1. Public Mental Health and Policy: Optimism and Pessimism
Firstly, some personal reflections… - by disposition are you an optimist or a pessimist (or a realist?) Then, in the public realm…. - are you an optimist or a pessimist (or a realist?)

2. Public Mental Health and Policy (1)
MH, PH providers and LAs before 2012 (?)
Every Child Matters 2003
Children`s Act 2004 (Trusts and Plans)
JSNAs 2008/09
Equalities Act 2010 – Public Sector Equalities Duty

3. PMH and Policy (2) Coalition Government 2010/15
No Health without Mental Health 2011
NHS and Social Care Act 2012:
- Health and Wellbeing Boards,
- CCGs, Transfer of PH functions to LAs
- PHE and NHE England
- H and Wellbeing Strategies
CMOs Annual Report Sept 2014
Better Care Fund 2015

4. Public Mental Health and Policy cont
NHS 5 Year Forward View Community Engagement , Mental Health including workforce development , MH Concordat
Sustainable Transformation Plans published 2017
Suicide Prevention & Postvention PHE
- Local Suicide Prevention Planning 2014
- Local suicide prevention planning - A guide for LA 2016
Identifying & Responding to Suicide Clusters & Contagion 2015
Preventing Suicide in Public Places
Support After a suicide : A guide to providing local services 2016

5. Public Mental Health Policy (3) (2016)
Reductions in PH budgets and pressures on the NHS/Social Care
Retrenchments in CCGs
Sustainability and Transformation Plans
Devo-Manchester….
Launch of work-stream on Child Health Green Paper
FPH`s Better Mental Health for ALL

6. Public Mental Health Policy (4) 2017
National Prevention Alliance for Mental Health/PHE: Prevention Concordat for Better Mental Health JSNAs and mental health Return on Investment tool and local informatics Local Champions Green Paper on Child Health

7. NHS Long Term Plan 2019 Mental Health Services
To deliver timely, high quality mental health support, the NHS Long Term Plan will:
This Long Term Plan sets out new commitments for action that the NHS itself will take to improve prevention
Action by the NHS is a complement to, but cannot be a substitute for, the important role for local government
Increase funding for mental health
Provide a single point of access through NHS 111 to timely, age-appropriate mental health crisis care for everyone.
Continue investment in perinatal mental health care for mothers and their partners
Roll out new and established services in the community and hospitals, including talking therapies and liaison teams
reducing suicides will remain an NHS priority
Mental health support for children and young people will be embedded in schools and colleges

8. Includes 5 ways to well being
Prevention is better than cure: Our vision to help you live well for longer : Secretary of State for health vision Developing Green Paper 2019
Health and social care secretary Matt Hancock published his vision in Nov 2018 for how he plans to revolutionise the government’s approach to prevention and announces a Green Paper in 2019.
The approach will see a shift in focus towards primary and community care services and the value they can bring in offering early support.
50% Mental Health
Includes 5 ways to well being

9. Scotland Mental Health Policy
1.Better Mental Health for All: NHS Scotland 2016
improve population mental health through the promotion of mental wellbeing, prevention of mental health problems
improving the quality of life of those experiencing mental ill health
reduce inequalities in mental health
• reduce the health inequalities of those experiencing mental health problems.
2. NHS Scotland 2016 Mental Health Strategy:
Prevention and early intervention;
• Access to treatment, and joined up accessible services
• The physical wellbeing of people with mental health problems
• Rights, information use, and planning
3. Tackling the attainment gap by preventing and responding to Adverse Childhood Experiences (ACEs) 2017 The Scottish Adverse Childhood Experiences Hub
4. A CONNECTED SCOTLAND Our strategy for tackling social isolation and loneliness and building stronger social connections 2018
we want a Scotland where individuals and communities are more connected, and that everyone has the opportunity to develop meaningful relationships regardless of age, status, circumstances or identity – see framework

