Portsmouth Mental health and wellbeing summit June 2014

Mental Health Summit for Portsmouth

Janet Maxwell, Director of Public Health5th June 2014

www.portsmouth.gov.uk

Mental Health and Wellbeing

• No Health without Mental Health - 2010• Everybody’s business• Individuals, families, communities, schools, workplaces• Not just NHS commissioned MH services• Needs to be embedded in all our work• Prevention, treatment, recovery

2


5 Ways to Wellbeing

3

Connect..

Be Active..

Take Notice..

Keep learning.

.

Give..


Mental Health resilience

• Life course approach – Marmot• Understanding of links with social inequalities• Children and Young people• Adults, Families, Older people• Start early with prevention and early intervention

4


Young people

• Parenting and early years• School years• Entry to work• Sense of value and purpose• Educational and work opportunities• Relationships• Risk taking behaviour

5


Mental health resilience

• Early years• School setting• Workplace• Safer resilient communities• Environment

6


Inequalities

• Lead to poor mental health

• Result from poor mental health

• Inequalities in access and provision and experience of services

7


Recovery model

• Towards a vision of recovery –

William Anthony 1993

‘growing beyond the catastrophe of mental illness and developing new meaning and purpose in one’s life …’

‘taking charge of one’s life even if one cannot rake complete charge of one’s symptoms.’

‘developing stronger social relationships, skills for living and working, improved chances in education, employment and housing.’

8


No health with out mental health6 key objectives:

• More people will have better wellbeing and good mental health

• More people with mental health will recover.• More people with mental health problems will have good

physical health.• More people will have a positive experience of care

and support.• Fewer people will suffer avoidable harm• Fewer people will experience stigma and

discrimination

9


Links to other strategies

• Shaping the Future• Education and jobs• Flourishing city of culture• Housing, planning, transport, environment• Health and Wellbeing Strategy• Integrated health and social care – Children and Adults

10


Implementation plan – July 2012

• Translates NHwMH strategy into action• Parity of esteem• Practical ideas of how organisations work together• Builds on outcome frameworks• Create dashboard to evaluate outcomes

11


Local action

• CCGs, primary care, community and acute providers, LA – public health, adults and children services, H&WBB, Healthwatch, Scrutiny, Community groups, schools and colleges, employers, CJS, housing.

• Needs assessment• H&WB Strategy and priorities

12


National action

• Mandate to NHSE• Payment by Results• Links to other strategies- suicide, alcohol, veterans,

equality• PHE - better data and evidence, campaigns• Education, training, professional bodies• Work with national organisations – Mind, Rethink – Time

to Change

13


Closing the Gap Jan 2014

Priorities for essential changes in MH

Identifies 25 aspects where we can make tangible changes in the next 2 years:• Increasing access to MH services• Integrating physical and mental health care• Starting early to promote mental wellbeing and prevent

mental health problems• Improving quality of life for people with MH problems

14

www.portsmouth.gov.uk15

6. IAPT for children and YP7.Payment reflect quality and

outcomes8.Adults to have right of choice9.Reduce restrictive practice10.Friends and Family Test

1.Service quality, recovery, need2.Information revolution

3. Waiting time limits4.Tackle inequalities

5.Increased access to IAPT

16. Support new mothers17..Support Schools to identify

early18.Transition from CAMHS to

adult services19.Longer healthier lives20.Recovery approach in

homes

21.National liaison and for offenders

22.Support for victims of crime23.Employment support

25.Support for unemployed to work

26.Stop discrimination

11.Inspection to identify poor quality

12.Better support for carers13.Integration of MH and PH care14.Self harm response at frontline

15.Crisis response 24/7


Next steps

• What are we currently doing well?

• Where are the gaps?

• How can we address these?

• How will we know things are better?

• How can a city wide MH Alliance help?

16


Mental wellbeing – needs assessmentMental Health Summit, May 2014


Barton H and Grant M (2006). A health map for the local human habitat. The Journal of the Royal Society for the Promotion of Health. November 2006 126:252-253


What we know – risks to good mental health

19

PortsmouthEngland England

worseEngland best

“Systematic differences in mental health by gender, age, ethnicity, income, education or geographical area of residence are inequitable and can be reduced by action on the social determinants.”

