NO HEALTH WITHOUT PUBLIC MENTAL HEALTH POLICY & PRIORITIES – NORTH & SOUTH

1. NO HEALTH WITHOUT PUBLIC MENTAL HEALTH
POLICY & PRIORITIES – NORTH & SOUTH
Gerard Collins & Kate O’Flaherty
November 2017

2. What is public mental health?

3. Source – Well Scotland. Adapted from K. Tudor, ‘Mental Health Promotion:
Paradigms and Practice’, 1996

4. The Big Picture
• WHO – Major global concern, a main cause of the
burden of disease worldwide; largest single source of
economic burden (£1.6 trillion).
• Europe - 20% of the burden of disease; 27% of the
adult population.
• UK – Largest burden of disease (28%), costs up to
4.5% of GDP.
• NI – Greater mental health needs than England, costs
up to £1.0 billion?

5. NI – The need for action
• High levels of poverty & economic inactivity
• 29,100 incidents of domestic abuse
• High rates of self-harm & suicide
• The “Troubles” & PTSD
• Adverse childhood experiences; 40k children
affected by parental substance misuse
• Behaviour problems in children – 10%
• High rates of mental illness

7. GHQ respondents scoring 4 or higher 2014/15
No mental health
condition
79%
Diagnosed mental
health condition
20%
Undiagosed mental
health condition
1%

11. Bamford Review & Response
• Better services
• Support for carers
• Supporting people
• Better structures
• Health & wellbeing
• Psychological therapies
• Perinatal mental health
• Service Framework
• Recovery approach
• Crisis response
• Re-settlement
• Schools, workplaces
• Trauma
• Legislation
• Physical health

12. Mental Capacity Act (NI) 2016
 Decision-making framework in relation to acts that require
consent where person lacks capacity to consent
 100 enabling powers
 Safeguards to protect rights & interests of person who
lacks capacity
 Rights-based approach to strengthen personal autonomy
 Remove legislative discrimination against those with a
mental health problem
 Codifies common law defence of necessity into a
protection from liability for acts that otherwise would
require consent.

13. Programme for Government Outcomes
Long,
healthy
active lives
Safe
communities
Best start
in life
Care for
others &
help those
in need
A shared
society
A more
equal
society
More
people
working in
better jobs

14. PfG Action Plans
 Improve mental health
 Reduce preventable deaths
 Reduce health inequality
 Reduce poverty
 Reduce crime
 Improve self-efficacy
 Improve child development (pre-school)

15. Improve Mental Health

16. PfG actions on mental health & wellbeing
• Parity of esteem –
meeting physical health
needs
• Improving CAMHS &
ADHD provision
• Perinatal mental health
• Eating disorders
• Stigma
• Early years & infant
mental health
• Mental trauma service
• Psychological therapies
• Mental health &
wellbeing in education
• Looked after children
• Employment support
• Addiction services
• Suicide & self-harm
• Recovery colleges

17. Evidence base

18. Positive Mental Health Plan
 We enjoy long, healthy lives with
positive mental health throughout
 Promote positive mental health
for all; prevent mental health
problems

19. Best start Developing well
Living &
working
well
Ageing well
Awareness raising
Resilient
communities

20. Gaps & Scale
• Family Nurse
Partnership
• Psychological therapies
• Crisis services
• Assertive outreach
• Evaluation
• Primary care training
• Social prescribing
• Service integration
• Stigma
• Serious adverse
incident reporting