10. HEALTHY LIVES, FAIRER FUTURES: Call to Action Faculty of Public Health in Scotland. Includes:
Health in all policies
To use the Community Empowerment Act to improve population mental health
To reduce child poverty and mitigate the damage to our children
Make taxation more progressive
To prevent the impact of adverse childhood experiences and help the children of Scotland
Actions to mitigate against the impact of the UK welfare reforms

11. Making the jigsaw fit at local level - the Health and Wellbeing Board, CCG and STPs - other partners and providers individuals, families and communities

12. Health and Wellbeing: Boards, Strategies and JSNAs
What are the opportunities for Public Mental Health?:
1.JSNAs
2.Health and Wellbeing Strategies
3.Better Care Fund
4. Equalities Act

13. What should be in your Strategies and JSNAs?
Group 1: JSNAs, Public Sector Equalities Duty
Group 2: Health and Wellbeing Strategies, Better Care Fund Plans, STPs

14. What should be in your JSNA`s and Strategies?
Group 1:
Health and Wellbeing Strategies, Better Care Fund
Group2;
JSNA`s, Public Health Equalities Duty

15. Manchester City Council
STRATEGIC PRIORITY 6
Improving people’s mental health and wellbeing
Background
For too long, mental health and wellbeing has not received the attention that physical
health has been given. However, with the JSNA demonstrating the very high levels of
mental ill health and low levels of wellbeing in the city, and the impact this has on our
health, social and economic aspirations, it is time for this to take centre stage in our
local strategies.

16. Wigan Joint Strategic Needs Assessment 2011 Mental Health and Wellbeing
3.1 Introduction
3.2 Start Well
3.3 Develop Well
Personality Disorder
Learning Disability
3.5 Work Well
3.6 Age Well
Dementia
End-of-life
3.4 Living Well
Physical health of people with severe mental illness
Stigma
Psychological Trauma
Suicide and self-harm
Homes and Fuel Poverty
Homelessness

17. Hertfordshire`s Approach
“In Hertfordshire, our priority is to improve access to mental health services, to raise awareness of mental ill-health and available support across services for all ages and to prevent mental health problems and intervene at the earliest opportunity”.

18. Social determinants (Hert`s illustration)
“It is therefore important to tackle the social determinants of mental ill health such as bullying, housing issues, drug and alcohol abuse, social deprivation, domestic violence and poor physical health.”

19. Analysis (Hert`s illustration)
Groups currently disproportionately affected by mental health and emotional wellbeing concerns or who are currently facing barriers to accessing services should be targeted. It is estimated that 23 per cent of lesbian, gay and bisexual young people have tried to take their own life at some point. In comparison Samaritans say seven per cent of all young people in general ever attempt to take their own life.

20. Roles and expectations (Hert`s illustration)
What is your role?
• Use the Five Ways to Wellbeing recommended by the New Economics Foundation to prevent mental health problems.
• Take individual responsibility to look after your own mental health, including managing triggers to stress and other factors which affect your emotional wellbeing.
• Outline appropriate work related goals to reduce stigma and prevailing culture of low expectations.
• Use the information available to you to exercise your right to take control of the services you receive and improve your experience of care.

21. Your services should aim to:
• Improve inter-agency working, coherence of pathways and raise
awareness of services.
• Be proactive in identifying those who are at risk of having mental
health problems and put in place preventative measures.
• Work with all partners to ensure that there is a supportive, stable
and safe environment to aid recovery. This means good quality

22. What is the role of your community?
• Raise awareness of mental health and challenge the associated
stigma and discrimination.
• Raise awareness in the community of local services and support
which are available such as Child and Adolescent Mental Health
Services (CAMHS).
• Help hold public bodies to account, lobby for change and provide
advocacy.
• Provide services and support to those with mental health issues
and promote emotional wellbeing.
• Employers to promote mentally healthy workplaces.

23. Conclusions
1.Two Distinct Strands need to be incorporated within the JSNA and Health and Wellbeing Strategy - positive mental health and wellbeing for whole population, and appropriate support for people with a serious mental illness 2. The Prevention Concordat, due in April, will provide an important opportunity to shift the local focus towards population mental health