WHO, Calouste Gulbenkian Foundation. Social determinants of mental health. June 2014. http://apps.who.int/iris/bitstream/10665/112828/1/9789241506809_eng.pdf?ua=1


What we know – local inequalities

20

• 60.6% of adults in contact with secondary MH services live in stable and appropriate accommodation – ranked 9/12 comparator LAs

Section E2:Households found to be eligble for assistance, unintentionally homeless and in priority need during the quarter, by priority need category

9 month total %1. Applicant homeless in emergency 2 12. Households with dependent children 213 623. Households with pregnant member & no other dependent children 26 84.Aged 16/17 years old 2 15. In care and aged 18 to 20 4 16. Old age 6 27. Physical disability 42 128. Mental illness or handicap 27 89a. Drug dependency 0 09b. Alcohol dependency 0 09c. Former asylum seeker 0 09d. Other 1 010. Been in care 2 111. Served in HM forces 0 012. Been in custody/on remand 0 013. Violence/threat of violence 21 6 13a. Domestic violence 14 414. Total households 346Source: PIE. https://www.gov.uk/government/statistical-data-sets/live-tables-on-homelessness

Homelessness

April-Dec 2013



21

Homelessness

April-Dec 2013Section E3: Main reason for loss of last settled home for housholds found to be eligible, unintentionally homeless and in priority need during the quarter

9 month total %1. Parents no longer willing or able to accommodate 38 112. Other relatives/friends no longer willing or able to accommodate 27 83. Non-violent relationship breakdown with partner 9 34. Violence a. Violent relationship breakdown, involving partner 42 12

b. Violent relationship breakdown involving associated persons 13 4c. Racially motivated violence 0 0d. Other forms of violence 6 2

5. Harassment, threats or intimidation a. Racially motivated harassment 1 0b. Other forms of harassment 0 0

6. Mortgage arrears 4 17. Rent arrears on: a. LA or other public sector dwellings 0 0

b. Registered social landlord/other housing association dwellings 1 0c. Private sector dwellings 17 5

8. Loss of rented or tied accommodation due to: a. Termination of assured shorthold tenancy 79 23b. Reasons other than a. 78 23

9. Required to leave National Asylum Support Service accommodation 9 310. Left an institution or LA care a. Left prison/on remand 6 2

b. Left hospital 5 1c. Left other institution or LA care 1 0

11. Other reason for loss of last settled home a. Left HM-Forces 0 0b. Other reason 10 3

12. Total households 346Source: PIE. https://www.gov.uk/government/statistical-data-sets/live-tables-on-homelessness



22

Unemployment

• NEETS

• JSA claimant rates highest in most deprived wards (5% of working age population in Charles Dickens)

• Increasing median duration of unemployment – 13 weeks in March 2011 to 22.3 weeks in March 2014

• 68.1% point gap in employment rate for those in contact with secondary MH services and overall employment rate – ranked 2/12


Local research - mental wellbeing

• Tackling poverty needs assessment and strategy

23

http://www.hants.gov.uk/pccjsna/API_STR_JSNA_SEC_POV_NeedsAx270212.pdf

http://www.hants.gov.uk/pccjsna/API_STR_JSNA_SEC_POV_STRATEGY270212Printed.pdf


Local research - mental wellbeing• Positive Family Futures• Children’s survey• You say - survey of secondary school pupils• Children with autism spectrum conditions needs assess

ment• Looked after children needs assessment• CAMHS service review

24

http://www.hants.gov.uk/pccjsna/API_STR_JSNA_LIF_SUBS_SCHOOLSURVEY2013.pdf

http://www.hants.gov.uk/pccjsna/API_STR_JSNA_BURD_AUTISM_Child1.pdf

http://www.hants.gov.uk/pccjsna/API_STR_JSNA_BURD_AUTISM_Child1.pdf

http://www.hants.gov.uk/pccjsna/API_STR_JSNA_BURD_LAC_LACHNA.pdf


Local research - mental wellbeing• Adults with autism spectrum conditions profile,

consultation and strategic plan• Alcohol needs assessment• Substance misuse needs assessment• Profile of carers• Profile of adults with learning disabilities• Veterans needs assessment• Dementia profile, strategy• Suicide audit

25

https://www.portsmouth.gov.uk/ext/documents-external/hlth-autismstrategicplan.pdf

http://www.hants.gov.uk/pccjsna/API_STR_JSNA_LIF_AlcoholNeedsAx2012.pdf

http://www.hants.gov.uk/pccjsna/API_STR_JSNA_LIF_SUBS_Needs2012.pdf

http://www.hants.gov.uk/pccjsna/API_STR_JSNA_BURD_CARERS_DemandForCareAndAvailablityOfCarersPortsmouthJuly2013.pdf

http://www.hants.gov.uk/pccjsna/API_STR_JSNA_BURD_LD_Profile2012v2.pdf

http://www.hants.gov.uk/pccjsna/API_STR_JSNA_BURD_VETERANS_Ax2012_FINAL.pdf


Life satisfaction (overall well-being)

