Peninsula Teaching Public Health Network March 2010 Conference Parallel Session Mental Health Improvement Greg Usrey Health Improvement Lead (Mental Health)

There are many different definitions of the term mental health. More often than not it is used to denote mental illness and related issues of treatment. In this instance it is used as an umbrella term to cover both illness and wellbeing. Mental wellbeing is an area which is often overlooked and misunderstood. However, there is growing international recognition of the benefits of addressing mental wellbeing in a comprehensive approach to mental health. 'Mental illness': Mental illness refers to a diagnosable illness that significantly interferes with an individual's cognitive, emotional or social abilities e.g. depression, anxiety, schizophrenia. 'Mental wellbeing': There are also many different definitions of mental wellbeing but they generally include areas such as: life satisfaction, optimism, self esteem, mastery and feeling in control, having a purpose in life, and a sense of belonging and support. What is Mental Health?

What IS M ental H ealth I mprovement? Mental health improvement (sometimes called mental health promotion) involves any action to improve mental health. Like mental health, it is an umbrella term that may include action to do many things…..

Mental Health Improvement refers to activity to promote good mental wellbeing in the general population; to reduce the prevalence of common mental health problems; and to improve quality of life for those experiencing mental health problems or mental illness.[1] The approach is based on a social model of health which recognizes that mental state is shaped by social, economic, physical and cultural environments, including people’s personal strengths and vulnerabilities, their lifestyles and health-related behaviours, and economic, social and environmental factors.[2][1][2] Small improvement in population wide levels of wellbeing will reduce the prevalence of mental illness, as well as bringing the benefits associated with positive mental health [3] as shown in Table / Figure X (distribution of mental health figure).[3] [1][1] Towards a Mentally Flourishing Scotland: Policy and Action Plan Towards a Mentally Flourishing Scotland: Policy and Action Plan [2][2] Towards a Mentally Flourishing Scotland: Policy and Action Plan p5Towards a Mentally Flourishing Scotland: Policy and Action Plan [3][3] Mental Health, resilience and inequalities – Dr Lynne Friedli p 13Mental Health, resilience and inequalities – Dr Lynne Friedli

Protect and promote the mental wellbeing of the whole population, including those experiencing mental illness increasing; self esteem and confidence, feelings of belonging, coping skills, resilience, cognitive skills, etc.) Promoting wellbeing focuses on the building of competences, resources and strengths and has a major contribution to make to personal and social development.

Prevent mental illness reducing risk factors for mental illness (e.g. lack of support services including transport, shopping and recreational facilities, neighbourhood violence and crime, socio-economic disadvantage, parental mental disorder, bullying, etc) increasing protective factors (e.g. social support, community connectedness, good physical health, positive school environment, job control, infant attachment, etc) and (see table below for further information on risk and protective factors)

Improve the quality of life of those people experiencing mental health problems recovery oriented services reducing stigma and discrimination job retention and rehabilitation etc.

Mental Health Improvement not only concerns the beliefs, attitudes and behaviours of individuals…. but also broader socio- economic and environmental determinants.

Mental Health Improvement Network Network: Developing MHI Action Plans, Frameworks & Models Newsletter: Together Newsletter Seminar Programme: Research in Mind Seminar Series Website: - Dissemination & wider Communicationswww.phru.net/mhin

Social and economic cost of mental health problems in Scotland amounts to £8.6 billion – 9 per cent of Scotland’s Gross Domestic Product 11 million sleeping tablets prescribed in Greater Glasgow and Clyde in 2007 Self-reported work-related stress, depression and anxiety account for an estimated 12.8 million reported lost working days per year in Britain People with mental health problems have lowest rate of employment of any disabled group Depression on course to be the 2 nd highest ranked condition across the world in terms of disability adjusted life years (DALYs) by WHO Anti-depressant prescriptions have risen four fold in Scotland over last 15 years Glasgow City has amongst the highest rates of male and female suicide of any local authority area in the UK Why invest in Mental Health Improvement?

A worthwhile goal in itself and leads to better outcomes: overall prevalence / herd immunity physical health: mortality / morbidity positive health behaviours greater employability, productivity, earnings higher educational attainment / performance Reduction in crime & violence pro-social behaviour / social integration / relationships quality of life / recovery Benefits of positive mental health

HEAT targets – suicide, depression Delivering for Mental Health commitments – e.g. Scottish Recovery Indicator (SRI) Mental health dimensions of SOAs Sections of Mental Health Act Planning and Priorities Guidance – mental health improvement framework Equally Well – new national indicator for wellbeing Mental Health Improvement: Performance and targets dimension - examples

Wellbeing (adults aged 16 years and over): WEMWBS; via Scottish Health Survey (Warwick-Edinburgh Mental Wellbeing Scale - tool for measuring positive mental wellbeing at a population level; Scale comprises fourteen separate statements describing feelings related to mental wellbeing) Monitoring frameworks "Scotland's health is improving rapidly but it is not improving fast enough for the poorest sections of our society. Health inequalities... remain our major challenge."

Mental Health Improvement: Multiple Policy Connections Towards a Mentally Flourishing Scotland: Policy and Action plan 2009 – 2011 Keep Well Employment Better Health Better Care Living Better, Long Term Conditions Healthy Working Lives, staff health and wellbeing, absence management With Inclusion In Mind (local authorities) Choose Life – suicide prevention Children’s services planning Equalities legislation and inequalities policy And many many more…

Mentally Healthy Children and Young People Suicide Prevention and Choose Life Physically Healthy Inpatient Mental Health Services Challenging stigma and discrimination (Glasgow Anti Stigma Partnership) Mentally Healthy in Later Life Mentally Healthy Communities Mentally Healthy Employment and Working Life Young Parents Pupils Students SafeTalk ASIST Scottish Mental Health First Aid BME Groups Carers LGB Groups Local National International HPH / HPHS Service Users NHS Local Authorities Voluntary / Charitable organisations Community Planning Scottish Government / Westminster? Community Groups Schools Uni / HE / FE Faith Leaders Asylum Seekers / Refugees

Winning arts and minds

Storytelling Project School Mental Health Curriculum Pack LGB Mental Health NHS & Local Authority ‘Single Outcome Agreements’

Greg Usrey Health Improvement Lead (Mental Health) Mental Health Partnership NHS Greater Glasgow & Clyde Dalian House, 1 West 350 St Vincent Street Glasgow G3 8TS T: F: Web: