Firstly, we have to say thank you so much to everyone who made it along to our Mental health hustings the other week.
Secondly, we must apologise on behalf of the Liberal Democrats who weren’t able to attend due to several glitches in communication. Please don’t read anything into their absence on the night: that was wholly accidental and inadvertent.
As a follow-up and just in time for tomorrow’s elections, a number of those attending on April 11th and several people who couldn’t make it have asked to submit mental health related questions to the panel/parties. At the time of writing we'[d received replies from Wendy taylor of the the LibDems and Andrew Gray from the Greens.
The questions are in no particular order, and following each is the reply, firstly from the LibDems, and then that of the Green party:
“Were you to be elected, what tangible measures would you take to improve mental health and wellbeing at a) a ward level and b) city-wide?”
There are a number of ways local Councillors can be involved in promoting mental health and well-being. Within the ward I would use my role as a school Governor to make sure that schools have policies in place to identify children withe mental health problems and direct them to the appropriate services. I would ask how well the new one point of contact for children needing mental health treatment is working and what can be done to speed up access to treatment. I also believe that loneliness and isolation are major factors in poor mental health and would work with our local residents’ associations to ask them to try to include everyone in their area and encourage those on their own to attend and take part in local events. I would also work with voluntary groups to support work they are doing.
On a City-wide level, I have already been involved in reviewing mental health provision as Chair of the Health Scrutiny Committee. I would make sure the Committee continues to monitor mental health services and press the CCG to equality to mental and physical health and to make sure no-one in crisis is turned away. The STP also needs to include a strong focus on mental health services and encourage more community support.
(a) helping build up the community where it doesn’t exist automatically (Heaton is an area with high turnover and many short-term residents). Includes enabling existing community groups and networks to be more visible and better advertised to new residents (e.g. using events, noticeboards, small grants, online directories, social media).
(b) As a ‘minority’ councillor with only a small group of fellow Green councillors (or possibly a lone Green councillor), my capacity for influencing Council or NHS policy as a whole would be very limited. So I am focussing on what I could do to serve the wider mental health and wellbeing needs of all. I would be keen to work in partnership with members of other parties and the council’s mental health champion, to ensure that anything we achieve in Heaton can be applied elsewhere.
“What is your position on the ongoing saga relating to the provision of in-patient mental health beds for Newcastle?”
The Health Scrutiny Committee was involved in the review of mental health in-patient services and I took part in visits to the in-patient units at Newcastle General & in Morpeth. I was delighted when a decision was made to have in-patient services at St Nicholas hospital. as this was clearly the wish of patients and carers. It is therefore deeply disappointing that so little progress has been made so far to implement this decision and I will continue to press the CCG to sort out funding and get the work done to allow St Nicholas to become the mental health in-patient facility for Newcastle residents.
Reducing in-patient beds should be resisted, especially where community-based facilities are under strain. In particular, health scrutiny panels should be challenging proposals to relocate in-patients to places that are not well served by public transport or at greater distance from their homes (like St George’s in Morpeth), as cutting off long-stay patients from the support of family or friends can only damage their recovery. Longer-term, integrating health and social care under the management of local authorities with elected local councillors should help to re-localise such services and stop the drift towards centralised services covering huge areas, which may work on paper but ignore the realities of people’s needs and support networks.
“There’s a tension between spending on emotional wellbeing for all, the whole populace, and yet also targeting resources at those with severe and enduring mental health difficulties.How do you manage such a tension?”
These are both important issues. The priority must be to ensure those with severe and enduring mental health difficulties get the support and treatment they need as quickly as possible. Emotional well-being for the population can be improved by working with local residents, voluntary organisations, churches and residents groups to make sure there are activities available to get the community together. I want all residents to be able to feel part of their local community and that members of the community care about them.
This tension underlines the need to find local solutions from within the community, rather than drawing on central Council or NHS funds which at a time of austerity and growing several mental distress need to be targetted. My hope is that whole populace/community-based services can be integrated with targetting spending and NHS services via a project like ‘Compassionate Frome’ (or Newcastle’s fledgling ‘Canny City’), so that the benefits of wider support bolster rather than undermine targetted and specialist support. This is part of creating the ‘resilient places and strong communities’ identified in the Psychologists Against Austerity report.
“As a former solicitor who left the profession on the cusp of burning out, I retrained as a personal trainer because exercise and nutrition was key in me managing my own high stress levels during low times. I’m now trying to pass those benefits on to others in the workplace and more generally.