9%

13%

67%

8%

16%

12%

17%

14%

11%

19%

79%

70%

19%

81%

65%

0% 25% 50% 75% 100%

My life is going well

My life is just right

I wish I had a different kind of life

I have a good life

I have what I want in life

Disagree Neither Agree

What we know - childhood


The Good Childhood Index:national comparisons

6.8

7.3

7.4

7.4

7.6

7.8

8.1

8.3

8.4

8.5

7.2

7.0

6.8

7.3

7.5

8.3

8.1

7.5

8.2

8.5

0 1 2 3 4 5 6 7 8 9 10

Appearance

Choice

Future

School

Time use

Health

Friends

Money

Home

Family

National This area


Prevalence and incidence of bullying

Have you been bullied in the past year?

Yes30%

No45%

Didn't want to answer12%Not sure

13%

9%

15%

44%

21%

12%

0% 20% 40% 60%

Don't want to answer

Not sure

More than three times

Two to three times

Once


What we know - childhood• ½ of all lifetime mental health problems emerge before the age of 14 yrs and ¾ before mid 20s

• Rates of mental disorder rise steeply in middle to late adolescence. By 11–15 yrs it is 13% for boys and 10% for girls, and approaching adult rates of around 23% by age 18–20 yrs

• Self-harming in young people is not uncommon (10–13% of 15–16 yr olds have self-harmed)

• 11–16 yr olds with an emotional disorder are more likely to smoke, drink and use drugs.

National data from Report of the Children and Young People’s Health Outcomes Forum – Mental Health sub-group, July 2012

29


What we know - childhoodLooked After Children

• Health of children and young people in care is often poor before entering care system – may reflect poor early life experiences, family influences and environmental risk factors

• About 60% of Looked After Children and 72% of those in residential care have some level of emotional and mental health problem. A high proportion experience poor health, educational and social outcomes after leaving care

• Looked After Children and care leavers are between four and five times more likely to attempt suicide in adulthood

Youth Justice System

• 1/3 of all children and young people in contact with the youth justice system have been looked after

• NB A substantial majority of children and young people in care who commit offences had already started to offend before becoming looked after

• Young people in prison are 18 times more likely to take their own lives than others of the same age.

National data from Report of the Children and Young People’s Health Outcomes Forum – Mental Health sub-group, July 2012Local data from www.jsna.portsmouth.gov.uk

30


Self-reported wellbeing, people aged 16+ yrs, 2012/13

31

Indicator Liv

erp

oo

l

Sa

lfo

rd

Ne

wc

as

tle

up

on

Ty

ne

Sh

eff

ield

Le

ed

s

Ply

mo

uth

So

uth

am

pto

n

Bri

sto

l, C

ity

of

Po

rts

mo

uth

Bri

gh

ton

an

d H

ov

e

So

uth

en

d-o

n-S

ea

Bo

urn

em

ou

th Port

smou

th

Com

pare

d to

Eng

land

2.23i - Self-reported well-being - people with a low satisfaction score 8.4 6.3 7.0 7.3 6.1 4.5 4.4 5.4 6.2 4.9 6.4 6.7

2.23ii - Self-reported well-being - people with a low worthwhile score 6.0 5.1 6.2 5.4 4.5 5.4 3.7 - - 5.3 - 4.9 -

2.23iii - Self-reported well-being - people with a low happiness score 15.2 13.3 11.9 11.5 9.7 10.4 10.1 11.8 12.7 12.1 9.9 10.1

2.23iv - Self-reported well-being - people with a high anxiety score 29.0 22.8 21.0 23.5 21.7 24.1 23.0 20.9 17.5 25.4 22.0 20.0

Fourth highest or worst values Significantly worseFifth to eighth highest worst values values No differentLowest four values Significantly better

Significance not tested* Value suprressed Value not recorded -

(Where not all the data has been provided for regional comprators, tri-colouring split by thirds of number of values given for indicator)

Source: ONS. First annual experimental Annual Population Survey of Subjective Well-being, 2013. Reported in Public Health Outcomes Framework, May 2014


What we know – adults ...

