Jude Stansfield

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Jude Stansfield

  1. 1. Introduction to PHE and theWell-being & Mental HealthprogrammeJude StansfieldConsultant in Public Health (interim)Wellbeing and Mental HealthHealth and Wellbeing DirectorateJude.stansfield@phe.gov.uk1 Mental Health in Public Health National Event - 6 March 2013 - Coin Street Neighbourhood Centre, London
  2. 2. Public Health England• Public Health England is the authoritative leader innational public health and the expert service provider forpublic health in England• Public Health England’s mission is to work with andalongside others to protect and improve the public’shealth and well-being and reduce inequalities throughour advocacy; application of knowledge, evidence andinsight; transparent reporting of outcomes; and nurturingthe public health system and workforce2 Introduction to Public Health England
  3. 3. 3 Introduction to Public Health England– Four regions, fifteen centres– Eight Knowledge andIntelligence Hubs– London– South West– South East– West Midlands– East Midlands– North West– North East, Yorkshire and theHumber– East– Other local presence– ten microbiology laboratories– field epidemiology teams– Centre for Radiation Control unitsNationwide Reach
  4. 4. Local AuthoritiesLocal Authorities, with detailed understanding of theircommunities and circumstances are the natural leaders forpublic health in their areas. Public Health England willsupport them with knowledge and expertise to help themdeliver on their responsibilities• PHE is structured into four regions and fifteen centres spreadacross the country. The centres are key to the interaction withlocal authorities4 Introduction to Public Health England
  5. 5. Partnerships will be keyPublic Health England cannot succeed by itself. Ourpartnerships with local authorities, the NHS and the thirdsector are what will allow us to achieve the outcomes wewant.Our partners provide broader avenues by which the publicinteract with the health system and may be advocates forpublic health. PHE will work with and support our partnersto ensure the best outcomes.5 Introduction to Public Health England
  6. 6. Health and Wellbeing DirectorateThe PHE Health and Wellbeing Directorate will lead PublicHealth England’s work to improve health and wellness andaddress the major drivers of disease, disadvantage, anddeath across England.The Directorate will use an integrated approach workingwith local government, the NHS, voluntary sector andothers to support the development, implementation andscale-up of robust, effective population health programs,promote well being, tackle health inequalities, and addressthe social determinants of healthIntroduction to Public Health England6
  7. 7. The Directorate’s ApproachHealth and WellbeingHealth andWellbeingDirectorateIntegratedApproachDeliverAccelerate PublicHealth OutcomesEngagePublic Educationand EmpowermentSupportPublic HealthWorkforce CapacityChampionScale High ImpactInterventionsPartnerTackle HealthInequitiesSupport local government, voluntary sector, the NHS andother partners in their mission to align activities andpromote improved outcomes for the public’s health andwell being and to reduce health inequitiesInform, educate, and empower the public andcommunities nationwide, especially those in greatestneed, to take better control of health, their determinantsand outcomesSupport the development of a robust public healthworkforce who are knowledgeable, capable,passionate and effective in improving health, promotingwellness, and addressing health inequitiesChampion science and translational research toinform the development, implementation, and scale-upof high-impact evidence-based strategies to improvepublic health outcomesEngage multisectoral partnerships, including withother government departments, to focus on andaddress health inequities and to tackle the socialdeterminants of healthThe Directorate will use anintegrated approachworking with a range ofpartners to support thedevelopment, implementationand scale up of robust, effectivepopulation health programs andto address the socialdeterminants of health
  8. 8. Health Impact PrioritiesHealth and Wellbeing DirectorateHealth andWellbeingDirectorateHealthImpactPrioritiesWell beingand MentalHealthMental disorder accounts for largest burden (23%) of diseases inEngland and affects >1 in 4 of the population at any timeMental wellbeing assoc with improved outcomes in health, education,employment, reduced crime and antisocial behaviourPublic mental health: Better assessment; interventions; prioritizationDiet,Obesity, andPhysicalExerciseAll major causes of CVD and cancer. Poor diet accounts for one third ofdeaths from cancer and CVD. Low levels of physical activity increasesthe risk CVD, colorectal and breast cancer by 20-35%. Obesityincreases risk of type II diabetes (5-13 times), hypertension (2-3 times)and colorectal cancer (3 times) in men.TobaccoControl andSmokingCessationAccounts for 20% of new cases of cancer (23%M and16%F)Tobacco causes nearly 1 in 5 deaths in England annuallyFor each death, 20 more suffer tobacco-related illnessesComprehensive cessation programs; excise tax increases; 100%smoke-free policies; media campaigns; cessation access; advertisingrestrictions work.AlcoholModerationand DrugRecoveryMuch of the cost of drug and alcohol misuse occurs to thecriminal justice system. The main costs to society from drug analcohol is from related crime. This is different to other lifestylehealth related areas and needs a different public healthresponse.HIV andSexualhealthBy the end of 2012 likely more than 100,000 PLWHA in the UKLate diagnosis a major problem with 50% diagnosed with CD4<350Millions of STD diagnosed annually, esp. among youth, MSM, minoritiesHIV/STD screening, early treatment, partner notification, socialmarketing campaigns, condom access, and policy to address stigmaand discrimination are key interventionsWhile supporting andensuring progress againstthe PHOF, the Directoratewill provide enhancedfocus on the majordrivers of mortality andmorbidity in Englandwhere further gains maybe made by scalingknown, effective strategies
