IMPROVING MENTAL WELLBEING IN ACUTE SETTINGS

Transcription

1 IMPROVING MENTAL WELLBEING IN ACUTE SETTINGS Building Bridges and Improving Health in Hospitals Conference, 19th March 2012 Jude Stansfield Mental health & wellbeing Programme Manager

2 Key messages Mental wellbeing is specific, measurable and achievable Poor mental wellbeing impacts on morbidity and mortality Holistic approaches to addressing physical and mental health are needed Parity of esteem between physical and mental

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4 Improving mental wellbeing leads to better outcomes in physical health: - protection from heart disease - stroke incidence and survival - harmful health behaviours (smoking, drinking, drugs) (Chida & Steptoe 2008; meta-analysis of 35) overall lifetime mortality rates and life expectancy - adds 7.5 years

5 Prevention of mental illness High costs of mental illness billion annually; Mental illness is highest burden of all disease: Mental disorder 22% Cardiovascular disease 16.2% Cancer 15.9% Treatment, however effective, will only avert up to 40% of the burden of disease; Half of lifetime mental illness begins by age 14, 75% arise by midtwenties; Highest in prevalence, persistence and impact; Friedli & Parsonage

6 People with poor well-being are more likely to: Be ill and see their health as not good Recover from illness slower Be sedentary, exercising less, smoking more, drinking more Have poorer mobility, self-care, self-management and pain management Have higher service utilisation (as frequent attendees with medically unexplained symptoms and poor attendance rates) Be isolated and low satisfaction with personal relationships (NWPHO 2010, Hennell 2011)

7 Social relationships and mortality risk Odds of decreased mortality (Holt Lunstad, 2010)

8 Integrating physical and mental health Mental illness increases the risk of physical illness Depression increases the risk of mortality by 50% and doubles the risk of CHD People with a SMI die years sooner They have higher rates of respiratory, cardiovascular and infectious disease, obesity, abnormal lipid levels and diabetes Less likely to benefit from mainstream screening and public health programmes Physical illness increases the risk of mental illness People with long-term conditions have increased risk of depression, diabetes, hypertension, coronary artery disease (2-fold), COPD, cerebro-vascular disease (3-fold) Those with two or more conditions are 7 times more likely to have depression

9 Hospital impacts on mental wellbeing? Positive mood, energy, self esteem, happiness Autonomy, control, capability Motivation, optimism, confidence Clear thinking, problem solving, self care Relationships with others Resilience, managing change Stress management, emotional intelligence Respect, trust, dignity, fairness

10 Mental Wellbeing Scale - swemwbs None of the time Rarely Some of the time Often All of the time I ve been feeling optimistic about the future I ve been feeling useful I ve been feeling relaxed I ve been dealing with problems well I ve been thinking clearly I ve been feeling close to other people I ve been able to make up my own mind about things

11 Locality mean mental wellbeing scores Mean WEMWBS score Warrington Halton and St Helens Stockport Cheshire West Blackburn and Darwen Heywood, Middleton and Rochdale Central and Eastern Cheshire Central Lancashire North West Wirral Sefton East Lancashire Cumbria Manchester Tameside and Glossop North Lancashire Knowsley Blackpool Liverpool

12 How can services improve wellbeing? Recognising how the hospital experience and intervention (what we do and how) impacts positively and negatively on mental wellbeing - Mental Wellbeing Impact Assessment Recognising how mental wellbeing of patients impacts on disease, recovery and service use - training and assessment Assessing mental wellbeing - holistic assessment Making every contact count - brief interventions include mental wellbeing - 5 ways to wellbeing Interventions to improve health, manage treatment or illness or recover from illness address mental wellbeing throughout the pathway/ journey Measuring wellbeing outcomes - WEMWBS Using strengths based approaches that enhance people s wellbeing - motivation, capability and resilience

13 How can services improve wellbeing? Recognising mental illness and providing an accessible and appropriate service for people with mental health problems Referring to appropriate services and support when needed Staff wellbeing - HSE standards, workplace wellbeing charter Community wellbeing - Social value/ SROI Championing wellbeing

14 Five Ways to Wellbeing Evidence based messages for individual behaviour change Connect Be Active Take Notice Keep Learning Give New Economics Foundation/ Foresight report 2008

15 Enabling people to CONNECT Connecting with services better reducing exclusions/ exemptions/ DNAs/ frequent attenders; Positive relationships between and amongst staff, management, patients and community - respectful, listening, co-productive Supporting patients connections with family, friends and communities;??

16 Enabling people to BE ACTIVE Lets get Moving clinical pathway Health walks Exercise on Prescription Walking routes to services/ workplaces - active travel??

17 Enabling people to TAKE NOTICE Responding to individual mental wellbeing - taking notice of the whole person - holistic approaches; Arts in health/ hospital; Natural Health Service; Sustainable development; Reflective practice; Chaplaincy, counselling, CBT, Mindfulness, relaxation, befrienders??

18 Enabling people to KEEP LEARNING Health literacy/ skills for health Expert patients Information prescriptions Condition management Workforce development??

19 Enabling people to GIVE Volunteering opportunities Expert patient LINKS Carers support Co-production Organisational membership schemes Asset & skill sharing - timebanking Social Value/ Social Return on Investment??

20 Discussion 1. What might acute providers implement within a programme for improving mental wellbeing? 2. What is needed to enable such an approach?

21 Thank you