healthy lifestyles (exercise, diet, smoking cessation..) Carers: emotional wellbeing support Self-help: CBT based (esp. with support/guidance) Stigma: education, social contact, arts approaches MH Awareness: MHFA, Wheel of Wellbeing Mindfulness Suicide prevention training for GPs Workplace health promotion programmes Early diagnosis & treatment of depression at work Debt advice services (MH promotion: The economic case DoH 2011)

MH Promotion & some Related Services

Current First Steps Service 1.Developing Capacity to promote mental health, prevent and provide early intervention in Health and Social Care Providers and the Community 2.Mental Health Awareness Raising and Anti- Stigma Work in the wider community Approx % of time spent on 1 & 2 3.Client Intervention: self-help, psycho-education and sign-posting clients to relevant services Approx % of time spent on 3

First Steps: High risk groups –older adults –men –carers –people with long term health conditions –black minority ethnic groups (BME) –unemployed –homeless people –victims of abuse –lesbian/gay/bisexual/ transgender (LGBT) –prisoners –veteran families –victims of emergencies

Current Contract Performance Measures –MH awareness/training: no.s & org.s & CCGs Knowledge & confidence change, usefulness –Calls, s, booklet req.: no.s & demographic info –Org.s clients signposted to: general & specifically Social prescribing & Community Connections –Project reports (e.g. work with high risk groups) –Website: visitor no.s & location, top page views –Service user involvement

Future Possible Developments Integration of Time to Change-Surrey Suicide prevention training Mindfulness (resources/sessions) Inclusion of arts approaches Action for Happiness courses for public

Discussion & Task

Questions for groups to discuss 1.What is working well with First Steps? 2.What is not working so well/can be improved? 3.What should we do more of and less of? Are the proportions of time/resource spent on service areas appropriate?

Questions for groups to discuss 1.What would you like to see in the future First Steps? 2.Please rank the list of future possible developments – with 1 the most important to deliver and 5 the least imp. 3.What are your ideas for measuring quality/success? Groups feedback their answers to the room

The Social Value Act The Public Services (Social Value) Act 2012 became operational in January 2013 outlining that public authorities are required to consider the following at the pre-procurement stage: “how what is proposed to be procured might improve the economic, social and environmental well-being of the relevant area, and how, in conducting the process of procurement, it might act with a view to securing that improvement.”