mental health services 2015 & beyond dr nick broughton
Post on 18-Dec-2015
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“Apart perhaps from global warming, there is no other major problem which is so neglected worldwide”
“Thrive – the power of evidence-based psychological therapies”
Richard Layard & David Clark
By condition…. % in treatment
Anxiety and depression 24
PTSD 28
Psychosis 80
ADHD 34
Eating disorders 25
Alcohol dependence 23
Drug dependence 14
Largest proportion of the disease burden in the UK (22.8%), larger than cardiovascular disease (16.2%) or cancer (15.9%)
People with psychosis die 14-20 years earlier than the general population
Depression associated with 50% increased mortality from all disease
59% triple amputees can be treated to get back into employment7% SMI in paid work
The Statistics
• 1 in 6 suffer from depression or anxiety• 1/3 of families include someone who is mentally ill• Mental illness accounts for 40% of all illness• 75% never get treatment• As many people kill themselves as die from war &
homicide• 7% of British teenagers have tried to kill or harm
themselves• 10% 5-16 year olds suffer from a serious mental health
problem• 50% of serious mental illnesses begin in childhood• 4.6 million living with long term physical & mental health
problems
Economic cost to Britain of Mental Illness
Cost to economy Cost to taxpayers
Unemployment, absenteeism & presenteeism
4 2
Crime 2 1
Physical healthcare
1 1
Total 7 4
(% of national income)
Integrated physical & mental health care for
long term conditions
Integrated physical & mental health care for
long term conditions
• Co-morbid MH problems are associated with a 45-75% increase in service costs per patient
• Between 12% and 18% of all expenditure on long-term conditions is linked to poor mental health and wellbeing
• If a person with a LTC has an untreated MH condition they cannot recover as well and they die earlier
24/7 Assertive outreach/ community forensic team
24/7 Assertive outreach /rehabilitation & recovery team
24/7 Assertive outreach /rehabilitation & recovery team
Rehabilitation / recovery team
Rehabilitation / recovery team
CMHT/ Enhanced primary care SMI with 3rd sector outreach
CMHT/ Enhanced primary care SMI with 3rd sector outreach
NHSE direct commissioned services
CCG commissioned services
Local authority commissioned
Commissioning the beds Commissioning the beds Commissioning the teams Commissioning the teams
The Mental Health System
No Health Without Mental Health - 2011
• Government strategy set out six key objectives:
1. More people will have good mental health
2. More people with mental health problems will recover
3. More people with mental health problems will have good physical health
4. More people will have a positive experience of care and support
5. Fewer people will suffer avoidable harm
6. Fewer people will experience stigma and discrimination
Increasing political support
• “This government has made improving mental health services a bigger priority than ever before, and we’re determined that mental health is treated with as much importance as physical health in the NHS”
Rt Hon Norman Lamb MP, 16 September 2014
London Health Board: MH priorities
• Mental Health & Employment The development of more effective support to ensure that
talent is not lost from the London workforce because of mental illness
• Adolescent Resilience Working with schools & across all agencies to support
adolescents to improve their resilience, so improving education outcomes & mental wellbeing
• Digital Mental Wellbeing Supporting the joint commissioning of a digital wellbeing
service to all 6 million adults in London to enable them to develop & maintain emotional resilience
Call for commitment to parity of esteem
• Ensure fair funding for mental health services• Give children a good start in life• Improve physical health care for people with mental health problems• Improve the lives for people with mental health problems• Enable better access to mental health services
The way forward
• Promote good mental health: Neighbourhoods, communities, schools (the 4 Rs), building resilience, addressing dyslexia, training school nurses & form tutors, engaging school governors
• Prevention and early intervention:– Parenting programmes– Early intervention in psychosis– Students against depression
Effective treatment
• Timely access to help when it’s needed:– Perinatal mental health support– Psychological therapy– Crisis care– Liaison psychiatry– Diversion
Support recovery
• ‘Job, home, family and friends’• Employment and education• Action to tackle stigma & discrimination• Support with housing, benefits, debt, etc• Peer support• Support for carers
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