1. Achieving system change for well-being through HIA Health Impact Assessment International Conference 10th October 2008, Liverpool Jude Stansfield, Public Mental Health Lead, CSIP NW jude.stansfield@csip.org.uk Lambeth, Lewisham, Liverpool, and South London & Maudsley NHS Primary Care Trusts and Mersey Care NHS Trust working together

2. Well-being: national policy   2000 Local Government Act   the ‘power of well-being’   2005 DEFRA - Securing the Future, Sustainable development strategy   Well-being is at the heart of sustainable development   commitment to exploring how policies might change to focus explicitly on well-being

3. What can Governments do?  New Economics Foundation manifesto for flourishing societies, 2004   Measure what matters   Create a well-being economy   Reclaim our time   Create an education system that promotes flourishing   Refocus the health system to promote health   Invest in early years and parenting   Discourage materialism and promote authentic advertising   Strengthen civil society, social well-being and active citizenship

4. Well-being: national policy   2005 DWP Health, Work & Well-being   Health & well-being of working age people   2006 DH - Our Health Our Care Our Say   transforming services to a well-being focus   2006 DCLG Strong & Prosperous Communities   place shaping: the creative use of powers and influence to promote the general well-being of a community and its citizens   2007 DCSF Children’s Plan: Building Brighter Futures   happy and healthy - securing health and wellbeing   2008 DH High Quality Care for all   preventative services for wellbeing

5. Challenges  What does well-being mean?  What determines our well-being?  How do we measure it?  How do we improve well-being - what works?

6. Whitehall Well-being Working Group “well-being is a positive physical, social and mental state; it is not just the absence of pain, discomfort and incapacity. It arises not only from the action of individuals, but from a host of collective goods and relationships with other people. It requires that basic needs are met, that individuals have a sense of purpose, and that they feel able to achieve important personal goals and participate in society. It is enhanced conditions that include supportive personal relationships, involvement in empowerment, and a healthy and attractive environment.”

7. Ensure a Positive Start in Life Build Resilience & a Safe, Secure Base Integrate Physical & Mental Health & Well -Being Develop Sustainable, Connected Communities Promote Meaning & Purpose Reduce Risk Factors Promote Protective Factors Nurse J 2008 Create Flourishing, Connected Communities A Public Mental Health Framework for Developing Well–Being

9. MentalWell-beingImpactAssessmentToolkit Download at: Download at: www.northwest.csip.org.uk/mwia

10. MWIA or HIA?  Need to support shift to mental health and well-being  Review of existing HIA tools  Improvement recommendations for HIA  Integrated or add-on process to HIA

11. MWIA benefits  Engages a broad audience in HIA  Supports a specific policy challenge  Engages stakeholders in making and owning the change - active engagement  Increases awareness of the determinants of mental health & well-being  Identifies and measures indicators over time

12. Determinants & Protective Factors  Population characteristics  Enhancing control  Increasing resilience & community assets  Facilitating participation  Promoting inclusion Individual, community, structural levels

13. Control E.g.  Decision making  Independence  Democracy  Self help  Job control  Choice

14. Resilience E.g.  Hopefulness  Problem solving  Spirituality  Creativity  Trust & safety  Social network & support  Public & green spaces  Accessible services

15. Participation E.g.  Valued roles  Sense of belonging  Getting involved  Connecting with others  Access to paid work  Transport  Affordability

16. Inclusion E.g.  Positive identities  Tolerance & cohesion  Practical support  Challenging discrimination  Tackling inequalities

17. MWIA usage so far…   Lewisham & Lambeth regeneration projects +   Comprehensive MWIA on Liverpool Capital of Culture   www.ihia.org.uk   Regional capacity building programmes   Well London   National/ international dissemination e.g. Scotland, Belfast, Australia, New Zealand, Canada   EC/ Portugal presidency

18. National MWIA Collaborative  Co-ordinating MWIA activity & developments  MWIA training  MWIA report of progress  Revising tables of determinants  National networking event  Work with young people  Whole system demonstration sites  DH collaboration

19. Sustainable Well-being through MWIA…  Supports policy direction  Evidence based  Actively involves stakeholders  Builds understanding  Measures change over time  Control, resilience, participation, inclusion