Mental Health Services Insight Review Accessing mental health services in Leeds November 2020 V1 This paper will pull together existing insight and data from various sources in order to: • Describe the population who live in Leeds • Outline the needs and preferences which have already been collected from people • Outline any common themes from previous research or engagement work • Identify any gaps in this insight or data Contents: 1. Background – What is the Clinical Commissioning Group and why are we carrying out this insight review? 2. The Area and Current Health Provision – Introduction to the local area. 3. Population – Who lives in Leeds? 4. Insight review – What do we already know about the needs and preferences of people living in this area?
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Mental Health Services Insight Review Accessing mental health services in Leeds
November 2020 V1 This paper will pull together existing insight and data from various sources in order to:
• Describe the population who live in Leeds
• Outline the needs and preferences which have already been collected from people
• Outline any common themes from previous research or engagement work
• Identify any gaps in this insight or data
Contents:
1. Background – What is the Clinical Commissioning Group and why are we
carrying out this insight review?
2. The Area and Current Health Provision – Introduction to the local area.
3. Population – Who lives in Leeds?
4. Insight review – What do we already know about the needs and preferences of people living in this area?
1. Background – What is the Clinical Commissioning Group and why are we carrying out this review?
NHS Leeds Clinical Commissioning Group (CCG) is responsible for making sure that all people living in Leeds have access to the healthcare services they need, when they need them. We know that if we are to provide high quality, safe and compassionate services, we need to understand the needs and preferences of local people and use their feedback to improve our services. We have a statutory duty to:
• Involve patients and carers in planning, managing and making decisions about their own personal care and treatment (care planning).
• Involve the public in the commissioning process itself, so that the services provided reflect the needs of local people.
To inform the future commissioning of mental health services in Leeds, a summary of previous research and engagements with local people would be helpful to inform future developments of commissioning. This insight review seeks to pull together what people living in Leeds have already told us about their needs and preferences in relation to accessing mental health services, including access to crisis and early intervention services. It aims to highlight common themes and any gaps, in order to support future improvements to people’s experiences of receiving health and care services.
2. The Area and Current Health Provision – Introduction to the local area Leeds is an area of great contrasts, including a densely populated inner city area with associated challenges of poverty and deprivation, as well as a more affluent city centre, and suburban and rural areas with villages and market towns. Leeds has a relatively young and dynamic population and is an increasingly diverse city with over 140 ethnic groups including black, Asian and other ethnic-minority populations representing almost 19% of the total population compared to 11% in 2001. There are 94 GP practices which cover a population of around 870,000 people in Leeds. Primary Care Mental Health Services (PCMHS) are usually provided through GP practices to people who are feeling low, vulnerable or anxious. There are three different PCMHS in Leeds:
• Improving Access to Psychological Therapies (IAPT)
• Primary Care Mental Health Liaison Service
• Perinatal Mental Health
Community Links delivers PCMHS for the city: https://www.commlinks.co.uk/services/leeds/iapt/?search_location=&search_category=
Statutory mental health services are provided by Leeds and York Partnership Foundation NHS Trust (LYPFT) who are the main provider of specialist mental health and learning disability services in Leeds. They provide 24 different clinical services including community mental health, inpatient, crisis and autism services They offer support and treatment for a wide range of mental health conditions. https://www.leedsandyorkpft.nhs.uk/ Leeds City Council (LCC) and NHS Leeds CCG both commission a number of community-based adult mental health services from local third sector providers. “Third sector” is a collective term used to describe voluntary, community, charitable, and social enterprise groups and organisations, which usually operate on a not-for-profit basis. Where appropriate, third sector services will link in with ‘statutory’ NHS services, and with Council services, to provide a wider and more diverse service offer to support mental health service users. Third sector services cover a wide range of support services that can be categorised into some of the areas below:
➢ Crisis and urgent care support
➢ Supported accommodation
➢ Specialist community support and treatment
➢ Service user involvement
➢ Refugee and asylum seeker support
➢ Advice and information on mental health and wellbeing in Leeds
3. Population There an estimated 793,139 people living in Leeds, as of 2019. Of that number 49.1% (389,345) are estimated as being male and 50.9% (403,794) are estimated as being female. Leeds is above the national and regional average for people aged between 20-24 and 25-29, likely owing to the large student population.
18.9% (141,771) of the population come from minority ethnic communities. 12.5% (99,000) of Leeds’ population were born outside of the UK and 4.5% of households in Leeds do not have English as a main language.
Nearly 200,000 people live in the most deprived 10% of neighbourhoods (when ranked nationally). These people have 2-3 times the risk of a common mental health disorder compared to the general population. Specific associations/causes include – poor housing/homelessness/debts/unemployment. As of June 2020, around 3.5% of the population are classed as unemployed.
▪ Feelings of isolation if separated from work colleagues/social
isolation if at home alone
o Furloughed workers
o Concerns about job security
o Having to return to work whilst COVID-19 cases are still prevalent
• Being socially isolated, not being able to meet family/friends if not close or in a
‘bubble.’
A survey of over 14,000 adults by the mental health charity Mind has revealed that
existing inequalities in housing, employment, finances and other issues have had a
greater impact on the mental health of people from different Black, Asian and Ethnic
Minority (BAME) groups than white people during the coronavirus pandemic. The
online survey of over 25s in England and Wales found:
• Almost one in three (30%) BAME people said problems with housing made
their mental health worse during the pandemic, compared to almost one in
four (23%) white people.
• Employment worries have negatively affected the mental health of 61% of
BAME people, compared to 51% of white people
• Concerns about finances worsened the mental health of 52% of people who
identified as BAME, compared to 45% of those who identified as white.
• Other issues saw a similar pattern, including getting support for a physical
health problem (39% vs 29%) and being a carer (30% vs 23%).
4. Insight Review – What do we already know about the needs and preferences of people living in Leeds about mental health services?
In an insight review we look at feedback from various sources over the last couple of years. Where we find gaps, such as a lack of feedback from specific communities, we will arrange focussed engagement. This approach to engagement ensures that we start with the information we already have and avoid engagement fatigue. In this review we have explored feedback from. Each practice will follow the order below:
a. Feedback from Care Opinion (www.careopinion.org.uk) which provides an online platform for people to share their stories about accessing health and care services.
b. Feedback from recent NHS Leeds CCG engagements where we heard from the people of Leeds on different areas of mental health services.
c. Feedback from wider research and engagements which heard from the people of Leeds.