Wellbeing Summit Commissioning Population Mental Health and Wellbeing Chris Heginbotham and Karen Newbigging 8 th December 2010
Two Guides 1. Commissioning Mental Wellbeing a Leadership Brief for Boards and senior staff of PCTs and Local Authorities. 2. Commissioning Mental Wellbeing for All a toolkit for commissioners with practical implementation proposals and resources
Purpose The toolkit is designed to support health and local authority commissioners and partner organisations to devise mental health improvement strategies to meet local circumstances and local population needs. It aims to raise awareness of mental wellbeing as a central purpose of commissioning, rather than an unintended by-product.
Process of development Commissioned by National Mental Health Development Unit January 2009 Phase 1 Reviewing evidence and policy Engagement with health and local authority commissioners on content and identify implementation issues Two draft sets of guidance (Strategic and Technical) November 2009 Phase 2 Field testing with health and local authority commissioners Engagement with leadership groups Refinement of the evidence base Publication December 2010
The starting point Mental wellbeing is more than the absence of mental health problems Commissioning for mental wellbeing takes place within a context of integrated commissioning and the key delivery mechanisms are: Joint Strategic Needs Assessments Multi-agency partnerships and agreements Health ad Wellbeing Boards PCT/GPCC Local Delivery Plans and Strategic Plans Children s Trusts Practice-based commissioning Personalisation Place based budgets
Overview of content The meaning of mental wellbeing Values and principles underpinning the approach Making the case for public mental health and wellbeing Commissioning areas for which there is good evidence of effectiveness Practical tools: monitoring and evaluation
Three inter-related aspects
Opportunities for mental health promotion: a population perspective (adapted from Barry & Jenkins, 2007) Healthy population Population at risk Population with symptoms Populations with mental disorder Build resilience and maintain healthy lifestyle and environments Strengthen resilience and reduce avoidable risks Early diagnosis and intervention Treatment and recovery of treatable disability Health promotion Prevention of disorders and mental health problems Detection and identification Optimal management and care Improved population mental wellbeing Prevention or delay in the onset of mental health problems Increased rate of recovery from poor mental health Improved recovery and inclusion
Opportunities for mental health promotion: a population perspective (adapted from Barry & Jenkins, 2007) Approach is to promote mental wellbeing for all. Healthy population Population at risk Population with symptoms Populations with mental disorder from a perspective of building resilience Build resilience and maintain healthy lifestyle and environments Strengthen resilience and reduce avoidable risks Early diagnosis and intervention Treatment and recovery of treatable disability and focussing on assets not deficits Health promotion Prevention of disorders and mental health problems Detection and identification Optimal management and care to achieve whole system improvements Improved population mental wellbeing Prevention or delay in the onset of mental health problems Increased rate of recovery from poor mental health Improved recovery and inclusion
We offer four arguments: Economics wellbeing makes economic sense and is cost effective Ethics wellbeing is morally the right thing to do Equalities wellbeing helps to takle health and social inequalities Evidence it works!
We want to be inclusive Creating the conditons for material well-being Improving the quality of the physical environment Reduction of unemployment Strengthening community cohesions Learning and educational provison Investment in upstream interventions Local authorities GPs, PCTs and health services Strategic leadership for the health service Integrating mental wellbeing and physical health Investment in upstream interventions Identification of at risk groups Voluntary sector Communities Promoting the understanding that health and wellbeing is the responsibility of everyone Empowering and engaging local communities Local groups, employers and businesses, social enterprises, social relationships Understanding the assets, resources and needs of local people Innovative and informal responses to strengthening mental wellbeing
And we support the Marmot approach of proportionate universalism, exemplified here
The Leadership Brief encourages acceptance of the value of investing in wellbeing and makes the case to assist senior leaders develop wellbeing strategies. The Toolkit offers practical information for commissioners based on a ten point commissioning cycle that will enable a whole system approach to be adopted.
With detailed information on ten commissioning areas linked to five lifecourse domains Children and adolescents/young people (Commissioning areas 1, 2, 3) Adults up to 55 (Commissioning areas 4, 6,7,8,9) Safe, sustainable, connected communities (Commissioning areas 6,10) Older adults 55+ (Commissioning areas 5, 6, 7, 8, 9 ) Groups with specific vulnerabilities (Commissioning areas 6, 7, 8, 9 )
Acknowledgements These Guides could not have been written without help from a number of people, in particular: Dr Jonathan Campion, Department of Health; Professor Margaret Barry; Catherine Jackson for her editorial suggestions and the members of the Project Advisory Group: Gregor Henderson, National Mental Health Development Unit; Andy Bennett, National Mental Health Development Unit; Dr Sarah Carter, Department of Health; Dr Michael Clark, West Midlands Strategic Health Authority; Keith Foster, National Mental Health Development Unit, Louise Howell, National Mental Health Development Unit, Kate O Hara, NHS West Midlands, Jude Stansfield, North West Regional Development Agency; Martin Seymour Local Government Improvement and Development; Elizabeth Wade, NHS Confederation and Dr Jo Nurse and her team at the Department of Health. We are also grateful to Laura Buckley, Jackie Coupe and Marian Lawrenson at UCLan.
Thank you KNewbigging@uclan.ac.uk CJHeginbotham@uclan.ac.uk;, University of Central Lancashire 01772 892780 (office) 07974 929367 (KN)