  9. 9. Life Course PerspectiveHealth and Wellbeing DirectorateHealth andWellbeingDirectorateLife CoursePerspectiveHealthy Infants,Children, andYoung AdultsHealthy Adultsand OlderAdultsHealthcarePublic HealthHealthy Peoplein HealthyPlacesHealth in AllPoliciesA focus on improving health and healthoutcomes for mothers and infants, children,teens and young adultsAll people, and especially those at greater riskof health disparities, will achieve their optimallifespan with the best possible quality of health,including mental health, in every stage of lifeSupport sound decision-making and policychange within the NHS to deliver, scale up,evaluate and improve effective clinicalpreventive services that drive population healthEnsuring that the places where peoplelive, work, learn, and play will protect andpromote their health, especially thosepeople at greater risk of health disparities.Inform and support DH and other governmentpartners in sound decision-making and policychange at all levels to deliver and evaluateprogrammes and address social determinantsof health.Expert Advisors will assistPHE technical leads todevelop, implement andmonitor population health,and health and wellnessacross the lifespan in 5domains. They will alsoassist PHE in promotingthe value and impact ofthis approach to ourpartners and stakeholders.
  10. 10. Promoting Innovation for ImpactHealth and Wellbeing Directorate is committed to:• Supporting the development and delivery of high quality, effective, evidence-based prevention programmes• Using new technologies, including digital and social media, to engage andempower individuals, communities and our partners about health and well-being• Building capacity in important areas including public mental health,population healthcare, accidents injuries and violence• Working with diverse partners to encourage settings-based approaches tohealth and well-being, in addition to promoting health across the lifespan• Integrating insights from behavioural science to improve the effectiveness,efficiency, and acceptability of our programmesIntroduction to Public Health England10
  11. 11. Wellbeing and Mental Health – A PHE PriorityPublic Health’s role in improving Mental Health•Mental health is fundamental to our overall health and wellbeing.•Mental ill-health accounts for nearly a quarter of the total burden of illness,costs the economy over £105 billion every year, is associated with poorerphysical health and premature mortality, and at any one point in time, a quarterof the population are affected by a mental health problem.•There is good quality evidence that improving mental health over the lifecourse, in neighborhoods, with communities and across key settings has a widerange of health, social, educational and economic benefits to individuals,families and communities as well as helping to reduce crime, anti-socialbehavior and inequalities in health and wellbeing.11 PHE’s Mental Health Programme 2013
  12. 12. Public Health and Mental Health: Whereare we now?•Positives–Encouraging and growing evidencebase of interventions–Encouraging and improving metrics–A developing ‘community of interest’ isemerging–Desire for more integrated andinnovative approaches that focus onwellbeing–Local Government has the potential toget ‘mental wellbeing’ and drive changes–Some examples of good and growingpractice across the country (and fromoverseas)–Strong policy and strategic framework•Areas for improvement–Low mainstream awareness,capacity and leadership–Lack of a clear ‘mainstream’narrative.–Lack of integration of mental healthacross public health and healthimprovement actions andprogrammes–Poor linkages between mental andphysical health–No significant national leadership formental health in public health–No national implementation plan formental health in public health12 PHE’s Mental Health Programme 2013
  13. 13. PHE’s Mental Health Programme• Programme Aim: To integrate mental health across PHE’s corefunctions and priorities, working with key partners - Local Government, theNHS CB, VCS, DH, OGDs and others – to accelerate health impact.• Programme Objectives: PHE’s mental health programme willprovide an enhanced focus on:• Addressing health inequalities: By integrating mental health within andacross PHE programmatic and health equity activities• Capacity building: By engaging, educating and supporting PHE staff andthe wider PH workforce on mental health• Implementing and scaling high impact activities: By working with, andproviding advice and support to partners to identify priority actions forimplementation13 PHE’s Mental Health Programme 2013
