1. 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?)

2. 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

3. Parity of Esteem - Valuing mental health equally with physical health
Closing the gap
People with Severe Mental Illness (SMI) die years earlier
People with Learning Disabilities die 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)

4. 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

5. 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)

6. 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

7. 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?