Agenda item

A report on the draft strategy is enclosed.

Dick Frak, Interim Director of Commissioning, Children's and Adults' Services and Caroline Gilmartin, Director of Integrated Commissioning presented on the developing Mental Health Strategy. They said that the council and the CCG had considered the recommendations by the joint scrutiny review into the emerging Joint Mental Health Strategy and used that as a basis to then appoint consultants to undertake further work. An open space event was held with over hundred stakeholders.

Catherine Negus, Research and Intelligence Officer, Healthwatch also briefly presented on Healthwatch findings and contributed to the discussion. She said the  consultation event had some good features- it was a very open space, but it was easier for more confidant people, and only 7 purely service users attended. She reinforced the themes identified in the report but identified some gaps to fill. These included :

·  the social determinants of Heath - housing, debts etc.

·  Complex cases can be impacted by early discharge and there is a problem with revolving door in and out of services.

·  Service users would like to see more ambition and creativity for talking therapies and other approaches to serious mental heath

·  Crisis care been a big issue with services users.  

Dick and Caroline responded. He spoke about GPs services and the possibility of having a consultant in mental health to deal better with pinch points. A better flow at A & E is needed. Feedback from services users is that A & E was not a good experience; waiting times were long with unsuitable spaces to be seen. There is a lack of an adequate dedicated response to mental health users needs in emergency care.

The following points were raised by members:

·  Would it be possible to include targets that highlight areas in the strategy implementation plan where services are either struggling or doing well? Dick said the strategy would lead to an implementation plan with ratings. Caroline said there are quite a few KPIs, but these are often things like waiting lists for talking therapists. Currently the council and CCG do not have a shared framework, nor have organisational ones yet been brought together to look at gaps and milestones.

·  Who is the Joint Strategy owned by? Jointly by council and health, but also hopefully more widely by community.

·  Are the council looking at preventative work to prevent poor mental health and stresses, for example regeneration? Dick said that the council we are looking and linking in the wider services of the council to bring about better mental health and wellbeing. The Joint Strategy was joined at the beginning by a deputy councillor who brought that broader approach in. At the moment much of our resource goes towards treating a narrower range, however in events people do want to address the wider issues: loneliness, housing.

·  People in mental health crisis do not do well in busy A & E services. Do we really need to have people in mental health crisis in A & E? Caroline clarified that people do sometimes need to come to A & E, however the pathway is not good enough. She spoke about long waits times, and concerns particularly for young people. King’s have said that a refurbishment is underway, and the chair said that KCH are due to come to the next meeting. The CCG said that they are looking more at increasing the consultant psychiatrists on site, and better facilities.

·  What about the impact of drugs & alcohol on mental health? During the consultation the drug and alcohol issue didn't emerge. A member said that current drug users might not come to events or even admit problems to themselves. Carline spoke about the evidence in A & E that drugs and alcohol are linked to mental health.