Gerard Collins (Department of Health)

NO HEALTH WITHOUT PUBLIC MENTAL HEALTH

POLICY & PRIORITIES – NORTH & SOUTH

Gerard Collins & Kate O’Flaherty

November 2017

What is public mental health?

Source – Well Scotland. Adapted from K. Tudor, ‘Mental Health Promotion:

Paradigms and Practice’, 1996

The Big Picture

• WHO – Major global concern, a main cause of the burden of disease worldwide; largest single source of economic burden (£1.6 trillion).

• Europe - 20% of the burden of disease; 27% of the adult population.

• UK – Largest burden of disease (28%), costs up to 4.5% of GDP.

• NI – Greater mental health needs than England, costs up to £2.0 billion?

NI – The need for action• High levels of poverty & economic inactivity

• 29,100 incidents of domestic abuse

• High rates of self-harm & suicide

• The “Troubles” & PTSD

• Adverse childhood experiences; 40k children affected by parental substance misuse

• Behaviour problems in children – 10%

• High rates of mental illness

GHQ respondents scoring 4 or higher 2014/15

No mental health condition

79%

Diagnosed mental health condition

20%

Undiagosed mental health condition

1%

Bamford Review & Response

• Better services

• Support for carers

• Supporting people

• Better structures

• Health & wellbeing

• Psychological therapies

• Perinatal mental health

• Service Framework

• Recovery approach

• Crisis response

• Re-settlement

• Schools, workplaces

• Trauma

• Legislation

• Physical health

Mental Capacity Act (NI) 2016 Decision-making framework in relation to acts that require

consent where person lacks capacity to consent

100 enabling powers

Safeguards to protect rights & interests of person who lacks capacity

Rights-based approach to strengthen personal autonomy

Remove legislative discrimination against those with a mental health problem

Codifies common law defence of necessity into a protection from liability for acts that otherwise would require consent.

Programme for Government Outcomes

Long, healthy

active lives

Safe communities

Best start in life

Care for others &

help those in need

A shared society

A more equal

society

More people

working in better jobs

PfG Action Plans Improve mental health

Reduce preventable deaths

Reduce health inequality

Reduce poverty

Reduce crime

Improve self-efficacy

Improve child development (pre-school)

Improve Mental Health

PfG actions on mental health & wellbeing

• Parity of esteem –meeting physical health needs

• Improving CAMHS & ADHD provision

• Perinatal mental health

• Eating disorders

• Stigma

• Early years & infant mental health

• Mental trauma service


• Mental health & wellbeing in education

• Looked after children

• Employment support

• Addiction services

• Suicide & self-harm

• Recovery colleges

Evidence base

Positive Mental Health Plan

We enjoy long, healthy lives with positive mental health throughout

Promote positive mental health for all; prevent mental health problems

Best start Developing well

Living & working

well Ageing well

Awareness raising

Resilient communities

Gaps & Scale

• Family Nurse Partnership


• Crisis services

• Assertive outreach

• Evaluation

• Primary care training

• Social prescribing

• Service integration

• Stigma

• Serious adverse incident reporting

Gerard Collins (Department of Health)

Healthcare