1. Integrated Workforce Assessment Modelling Programme Mental Health Focus Skills for Health Research Team January 2015

2. Mental Health Focus Provide some overall context Remind people of some key facts around Mental Health Some initiatives taking place in the Islington area Introduce some overall stats about the workforce

3. Context - Drivers shaping the development of the UKs Health Sector

4. Drivers shaping the development of the UKs Health Sector Five Year Forward View (some similar drivers identified) –Scientific Advances –Costs and funding –Resiliance –Changes in patient needs –Advances in Treatments

5. Why are we interested in Mental Health? Part of the project priorities to explore the development of the integrated health workforce. One of four important themes. The importance of mental health is underlined by a number of high profile organisations. The World Health Organisation –Mental health is an integral part of health; indeed, there is no health without mental health –Mental health is more than the absence of mental disorders –Mental health is determined by socioeconomic, biological and environmental factors

6. National indicators mental health 5 of the 10 leading causes of disability worldwide are mental health problems (World Health Organisation, 2000) Poor mental health is the largest cause of disability in the UK (Department of Health, 2013) Mental health is an issue across the age spectrum (children, adolescents, adults & older people) Mental health appears to be a more significant issue for Islington

7. Mental Health in Islington Islington has a significantly higher level of mental health need than London or England In Islington, 12.6% (22,692) of people aged 18 and over were recorded as being diagnosed with depression in 2011/12. This is higher than both London and England averages (8.1% and 11.7% respectively) For Mental Health prevalence (defined as register of patients with schizophrenia, bipolar affective disorder and other psychoses) –England = 0.8% –London =1.0% –Islington = 1.50%

8. Key facts about mental health in Islington 28,500 adults in Islington are estimated to be experiencing depression and anxiety disorders during any Week 2009/10 72% of the number of people expected to have dementia in Islington are diagnosed (2010/11) 20 suicides per year were reported in Islington between 2009-11 1,532 people with mental health needs received social care service support in 2010/11

9. Mental Health Needs Mental health needs vary according to gender, ethnicity and age and are influenced by family, social and environmental determinants. Islington has a significantly higher level of mental health need than London and England. High-needs groups include: –People with disabilities or long term physical conditions at greater risk of depression. –Some BME groups with a significantly higher prevalence of diagnosis of psychotic disorders. –Prisoners and offenders have high levels of mental health disorders and high rates of suicide compared to the general population. –Other socially and economically deprived groups, such as people who are long term unemployed.

10. Mental Health Needs – At Risk Groups In Islington, 17% of Irish people are likely to have a diagnosis of depression, the highest rate by ethnic group People from some BME communities are more likely to be diagnosed with a psychotic disorder Dementia affects a greater proportion of women than men

11. Where are people with Mental Health needs living within Islington? Indices of Multiple Deprivation (GP locations highlighted) Mental Illness, anxiety, depression and nerves ‘hotspots’ (Pharmacy locations highlighted )

12. Changing Population of Islington Islington has a younger population profile than many other areas of England Between 2012 and 2037 ONS modelling suggests: –70,000 increase in total population of Islington = 33% growth in (one of the largest percentage increases in England) –In absolute terms the population aged between 35 and 64 will grow the most (additional 34,000 people) –In percentage terms the population aged between 65 – 79 and 80+ will increase the most with an 80% increase in people in these age categories (additional 14,000 people). They will however still make up a small proportion of the overall population Components of population change show: –+10,000 through net migration (internal and international) –+60,000 through natural change (births and deaths)

13. A look to the future…. Total population in Islington is set to increase by 33% (70,000 people) between 2012 and 2037 Some conditions won’t be increasing in prevalence but this increased population will increase demand. Some conditions will increase in prevalence so demand will grow faster than the population. What does this mean for Mental Health and Integrated care?

14. Possible Future needs and estimates around mental health needs in Islington Islington Evidence Hub indicated possible future needs and estimates –Mental health conditions among children and young people aged 5-17 will increase from 3,129 in 2010 to 3,337 in 2020, an overall increase of 6.6% –The number of people with depression and anxiety will increase by 3.4% to 29,426 in 2015 and 30,224 in 2020 –The number of people with psychosis and bipolar disorders will increase 10.2%, from 3,032 in 2010 to 3,241 in 2020 –The number of people (65 and over) estimated to have dementia will increase by 11% from 1,261 in 2012 to 1,400 in 2020; and 666 of these (47.6%) will be 85 and over

15. The Organisations & Workforce in Health & Social Care

16. Organisations working in Health and Social Care An estimated: 43 Establishments delivering Adult Social Care –7 Statutory local authority –12 Private sector –24 Voluntary or third sector 3 NHS Trusts within the boundary(including Moorfields Eye Hospital), some fluidity as the population served by other trusts 37 GP practices 45 Community Pharmacies

17. Recent initiatives around Mental Health Primary care and community setting: Improving Access to Psychological Therapies (IAPT) iCope service Mental Health Champions, Mental Health First Aid Training, Islington MIND and Crisis House Direct Action Project Recovery services for people with serious mental Illness Secondary Care: The Crisis Resolution Treatment Team The Early Intervention Service (EIS) Non-psychosis and psychosis services Outreach service (OAT) Acute inpatient services

18. Occupational Profile – Health & Adult Social Care HealthAdult Social CareTotal Estimated Total % % % Medical and Dental 64010%6405% GPs 1703%1701% Registered Nurses 1,72026%1001%1,82013% Therapists/AHPs 1,07516%1,0758% Social Workers 2002%2001% HCAs/Care Workers /Senior Care Workers 1,74026%3,20045%4,94036% Managers 2003%2002%4003% Admin and clerical 6209%6205% Other 4307%3,40043%3,83028% Total Workforce 6,600100%7,000100%13,600100% Sources: SfC – NMDS Adult Social Care, ESR data, Labour Force Survey 2013

19. Camden & Islington Foundation Trust - Workforce Source: ESR FTE 100 20 15 95 190 National nursing split Estimated C&I FTE Community Psychiatry37%140 Other Psychiatry54%200 Community LD5%20 Other LD5%20 Nursing and midwifery national breakdown

20. Social Care Workforce Adult Source: SfC NMDS (all staff in post numbers rounded to nearest 5)

21. Workshop Hub and Spoke Model The Patient or Person Individual Self Care Friends & Family Self Help Networks Professionals as Authorities Professionals as Facilitators Professionals as Partners