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Call to Action for Mental Health in the Peninsula Wednesday 26 February 2014 South West Strategic Clinical Network Conference report: Call to action for mental health in the peninsula Wednesday 26 February 2014 #mentalhealthpeninsula About this report This report summarises the contributions and outcomes from a conference, Call to Action on Mental Health in the Peninsula, which was held by the South West Strategic Clinical Network for Mental Health on Wednesday 26 February 2014. It includes summaries of the keynote speeches and details of the commitments made by delegates on the day to take action to improve the management of mental health crises. “There’s a really big drive, nationally, politically around mental health. We are the first area – the first Strategic Clinical Network, that is – to host such an important event.” Amanda Fisk, Director of Operations and Delivery for NHS England (Devon, Cornwall and Isles of Scilly), welcoming delegates to the event 2 What the event was all about The Call to Action conference had three main objectives: 1. To identify potential improvements that could support people in mental health crisis. 2. In response to the national Concordat1, published on 18 February 2014, to build consensus for a local crisis care Concordat for mental health. 3. To identify what each person attending the event could commit to this agenda and to pledge to take action. 1 See Appendix 1 – Concordat principles and outcomes https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/281242/3 6353_Mental_Health_Crisis_accessible.pdf 3 Who attended The Call to Action conference was attended by 125 delegates, including: people with lived experience of mental health, carers, MPs, clinicians, hospital leaders, GPs, and representatives from CCGs, voluntary sector bodies, local authorities, health and wellbeing boards and the police. See Appendix 3 for the full list of attendees. 4 Setting the scene Statistics in brief One in four people in the UK will suffer a mental health problem in the course of a year. The cost of mental health problems to the economy in England has recently been estimated at £105 billion, and treatment costs are expected to double in the next 20 years. Cornwall has a significantly higher rate of hospital admissions for mental health than the England average but Devon has a significantly lower rate. Depression Depression is common and disabling. Mixed anxiety and depression contributes 12 per cent of the total burden of non-fatal global disease and by 2020, looks set to be second after cardiovascular disease in terms of the world's disabling diseases. Dementia Dementia is a syndrome characterised by progressive global deterioration in intellectual function and is a main cause of late life disability. The prevalence of dementia increases with age and is estimated to be approximately 20 per cent at 80 years of age. In a third of cases, dementia is associated with other psychiatric symptoms such as depressive disorder, adjustment disorder, generalised anxiety disorder and alcohol related problems. The peninsula has higher proportions of people registered with their GP as having dementia compared to the national average (2011-12). This may reflect the older structure of our population. Schizophrenia Schizophrenia is one of the most common serious mental health conditions. The illness has a range of symptoms including hallucinations, delusions and difficulty in thinking. Doctors describe schizophrenia as a psychotic illness. Devon and Plymouth have significantly lower rates than the national average. Spend on mental health 2011/12 The average national spend on mental health services (both NHS and Local Authority) is £182 per head. Spend in the peninsula is in line with this national figure. See Appendix 2 for more detailed statistics about mental health in Devon, Cornwall and the Scilly Isles. 5 Opening comments Opening comments: Adrian James, Chair of the Strategic Clinical Network for Mental Health (SW) “We need to be sure that everybody who uses services, everybody who works in services, has great aspirations for people and that we don’t accept second best and we don’t accept that there is nothing that can be done.” Today is all about action. Each of us here needs to think what we are going to do as a result of today to improve outcomes and the experience of care for people with mental health issues. Part of today is about holding people to account. There are many examples of great care in our region but more needs to be done. We need a true recovery approach so everyone can reach the aims that they want to achieve. Parity of esteem Today is about parity of esteem for mental health. Parity of esteem starts with everybody accepting that they could have a mental health problem; they could have a mental health crisis. It’s also about raising aspirations. We need to be sure that everybody who uses services, everybody who works in services, has great aspirations for people and that we don’t accept second best and we don’t accept that there is nothing that can be done. There are lots of people in the community who know what a physical health crisis is, they know what to do. If you experience a physical health crisis, you know exactly what will happen. For example, you know that an ambulance will come in about eight minutes and that you will be admitted to particular unit in a particular hospital. 6 If you have a mental health crisis, you don’t know what is going to happen. You don’t know the response of people around you – they are sometimes scared, they don’t want to know. You don’t know where you will be taken – you might be taken to a police cell rather than a healthcare facility. We have a particular problem here in Devon and Cornwall with this. And you don’t know what will happen at the end of that period of care. I would like when Norman and Geraldine come back to visit us in three years that they could talk to service users and members of the public and they would say “this is what happens when someone has a mental health crisis in Devon and Cornwall.” If we can achieve that we will have achieved parity of esteem. 7 The government perspective Keynote speech: Norman Lamb, Minister of State for Care and Support “When I became Care Minister, I made it my mission to put mental health and physical health on an equal footing.” Mental ill health can affect any one of us and, when it does, it is the responsibility of a wide cross-section of society: from hospital staff, GPs, carers, the police. So it’s good to see representatives from all those services, and others, here today. It’s great to see service users and carers present, too – you are vital in the shaping of personalised and appropriate care. What the government is doing to support people with mental health problems We have enshrined in law the equal importance of mental health. We want to give people more control over how, where and when they get their mental health treatment, by extending personal health budgets. And more local areas are improving their mental health services, with support from our Mental Health Implementation Plan and Suicide Prevention Strategy. Closing the Gap, launched just over a month ago, outlines how patients will have a choice about where they get their mental health care – exactly the same as people can choose their hospital they want to carry out an operation. It also states that, from next year, waiting time standards will start to be introduced for mental health. Talking therapies, which are already helping 600,000 people, will be expanded so that 300,000 more people will get help. As the Deputy Prime Minister said, we know we have a mountain to climb to gain equality in mental health, but we are making sure the rights of those with mental health issues are championed. 8 Work in the South West You, too, in the South West have been challenging the status quo, and the projects that you are running are not only remarkable but having a great effect. Projects like the Corner Retreat Crisis House in Devon – which opened last November – where people who are experiencing mental distress have access to intensive 24 hour support, to prevent hospital admissions. Almost all the people who have been referred to the service have successfully avoided going to hospital. This type of innovative approach is exactly what is needed so we can respond to situations in a way that will benefit people with mental health problems. “That’s what impresses me about the South West – an appetite for positive change, a desire for innovation, a recognition that the status quo can be challenged and that care can become better.” The Crisis Care Concordat The Crisis Care Concordat, launched last week, is an agreement between NHS England and several organisations representing the police, mental health services, ambulance service and social workers about how to handle someone who is suffering a mental health crisis. On average 15,000 people every year are detained and taken to hospital by the police. Last year, however, the Police took another 7,700 people to police stations instead of hospital. This is simply unacceptable, particularly if the person is a child. But it isn’t the fault of the police. All too often, a police cell seems the only destination for someone having a mental health crisis, because health services aren’t able to respond quickly enough. For me, this makes no sense. It is intolerable. A police cell is surely the worst place for someone experiencing a mental health crisis to be – and is likely to exacerbate their condition.
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