Research demonstrates that exercise and nutrition have not only a preventative effect against some mental health conditions, such as anxiety and depression, but also represent a cost effective or often free method of treatment of the same once diagnosed. Moreover, they can be commenced immediately, with an instant positive effect, whilst the benefits of other methods of treatment are awaited, such as pharmacological intervention or talking therapies. They are also relevant to all age groups and can be a fantastic method of combating the social isolation often encountered, such as the Pie Club Mick referred to. I’m therefore interested in the plans for provision and/or funding which each of the candidates intends to implement or maintain re sports, exercise and nutrition.”
As a doctor I’m well aware of the benefits of exercise in many areas of health, such as reducing fatigue and improving well-being. I was responsible for implementing the “Mile a day” for children at Cragside Primary School and would encourage other schools to take this up. It has been shown to improve concentration as well as improving physical health, which in turn can improve mental health. By encouraging daily exercise for children, I would hope this will continue into adult life. I would want to look at ways of increasing social prescribing by GPs to include exercise in various ways to suit all individuals and to get more Community Pharmacies to become healthy living pharmacies and give local people advice on life-style to improve their well-being.
Recognising that multiple factors contribute to mental health is at the heart of Green thinking, including sport, exercise, nutrition and other aspects of healthy and active living. We are lucky in Heaton to have good green spaces to support outdoor exercise and well-being on each side of the ward: councillors will need to ensure that public health in its widest sense continues to be recognised as a key part of the remit for our city’s parks and allotments. More generally, councillors can help to promote (and sometimes to kick-start with funding) clubs and grassroots initiatives. Support for such groups across the city is more important in my view than more eye-catching projects like hosting big national sporting events.
“a) What has worked well, in relation to mental health and wellbeing for you?
b) What hasn’t worked well, in relation to mental health and wellbeing for you?
c) In an ideal world, what would things look like when it comes to mental health?”
a) What has worked well is seeing mental health services in practice and working with the mental health trust to try and imporve services. There is still a lot of work to do, but I’m encouraged by the move towards better community support and treatment
b) I was shocked when I failed to recognize that a close family member was suffering from depression and would want to make sure that information is readily available to make sure that mental health issues are detected quickly and support provided.
c) It would go a long way towards an ideal world for mental health services if the proposals in the Liberal Democrat manifesto for 2017 were to be implemented as follows:-
● Ringfence funding from within a one penny Income Tax rise, to provide additional investment in mental health.
● Continue to roll out access and waiting time standards for children, young people and adults. This will include a guarantee that people will not wait more than six weeks for therapy for depression or anxiety and no young person will wait more than two weeks for treatment when they experience a first episode of psychosis.
● Increase access to clinically- and cost-effective talking therapies so that hundreds of thousands more people can receive this support.
● Examine the case for introducing a dedicated service for children and young people based on the Australian ‘headspace’ model and building on many excellent youth information, advice and counselling services.
● Transform mental health support for pregnant women, new mothers and those who have experienced miscarriage or stillbirth, and help them get early care when needed.
● Continue to promote and invest in the Frontline programme to fast-track exceptional graduates into children’s social work, as well as the Think Ahead scheme aimed at encouraging high-achieving graduates to pursue a career in mental health social work.
● Ensure that no one in crisis is turned away, with new waiting time standards and better crisis care in accident and emergency departments, in the community and via phone lines. This will enable us to end the use of police cells for people facing a mental health crisis.
● End out-of-area placements, ensuring those admitted to hospital for mental ill-health are able to be treated close to home.
● Ensure that all front-line public service professionals, including in schools and universities, receive better training in mental health.
● Roll out the Liaison and Diversion programme nationally, helping to identify people who have mental health problems, learning disabilities, substance misuse or other vulnerabilities when they first come into contact with the criminal justice system.
● Tackle stigma against mental ill-health, including by building on the good work done by organisations such as Heads Together and changing the standard of proof in suicide conclusions in the Coroner’s Court.
● Ensure that LGBT+ inclusive mental health services receive funding and support.
a) A loving relationship, secure work on a slightly part-time basis (80%), daily commute involving walking through trees.
b) Routine stresses have included working too long hours, working with colleagues who are unhappy or undervalued, and silly ideas from over-paid senior managers.
c) Joined up policies across multiple areas of government could do a lot to improve mental health. So ending workfare and making work pay better will bring security and encourage better mental health. The Universal Basic Income would free people from the treadmill of ‘work at any cost’, supporting a more caring society, more part-time work and genuine self-employment, and the cliff edge of means-tested benefits: all these things would lower stress levels and enable better health care and prevention all round.