  14. 14. Proposed Domains for PHE Action• Improve, develop and shape the Narrative, understanding andpriority actions for mental health and wellbeing• Increase and build Workforce Capacity across the health and caresystem• Improve Knowledge and Intelligence (metrics and evidence) foraction• Achieve Sustainability of our efforts and accelerate health impact• Provide and Develop Leadership at all levels• Develop and deliver key Resources, Tools and Information14 PHE’s Mental Health Programme 2013
  15. 15. In 5 Years We Envision:15 PHE’s Mental Health Programme 2013AchievingSustainabilityAchievingSustainabilityDevelopingLeadershipDevelopingLeadershipDeliverResourcesDeliverResourcesA Proactive Local GovernmentPartnership Network, that has:-Invested in, championed, and ledchange in public mental health-Provided strategic direction andtraining locally-Engaged local communitiesPHE’s Leadership in PublicMental Health is recognised:-Nationally across the health andsocial care system-Globally for its high qualityprogrammes, training and capacitybuilding activitiesPHE is seen as a CredibleSource of information andAdvice:-Evidence Reviews published andextended-Development of quality standards,-Briefings, tools and resourcesShaping theNarrativeShaping theNarrativeBuildingCapacityBuildingCapacityMaking anImpactMaking anImpactA New NationalUnderstanding, Commitmentand Narrative on PublicMental Health:-Shared, Understood and accepted-Critical to improving the public’shealthA Network of Trained PublicMental Health ProfessionalsAcross the System:-Cadre of (>100) trainedprofessionals-Wider body of trained practitioners-Accreditation and CurriculumdevelopmentDemonstrable and RobustEvidence of Progress in:-Promoting the public’s mental health-Preventing mental illness and suicide-Improving the health and wellbeing ofpeople living with mental healthproblems
  16. 16. Our Approach: How we’ll get there16 PHE’s Mental Health Programme 2013AchievingSustainabilityAchievingSustainabilityDevelopingLeadershipDevelopingLeadershipDeliverResourcesDeliverResourcesEstablish a Local GovernmentDevelopment Network•LGA and wider local governmentengagement•LGA public mental health communityof best practice•National Network of trailblazers•Local Government developmentBuild a Leadership Programme•Professional network of nationalpublic mental health leaders•2014 international leadersconference•Establish an international network ofpublic health agencies working inmental healthInformation and Advice platformsestablished:•PHE website resources•NICE/PHE and partners evidenceand research programme leading toQuality Standards•Publications, briefings, facts sheets,tools and resourcesShaping theNarrativeShaping theNarrativeBuildingCapacityBuildingCapacityMaking anImpactMaking anImpactPHE strategic communication plan:•Digital/social media•Scientific and policy conferences•Communication tools•Articles in scientific journals•Events, annual PHE conference,support to other conferencesWorkforce Capacity and Capability:•Curriculum development andaccreditation (FPH, RCP and others)•Training courses on mental health inpublic health (RSPH and others)•Wider training and developmentprogrammes and eventsData and Indicators Identified andDeveloped:•Core metrics for monitoring mhprogramme•PHOF development•Establish new national MHIN•Systematic population surveys
  17. 17. Next Steps• Launch of PHE Mental Health Work Programme (alongsidepublication of 5 Evidence Reviews) in June, with Key Partners• Recruit PHE Mental Health team and create cross-PHE publicmental health practitioners network• Establish PHE Mental Health Programme Board• Develop specification for a National Mental Health IntelligenceNetwork• Publications – evidence reviews and key briefings as websiteresources17 PHE’s Mental Health Programme 2013
  18. 18. Preventing suicide in England:a cross-government outcomes strategyObjectives:• Reduce the suicide rate• Better support for those bereaved or affected bysuicide
  19. 19. Six areas for action• Reduce risk in high risk groups• Tailor approaches to improve mental health inspecific groups• Reduce access to the means of suicide• Provide better information and support to thosebereaved or affected by suicide• Support media in delivering sensitiveapproaches to suicide and suicidal behaviour• Support research, data collection andmonitoring
  20. 20. Making it HappenPartnerships & networks: national, regional, localLocal authorities: Public Health, Health & WellbeingBoards, social care, education, environment,housing, transportVoluntary sectorNHS England: commissioning primary care services,prison health, military health, Health visitingClinical Commissioning Groups: commissioningsecondary servicesPrisons, probation, youth justice, coroners
  21. 21. Current DH action• Reviewing “Help is at hand’ - looking for local examples of use• Developing the PHOF indicator on self-harm• Working with Royal Colleges and other professional organisationsto promote greater and appropriate involvement of families inpeoples care, and ensure practitioners are clear when they canshare information with families about a person who is having asuicidal crisis.• Publishing the first annual report on the new suicide preventionstrategy in the autumn.• Developing a website for all the data and resources about suicideand self-harm• National suicide prevention strategy advisory groupContact: helen.steele@dh.gsi.gov.uk

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