• In 2012/13, compared to England, Portsmouth had a lower prevalence of people aged 18+ yrs with unresolved depression since April 2006 QOF

• Estimated 22,100 Portsmouth residents aged 18-64 yrs are affected by at least one common mental disorder. Predicted to increase to c22,700 by 2020 Adult Psychiatric Morbidity Survey, 2007. and

ONS Mid Year Populations Estimates 2011(Census-based) Via PANSI, 2014

• .

32


What we know – adults …

Social isolation

• Effective actions – interventions that prolong/improve social activities, life satisfaction, quality of life significantly reduce depressive symptoms and protect against risk factors such as social isolation.

33

Indicator

Liv

erp

oo

l

Sa

lfo

rd

Ne

wc

as

tle

up

on

Ty

ne

Sh

eff

ield

Le

ed

s

Ply

mo

uth

So

uth

am

pto

n

Bri

sto

l, C

ity

of

Po

rts

mo

uth

Bri

gh

ton

an

d H

ov

e

So

uth

en

d-o

n-S

ea

Bo

urn

em

ou

th

Port

smou

th

Com

pare

d to

En

glan

d

Ranked order of deprivation (Index of Multiple Deprivation, 2010) 64.1 46.1 38.4 34.1 28.6 25.9 25.5 25.3 23.7 22.5 21.8 15.61.18i - Social Isolation: % of adult social care users who have as much social contact as they would like 48.8 37.5 45.5 44.9 47.5 48.7 40.8 42.5 48.6 46.9 46.3 40.2

1.18ii - Loneliness and Isolation in adult carers 27.4 40.0 51.9 43.0 42.1 36.5 47.4 46.2 57.3 34.1 40.5 35.3

Fourth highest or worst values Significantly worseFifth to eighth highest worst values values No differentLowest four values Significantly better

Significance not tested* Value suprressed Value not recorded -

(Where not all the data has been provided for regional comprators, tri-colouring split by thirds of number of values given for indicator)


Psychological therapies, 2013/14

34

68% female, 32% male

94% aged 18-64 yrs

Number of people who have entered psychological therapies (ie had first therapeutic session)

3201

Number of people 'moving to recovery' 637

Number of people who have completed treatment who did not achieve clinical caseness at initial assessment

135

Number of people moving off sick pay and benefits 126

Key KPIs



35

New Service requests beginning in quarters 2 & 3 %Portsmouth (no) England Portsmouth

White British 720 60 37Irish 4 1 0Any Other White Background 22 3 1

Mixed White and Black Caribbean 6 1 0White and Black African 1 0 0White and Asian 1 0 0Any Other Mixed Background 3 1 0

Asian or Asian British Indian 2 1 0Pakistani 1 1 0Bangladeshi 5 0 0Any Other Asian Background 4 1 0

Black or Black British Caribbean 1 1 0African 8 1 0Any Other Black Background 2 0 0

Other Ethnic Groups Chinese 1 0 0Any Other Ethnic Group 7 1 0

Not Stated 107 10 6Unspecified 0 3 0Invalid Data Supplied 0 1 0Not Known 1026 15 53Total 1921 100 100



36

New service requests beginning in Qtrs 2 & 3 by disability%

Portsmouth (no) England Portsmouth01 Behaviour and Emotional 105 6 1102 Hearing 20 4 203 Manual Dexterity 14 1 104 Memory or ability to concentrate, learn or understand (Learning Disability) 64 3 705 Mobility and Gross Motor 28 9 306 Perception of Physical Danger 13 7 107 Personal, Self Care and Continence 24 1 308 Progressive Conditions and Physical Health (eg HIV, cancer, MS, fits) 6 2 109 Sight 20 3 210 Speech 17 2 2XX Other 20 4 2NN No Disability 595 65 63ZZ Not Stated (PERSON asked but declined to provide a response) 18 70 2No code recorded 0 15 0Invalid code 0 11 0Other code 0 0 0Total 944 100 100



