Why there’s no health without mental health Hertfordshire health and wellbeing conference Andy Bell, 9 July 2015

Why mental health matters Mental health problems affect one in four of us each year One child in 10 has a mental health difficulty Mental health affects education, employment, relationships, etc Economic and social cost is £105bn a year in England

Unmet need Three-quarters of adults and children with mental health problems get no treatment or support Childhood mental health problems often persist into adulthood Wide range of effective treatments unavailable in many areas

Five key messages Prevention is possible Early intervention works Recovery is achievable Equality matters Doing better saves lives (and money)

Positive mental health Good mental health is not just absence of mental illness Resilience: to get through life’s ups and downs Emotional wellbeing

Prevention is possible Schools: whole-school approach including social and emotional learning and anti- bullying programmes Families: including prevention of violence, neglect and abuse Workplaces: good management Housing, unemployment, poverty, debt…

Early intervention works Delaying help or support increases long-term impact of poor mental health Crisis care is crucial: mental health emergencies are as important as any other Access and waiting times: speeding up time to get treatment

Early intervention: perinatal mental health Cost of perinatal mental ill health £8.1bn 73% of costs relate to child 10% of women with perinatal depression get NICE approved treatment Many fear disclosing distress or get poor response when they do Cost of raising standards £280m New money expected to help fill gaps

Investing in children’s mental health 10% of children (5-16) have a mental health problem Wide range of NICE approved treatments Group CBT for anxiety or depression saves £31 per £1 invested Many schools have some mental health provision: but no national standards Access to specialist care is poor

Early intervention: behavioural problems 5% children have severe behavioural problems + 15% have mild or moderate problems All face higher risk of poor health and curtailed life chances Evidence-based parenting programmes highly cost-effective Most parents ask for help but few receive it

Early Intervention in Psychosis (EIP) Support young people in first episode of psychosis (age 14-35) Two-week waiting time standard from April 2015 EIP services found to save £15 per £1 invested

Recovery is achievable Personal recovery: “building a life for yourself on your own terms, with or without symptoms of mental illness” Key elements: Hope for the future Control over your life (and treatment) Opportunity for a life outside of illness

Recovery oriented services Peer support Recovery Colleges Safer inpatient wards Employment support Welfare advice Support for carers, family and friends Physical health support

Employment 7% people using mental health services are in employment More than half would like to work Individual Placement and Support can achieve 50-60% work outcomes People in paid work have fewer hospital admissions

Southdown Supported Housing Provides employment support to Sussex Partnership NHS Foundation Trust 22 employment specialists working in clinical teams 1,200 clients a year (450 at a time) Last year helped 300 people into work

Welfare advice High levels of debt, housing insecurity and other welfare rights issues among service users Sheffield CAB service located within (and funded by) mental health trust: Cost per client £260 Cost of hospital admission £330 per day Cost of a relapse of psychosis £18,000

Equality matters Race equality: higher use of Mental Health Act and less of psychological therapies in some communities People with physical, learning or communication disabilities LGBT+ communities Insecure housing and homelessness Criminal justice system

The high cost of co- morbidity One in three people with a long-term physical illness also have a mental health condition This costs the NHS £10 billion a year, reduces quality of life and increases mortality Medically unexplained symptoms cost a further £3bn to the NHS People with schizophrenia have year shorter life expectancy

Integrated physical and mental health care Liaison psychiatry in all hospitals Better access to psychological therapies (including for people with complex needs) Joined up care for people with long-term conditions (eg diabetes and depression) Improved physical healthcare for people with mental health conditions: smoking cessation, cancer screening, etc

Whose business is mental health? NHS commissioners and providers Public Health Adult social care and children’s services Healthwatch Police and other emergency services Jobcentre Plus and Work Programme Schools and many more…

Not just a public sector issue Business: Cost of mental ill health £1,000 per employee Simple steps can improve health and reduce costs Opportunity to recruit new people Community: Faith groups Voluntary organisations Sports and social clubs

Key role of local councils Assessing local health needs Setting health and wellbeing strategies Commissioning social care and public health Meeting housing needs Leading local partnerships Influencing local communities Scrutinising services

The Mental Health Challenge Seven national charities: Centre for Mental Health Mental Health Foundation Mental Health Providers Forum Mind Rethink Mental Illness Royal College of Psychiatrists YoungMinds Supporting 40 council member champions

Member champions across England…

Benefits of the challenge Advice, information and support from national partners Network of member champions and lead officers Web site with resources for councils Thank you for joining us!

Future prospects? Growing public and political awareness Clear case for reinvestment in and within mental health Focus on children’s mental health NHS England ‘five year strategy’ Need more examples of innovative approaches and effective models

Year of Mental Health Start conversations: make it ok to talk about mental health Explore ways to promote positive mental health Break down barriers: a fairer chance for the one in four Make mental health everyone’s business

30 years of life-changing research We’re asking for your birthday wishes for mental health. What would you like to see happen and how can research change lives for the better? Send us your wish (and perhaps a donation) via our website at:

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