01.10.12
Designing and delivering mental health services
Source: National Health Executive Sept/Oct 2012
Lord Victor Adebowale, chief executive of Turning Point, discusses the role of NHS organisations and employers in tackling mental health issues.
As an employer, the public sector has a major role in tackling stigma and mental health issues. The economic cost of mental health issues, such as anxiety and depression, in England has been estimated at more than £105bn each year.1 But effective management can bring about significant savings for employers, as well as improving life for the individual.
Employers should be promoting mentally healthy workplaces, tackling the causes of mental ill-health and helping people with these problems. This is not optional but rather a duty we, as employers, have to our workforce.
The Government’s mental health implementation framework, launched in July 2012, offers specific advice on what local organisations can do to make workplaces more supportive environments. The framework builds on the 2011 mental health strategy No Health Without Mental Health by translating the vision into reality.
Turning Point was one of five leading mental health organisations who co-produced the framework. As part of a small writing group we helped shape the recommendations to ensure that people with complex needs were included and represented. I also chaired a summit in February as part of the vital engagement process with the sector to inform the framework, and we continue to work with the Department of Health in promoting the framework and ensuring its recommendations are adopted.
It’s aimed at everyone with a role in improving mental health locally, not just health and care services but also schools, employers, the criminal justice system and housing services. The document highlights useful guidance, examples and sources of information to help local organisations use their existing powers and resources to improve mental health and wellbeing.
If the implementation is successful at embedding the strategy’s aims in everyday practice, then we’ll see many benefits. These include public services tackling inequality, intervening early and working together around people’s needs and aspirations so that people with mental health problems have a better experience of employment – and stigma and discrimination are tackled.
Endorsed by the Royal College of General Practitioners and the Royal College of Psychiatrists amongst others, the framework makes specific recommendations for employers. For example, it encourages them to use suicide awareness and education (or training) programmes. The Mindful Employer initiative, which provides support for businesses in recruiting and retaining staff, is also highlighted as an example of good practice. Another suggestion is to train frontline workers across the full range of services so they understand mental health and the principles of recovery.
This is about being aware, intervening early and making sure the right support is in place for people who need it so they do not feel disadvantaged or discriminated against if they ask for help. It’s everyone’s responsibility to make sure their workplace is a healthy place to be. Leadership is needed to ensure healthy environments are created.
An important message for the NHS in particular is that, if the strategy’s aims are met, mental health will at last achieve parity of esteem with physical health. NHS organisations have a key role in identifying mental health issues earlier and spotting the links with other physical conditions. The framework highlights the need for better liaison between acute hospitals and the community, with mental health leads in place and everyone – from receptionists to doctors – understanding and recognising mental health issues. This approach should lessen the stigma that people face.
Another focus of the strategy is early intervention. Not only can it curb individual needs escalating but we know it also saves money: for every £1 spent, councils could save £9.20.2 Ensuring people are aware of services and have equality of access should be at the forefront of service design and delivery. This is particularly important for those with particular mental health needs including the homeless, BME groups and Gypsy Roma Traveller communities (GRTs) who are nearly three times more likely to suffer from anxiety than others.3
Sir David Nicholson and Duncan Selbie, who co-signed the framework, state in their foreword that ‘reforms to the health and care system provide a significant opportunity to improve people’s mental health and wellbeing’. For the NHS, the framework’s recommendations help to achieve the aims set out in the Mandate and various other documents. They can also contribute to the savings needed to meet the Nicholson challenge and achieve the outcomes set out in the Public Health, social care and NHS outcome frameworks.
This framework shows what can be achieved by working together. Mental health affects everyone and that means everyone has a part to play in ensuring co-production doesn’t stop with the drafting of the framework. My hope is that organisations, communities and individuals use the framework’s recommendations to improve support for people affected by mental health and associated complex needs, to deliver real change on the ground, in our schools, workplaces and health service.
References 1 Centre for Mental Health 2 Children’s Services Development Group 3 The Health and Wellbeing of Gypsies and Travellers report, Irish Travellers Movement in Britain, March 2012
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