37

New Service requests qtrs 2 & 3 provisional diagnosis%

Portsmouth (no) England PortsmouthF10 - Mental and behavioural disorders due to use of alcohol 0 0.1 0.0F31 - Bipolar affective disorder 0 0.1 0.0F32 - Depressive episode 96 11.9 5.0F33 - Recurrent depressive disorder 37 2.2 1.9F40.0 - Agoraphobia (with or without history of panic disorder) 7 0.3 0.4F40.1 - Social phobias 13 0.6 0.7F40.2 - Specific (isolated) phobias 8 0.3 0.4F41.0 - Panic disorders 14 1.0 0.7F41.1 - Generalized anxiety disorder 25 5.6 1.3F41.2 - Mixed anxiety and depressive disorder 63 11.6 3.3F42 - Obsessive-compulsive disorder 14 0.8 0.7F43.1 - Post-traumatic stress disorder 20 0.9 1.0F45 - Somatoform disorders 6 0.3 0.3F50 - Eating disorders 1 0.1 0.1F99 - Mental disorder, not otherwise specified 11 3.5 0.6Z63.4 - Disappearance and death of family member 7 0.4 0.4Other ICD10 code 2 3.5 0.1No code provided 1597 56.7 83.1Total 1921 100.0 100.0


What else we know….

• In 2012/13, about 1,960 people (0.9% of registered patients) were recorded by GPs as having severe mental illness (compared with 0.8% nationally) QOF, 2012/13

• Compared to England, this is a significantly higher prevalence of people with severe mental illness

38


0

2

4

6

8

10

12

14

16

18

20

1993/95 1994/96 1995/97 1996/98 1997/99 1998/00 1999/01 2000/02 2001/03 2002/04 2003/05 2004/06 2005/07 2006/08 2007/09 2008/10 2009/11 2010/12

DS

R p

er 1

00,0

00 E

urop

ean

Pop

ulat

ion

Mortality from suicide and injury undetermined : persons aged 15 years and overPortsmouth UA and comparators, 1993/95-2010/12, crude three year average trend (from annual rates)

Directly age-standardised rates (DSR) per 100,000 European standard populati

England Government Office of the South East Portsmouth *Southampton

Source: Health and Social Care Information Centre. © Crown Copyright. Compendium of Population Health Indicators (indicator.i c.nhs.uk) and National Statistics.

0

5

10

15

20

25

Males Females Persons

DS

R (

per

100

,000

Eu

rop

ean

sta

nd

ard

po

pu

lati

on

)

Suicide and mortality from injury undetermined, aged 15 yrs and overPortsmouth City and comparators, 2010-12

England South East Portsmouth

Source: Health and Social Care Information Centre. © Crown Copyright. Compendium of Population Health Indicators (indicator.ic.nhs.uk) and National Statistics.


Current research and gaps in knowledge

Current:• Tackling poverty needs assessment• Youth offenders health needs assessment• Health impact assessment of retrofit of Wilmcote House• Use of out-of-hours services by people with dual

diagnosis

Gaps• Health and wellbeing survey of adults• ???

40


Life course to tackling inequalities in mental wellbeing WHO/Gulbenkian Foundation


Current Services

Public Health Portsmouth 31 July 201342

Mental Health Services in Portsmouth

Preeti Sheth

Head of Integrated Commissioning Unit

www.portsmouthccg.nhs.uk


Key Facts

• Majority of statutory services provided by Solent NHS Trust and Portsmouth City Council in partnership.

• Adult Mental Health services provide care for 1600 people on a longer term basis (months to years)

• Around another 4400 people each year in Portsmouth access services for a short-term piece of work

44 www.portsmouthccg.nhs.uk


AMH Services


Community

Services

Talking Change

Voluntary Sector

Organisations


Talking Change

• Part of the national “Improving Access to Psychological Therapies (IAPT)” programme

• Talking Change provides evidence based, time limited psychological therapies for common mental health problems (mainly anxiety and depression)

• Nearly 4,000 people a year in Portsmouth use this service

• There is not a long waiting list and people can refer themselves

• Waiting times and Recovery Rates exceed national targets



Community Services• A2i (assessment to Intervention) service – fast access to

MH advice and short term intervention for people whose problems are more complex than Talking Change.

• Recovery Teams – providing care for around 1500

people who have longer term MH needs.

• IET (Intensive Engagement Team). Working with around 100 people – a mixture of young people at risk of developing psychosis and people with severe mental illness who are at risk of disengaging from services.


The Acute Care Pathway (ACP)

Day Treatment

Hawthorns (Acute Ward)

Maples (Intensive Care)

Person in Acute Crisis


Acute Care Pathway• CRHT (Crisis Resolution Home Treatment Team). Intervene

when people are at risk of hospital admission. Keep over 500 people out of hospital every year.

• Day Treatment Working with people who need extra support, but not full hospital admission.

• Hawthorns and Maples Wards Short admissions, for people who need a period of intensive hospital care. All admissions preceded by CRHT assessment, to see if care at home is an option.

