Using intelligence based decision making to help deliver the

Prevention Concordat for Better Mental Health

Cam Lugton Programme Lead – National Mental Health Intelligence Network, PHE

What is the Prevention Concordat for Better Mental Health?

What do we mean by prevention?Prevention involves reducing the incidence and prevalence of mental health problems and suicide. Prevention can occur at three levels:

• Primary prevention aims to prevent the onset of mental health problems by addressing the wider determinants of illness and using ‘upstream’ approaches that target the majority of the population.

• Secondary prevention involves the early identification of signs of mental health problems or suicide risk and early intervention to prevent their progression or the development of other health complications.

• Tertiary prevention involves working with people with established mental health problems to promote recovery and prevent (or reduce the risk of) recurrence.

Mental health promotion is part of primary prevention but also important for those experiencing and at risk of developing, mental health problems.

3 Prevention Concordat for Better Mental Health Programme

A Public Mental Health Approach to Prevention Concept informed by World Health Organization methodology for public mental health

which has been adopted by Public Health England

Everyone, irrespective of where they live, has the opportunity to achieve good mental health and

wellbeing - especially communities facing the greatest barriers and those people who have to

overcome the most disadvantages.

This includes those living with and recovering from mental illness. Mental health promotion

Reducing premature

mortality for those living with or

recovering from mental illness

Mental illness prevention and

suicide prevention

Key themes:• Reducing health inequalities

• Community centred approaches

• Embedding and integrating mental health

• Improving workforce capacity and competency

4 Prevention Concordat for Better Mental Health Programme

Five Priority Themes to Improve Prevention Planning

Needs and assets

assessment

Partnership and

alignment

Translating need into deliverable commitments

Defining success

outcomes

Leadership and

accountability

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Endorsement and Adoption The Prevention Concordat for Better Mental Health was launched September 2017

The 30 organisations who endorsed the concordat at launch each declared a pledge to engage in specific actions to deliver cross sector change.

Since launch the number of signatories continues to grow.

Age UK Association of Directors of Public Health UK Association of Mental Health Providers British Islamic Medical Association Care Quality Commission Catholic Bishops’ Conference of England &Wales Centre for Mental Health Children and Young People’s Mental Health

Coalition Department of Health (on behalf of government) Faculty of Public Health Health Education England Homeless Link Housing Associations’ Charitable Trust Local Government Association Mental Health Foundation Mind Muslim Council of Britain

Network Rail NHS Clinical Commissioners NICE The National LGBT Partnership National Suicide Prevention Alliance National Survivor User Network National Voices NHS Digital NHS England NHS Improvement Public Health England Rethink Royal College of Nurses Royal College of Psychiatrists Samaritans Student Minds StreetGames Youth Access

County Durham Derby City Hertfordshire Middlesbrough Redcar and

Cleveland Warwickshire

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Sign up round 2 – who is it aimed at?Anyone who has a commitment to promote positive mental health and preventing mental illness

for example:

• Partnerships: STP/ICS, Health and wellbeing Boards, Community Safety partnerships, Voluntary sector partnerships

• Organisations: Local authority, CCG, NHS Hospital Trust, Voluntary organisation,

• Communities: local community groups, faith groups, Big Locals

• National organisation or partnerships: Professional membership bodies, charities, government agencies

Submission dates:• wave 2 -end of September 2018• wave 3 -end of November 2018• wave 4 - end of February 2019

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Five Year Forward View for Mental Health

Prevention Concordat for Better Mental Health

The Mental Health and Wellbeing JSNA Toolkit

Five Year Forward View for Mental Health Prevention Overview

3.

NHSESupport

Rec 3: All local areas to have multi-agency suicide prevention plans in place by 2017, reviewed

annually thereafter and supported by new investment.

Align NHS I (Learning from death by suicide)

Lead PHE

Lead DH

Rec 43: Clear plan to develop and support the Mental Health

Intelligence Network over 5yrs, so that it supports data linkage across

public agencies, effective commissioning & implementation of new clinical pathways and standards

as they come online.

