Agenda item

The following are attached :

·  Cover report

·  Draft Joint Mental Health and Wellbeing Strategy

·  Appendix1:Summary of OSC recommendations (from previous scrutiny review)

·  Appendix 2: Governance plan  

The chair invited the following officers to introduce themselves and provide a brief presentation on the Draft Joint Mental Health & Well-being Strategy:

·  Genette Laws, Director of Commissioning | Children’s and Adults’ Services  | Southwark Council

·  Rod Booth, Head of Mental Health and Wellbeing, NHS Southwark Clinical Commissioning Group and Southwark Council

 The Director of Commissioning gave a brief overview of the history of the strategy’s development and the role of scrutiny in this process. The Head of Mental Health and Wellbeing spoke about recent compelling engagement, which included online engagement and two large scale open events.

The chair asked if there will time to incorporate the feedback from the consultation into the strategy? Officers said that the plan is going to the CCG and Cabinet in November and December and the Health & Wellbeing Board in January. The ongoing engagement will particularly feed into the action and delivery plans.

A member said he had some concerns that the strategy was reactive rather than proactive. He asked what work was been done of the causes of mental health; referencing scrutiny recommendations 20 and 25 and BME communities.  The Director of Commissioning referred to the importance of early years in providing a foundation for good mental health and physical health and that this also links to the  wider determinants of health such as housing. There is also a continuum between Mental Heath and Well being. 

Members asked if there are figures on BME and age. Officers confirmed that data is available.  Members asked if the plan can start to identify the populations and causes so service can start to address these issues and do preventative work. He asked if the council and CCG are commissioning services for those most at risk or if there was a more holistic approach? The Director of Commissioning said Public Health colleagues do have data on the at risk groups, which include high prevalence among black men and also LGBTQ+. She said that we do need to offer both universal services and to address causes and prevent crisis in particular communities. The Director of Commissioning offered to come back with Public Health providing data on the population risks, and also evidence on the causes.

A member asked if the planned  reduction of 10% in the suicide rate is ambitious enough. Is it possible to aim to eliminate? Officers said that they could start with zero as an ambition and that this was a good question. They would not want to duplicate work of the suicide prevention strategy.

A member asked if there is a question around access to IAPT and the possibility of a Southwark commitment to wait times. The Head of Mental Health and Wellbeing said access ought to be front and centre in action plan. Access timeline targets will be led by national targets. He commented that access to Housing and step down care are local priority issues to address. The member  asked for clarification and if there will be local or national targets?  Officers said targets would be national ones as these are ambitious to meet consistently.

A member spoke about a common experience of immigrants: ‘Ulysses syndrome'. This looks like mental health but is really a reaction to pressures of immigration. She asked if this could be picked up.  The Director of Commissioning this is a very specific question that would need to be taken up offline with SLaM  to look at then evidence , then this  can considered and to see if we need something in the strategy about the needs of migrants .

A member asked about the issues of the older community, such as social isolation and depression. The Director of Commissioning said that we need to look at a range of services and use of all the assets of Southwark to address issues such as this.  Members agreed with this and suggested multi- agency and faith communities , that given  the council has limited resources.

A member commented that lots of clinical care in the strategy talks about section 136 and Place of Safety, however there is little on the crisis pathway that the committee discussed earlier, or links with suicide prevention.  The Head of Mental Health and Wellbeing agreed that services do need to reflect the work done on crisis care of recent. There was a query about the use of scrutiny to facilitate this and user involvement going forward. The Head of Mental Health and Wellbeing said there is a reference group with a list of 300 people. In addition on Monday there was a call for a reference group specific to work with the BME community, which officers will be looking into.

The chair asked about the body that takes a formal decision on the strategy and if this is the Cabinet, CCG board of Health & Wellbeing (HWB) Board. Officers explained that the HWB is final but not a decision making body, whereas the CCG and Cabinet will formally approve as they have the governance decisions on resources.

Healthwatch provided feedback commenting that they are pleased with the development of the strategy. In addition  they would like to see more focus on a range of issues including prevention, education, and promotion of recovery and also a review of CAMHS. They would like to see better discharge, a better link with Drug and Alcohol services as duel diagnosis is a problem with links between addiction and mental health. They also noted problems identified by CQC with SLaM and that the move to community support needs evidence and not be the withdrawal of professional support. The paper they tabled provided more details.

RESOLVED

Healthwatch will provide their submission to the consultation for the committee

(Enclosed with minutes)

This item will return to the committee for further discussion on the points raised.

Officers will provide the JSNA data on Mental Health Inequalities (enclosed with minutes)