• Oakdene – 14 bedded Rehabilitation Unit for people who need inpatient stays of several months.



Voluntary Sector Organisations• Employment Service (Solent Mind) Adults aged over 16

who have a mental health issue and an employment-related support need.

• Peer Support Service (Richmond Fellowship) Peer Support is embedded in secondary mental health

services and peers focus on supporting individuals to

better manage their mental health and wellbeing

• Advocacy Service (SEAP) Mental health advocacy services including: Independent Mental Health Advocacy (IMHA), Independent Mental Capacity Advocacy (IMCA) and Deprivation of Liberty Safeguarding (DOLS IMCA) and community mental health advocacy.



Accommodation Based Services • Community Based Supported Living AMH Service –

(Richmond Fellowship) The service promotes independence and prevents the need to access higher intensity statutory services. The service supports about 55 individuals across 12 residential settings in the city.

• Extra Contractual Referrals (ECR’s) Are made when an individuals clinical circumstances are exceptional or there are specific requirements to reside outside the area. There are 43 individuals being supported through ECR arrangements which includes section 117 aftercare placements.

• In addition there are 87 individuals in mental health low support rest home care across the city.



CAMHS

• Solent NHS Trust provide CAMHS for Portsmouth and services are commissioned by Portsmouth CCG and Portsmouth City Council. The service model is made up of two generic teams and a number of targeted teams.

• The Tier 3 team is a generic multi-disciplinary specialist healthcare team offering assessment and intervention.

• The Primary Mental Health Worker Team is a generic uni- disciplinary Tier 2 service for children and young people whose issues cannot be managed at Tier 1 and don't require the services of Tier 3.



CAMHS Targeted Teams • Infant Mental Health team for parents and babies 0-2 years. Offers

intensive home based interventions that focus on attachment.

• Multi-Systemic Therapy team provides intensive home based targeted family support to young people 11-18, at risk of entering care or currently part of the criminal justice system or at risk of permanent exclusion from school or college.

• Paediatric Liaison a dedicated psychiatric and psychological service for children and young people (0-16 years) at QA Hospital.

• Targeted teams also include the CAMHS Learning Disability team and the CAMHS Looked After Children’s team for children 0-18.


Adult Mental Health-

What’s going well/What requires development

Matthew Hall

Operations Director - Adult Mental Health Services

What’s going well

Feedback from stakeholders• CQC Inspection

• National Service User Survey – 3rd highest in England people reporting care as “Good” or better.

Supporting people in mental health crisis• CRHT supports nearly 600 people a year

• Lowest acute bed usage in England

• Back home with support quicker if you do need admission

Value for money• Providing well rated local service for one of the lowest costs for

any city in England.

• Developing partnerships key to the future

What requires development

Community Staff engagement

• National Staff Survey - Community staff were less happy in their roles than

average for the Trust

Caseloads and throughput in A2i

• New team has been successful, but has been a bit overwhelmed – needs

different resourcing and stronger management

• Need to get more Recovery-based movement, through services.

Carer involvement

• We are working on this, but carers can still get overlooked.

Angela Dryer

Assistant Head Adult Social Care

Adult Social Care & Mental Health Services 5 June 2014

Background

• Adult Social Care are part of the Integrated Adult Mental Health (AMH) Service led by Solent NHS Trust

• Staffing include:– Social Workers, Community Development Workers

& Administrators• Social Worker based within the Older Persons Mental

Health Team• Dedicated Approved Mental Health Professionals

Service• Joint working with AMH from community social work

teams and hospital Social Work Team

59

3 Areas that are going well

• Joint working between ASC and OPMH, and involvement of OPMH service in ‘Virtual Wards’

• Carers are reporting that communication from In patient wards is valued. They value being able to speak to a consultant about someone's care and being able to give their view point.

• Dedicated AMHP service improved service for people requiring Mental Health Act Assessments in a more timely way and response times for S136 assessments best in country.

60

3 Areas for Development

• Personalised social care for people with MH problems– Direct Payments / Personalised Budgets take up very low

• Impact of Care Act 2014 on people within AMH services needing Social Care involvement

• Ensuring effective communication with carers - some staff manage to make carers feel involved even when consent to share information is limited but this is not consistent. Some carers feed back that they feel there is a barrier to communication with Care Co-ordinators.

61

Portsmouth Mental health and wellbeing summit June 2014

Health & Medicine

mental health care

good mental health

mental health problems

environment health

health map

promotion of health

mental wellbeing

poor mental health result