Lead NHSE

Lead PHE

Rec 2: National Prevention Concordat to support all

Health and Wellbeing Boards (+ CCGs) to put in place updated JSNAs and joint

prevention plans that include mh & co-morbid alcohol and

drug misuse, parenting programmes, and housing, by

no later than 2017

LeadPHE

Prevention Concordat Event: North East 24th Jan 2018

Lead PHE

NHSESupport

Align NHSE –led Recommendation 22 (improved physical health for people with SMI 280,000 more people with SMI will have access

to evidence based physical health checks and interventions)

Rec 20: Ensure that people with mental health problems at greater risk of poor physical health get access to prevention

and screening programmes. All mh inpatient units and facilities to be

smoke-free by 2018.

9.

Purpose of the Mental health and wellbeing

JSNA toolkit

10.

11.

Stakeholder voices

Local expertise

Knowledge of services Local data

Identified priorities

Overview metrics Links to

detailed metrics

Policy guidance

Robust evidence

base

National expert opinion

Local interventions

JSNA Process

Local inputs: Bespoke to area

National inputs:Do once and share

toolkit supports local action

Components

12.

Supporting components

Mental health and wellbeing JSNA toolkit 2017/18

Content:• HTML based with bite sized sections• Focus on prevention, wellbeing, risk

profiling and community assets• Intelligence on policy, case for change,

data and interventions• Guide follows life course

Mental health JSNA stocktake

(Kaleidoscope)

Content:• 100+ overview metrics• GP & ward level metrics

• Each domain follows life course • Gateway to a range of NMHIN topic

based profiles• PDF output report

Meeting the need – what makes a ‘good’ JSNA for mental health?

(Centre for Mental Health 2016)

Mental health primary prevention return on investment tool & report

(London School of Economics)

Prevalence & incidence

Quality & outcomes Finance

Risk factors

ServicesProtective factors

Understanding place

Understanding people

Perinatal

Working age adults

Older years

Data profile Knowledge guideChildren &

young people

Using the toolkit

13.

The Knowledge Guide

14.

All Knowledge Guide chapters begin with a list of topic related questions that a JSNA may seek to answer.

Each sub-section within these chapters provides • An introduction to the topic• An overview of some relevant policy and guidance• A link to the relevant metrics in the profile• Links to other available national data sources• Ideas for sources of local data• Links to relevant evidence and further information

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Knowledge Guide: Overview

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Understanding place and people

Socioeconomic deprivation

Child poverty Older people

living in poverty

HousingHomelessness

EducationEmployment

Gap in employment

Community wellbeingCrime Offending

levels

Fuel poverty

Population demographics

Equity of access

Vulnerable groups

Excess weight

Smoking

Physicalactivity Outdoor space

Self-harm SuicideComorbidity -

mental & physical illness

Alcohol misuse and drugs

Using the toolkit

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Using the profile

19.

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Data Profile: OverviewStructured into 6 domains

Variation within area (GP practice)QOF Depression: % of adults on register

Risk - variation within area (wards)

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Go to products:

Mental Health and Wellbeing JSNA Data Profile:https://fingertips.phe.org.uk/profile-group/mental-health/profile/mh-jsna

Mental Health and Wellbeing JSNA Knowledge Guide: https://www.gov.uk/government/publications/better-mental-health-jsna-toolkit

Google: Mental Health Fingertips or Mental Health Intelligence

Thank You Cam.Lugton@phe.gov.ukSign-up to the Prevention Concordat for Better Mental Health: publicmentalhealth@phe.gov.uk

Download full suite of resources: https://www.gov.uk/government/collections/prevention-concordat-for-better-mental-health#consensus-statement

Acknowledgements: PHE TeamsPublic Mental Health; Mental Health Intelligence Network; Health Economics