Mental Health and wellbeing Mental Health and wellbeing. Heidi Taylor Clinical Effectiveness Lead Pharmacist Welcome House keeping Setting the scene for the afternoon Thanks (posters / BSA?)

Key messages Parity of esteem Opening conversations Valuing mental health equally with physical health Opening conversations Not just the medicines Social Work Psychological Vulnerable patient groups Further learning / reading

Parity of Esteem - Valuing mental health equally with physical health Closing the gap People with Severe Mental Illness (SMI) die 10-25 years earlier People with Learning Disabilities die 15-20 years earlier People with autism can die up to 30 years younger Multifaceted reasons Diagnostic overshadowing Lifestyle Medication Lack of reasonable adjustments ‘have you had your annual health check?’ Conversely, people with Long Term Condition/s higher risk of developing mental illness e.g. depression / anxiety – IAPT Health and wellbeing No health without mental health Make every contact count Check out CPPE Add IAPT self-help (florish)

Opening conversations? No NMS or MUR for MH specifically, but MH more likely in Long Term Condition (LTC) - enquire about wellbeing. “How has this new diagnosis affected you?” “How are you in yourself” New medicine for MH condition? Q –Adherence to antidepressant? “How are you feeling about starting this new medicine?” “The medication can take 2-4 weeks to work, you may start to feel worse before you feel better” “Have you been told what to do / who to contact if you have thoughts of self-harm or suicide?” “what other support have you got?” (Anchors) See NHS choices self assessment questions on depression and information on anxiety. Sheffield Mental Health Guide – ‘Need help now?’ 50% non-adherance? After 6 months. Why? Side effects? Lack of understanding

Not just the medicines Social - (hobbies, exercise, avoid social isolation – Sheffield directory / flourish) Physiological (Sheffield IAPT, Right therapy, Right time) Work /education Working win =RCT – finishes in September DWP – Job centre plus (depression protocol)

Vulnerable patient groups Learning disabilities and autism. Winterborne view - over medication Premature death – LEDER report STOMP/STAMP – Make a pledge?! Non-pharmacological alternatives Challenge /discuss – link to resources of CP (LD service) Reasonable adjustments e.g. waiting outside/ quite space, easy read leaflets Flu jabs (carers too) - Respiratory deaths in LEDER review Dementia Antipsychotics – increase risk of stroke Much work done locally (from 11% to 5%) Review long term use (as dementia progresses, need may reduce) Dementia friends (signed up as a pharmacy?) Black Minority Ethnic (BME) underdiagnosed –stigma / don’t openly talk MH ? Access early intervention later to present in crisis Access to information (Choice and Medication available in different languages) Roll out of the Learning Disabilities Mortality Review programme (LeDeR) 31% - respiratory cause

Further learning / reading CCG intranet – Medicines and Prescribing CPPE courses (e.g. Mental Health, Mental Health Cards, condition specific) Explore the; IAPT website Sheffield Mental Health Guide Sheffield Directory What is going on in your neighborhood?