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Healthier Communities: implementation themes • The current trends in global healthcare • What people admire about England’s mental health developments • Making population health happen in practice • Case examples of population mental health • Digital, information, tech and estates, workforce key enablers • Mental health leadership: what makes for successes Geraldine Strathdee: Co-founder, Zero Suicide Alliance Mental health consultant working globally on population mental and integrated healthcare policy, strategy, leadership and informatics for quality improvement Join @DrG_NHS solution focussed twitter community
What’s it all for ? • What are people’s needs • What outcomes do they want, and who decides • How do we provide proven effective therapeutic interventions • What scale is the most efficient to achieve the best outcomes & value
Global respect for our approach in England :
Our People’s revolution : We have changed our societal ‘DNA’ & reduced stigma
Integration of mental health into the DNA of our culture, public awareness & media
‘Mental health is everyone’s business’ Integration’ of mental health into national policy, Cross Party and cross government
The People’s frontline and citizens leaders revolution with 32 million using the mental health section of NHS Choices by 2016
Transformational health policies for population approach & including mental health
• ‘Five Forward View’ NHS policy for Populations, mental health & integration approaches ( 2015-2020)
• 10 year NHS Plan’ direction for integration of populations, pathways, organizations, systems (2021-
Our ‘seen as awesome’ mental health informatics developments & commitment to Global Digital
Exemplars
Case examples : the methods, challenges, success, learning
The People’s health revolution :the integration of mental health into the DNA of our society & daily lives
NHS Choices user led website that 32 million people/ year hit this site to get mental health information & tools
NHS | Presentation to [XXXX Company] | [Type Date] 4
England’s mental health social movement: our success methods to date
and useful learning for the next 10 years
• Encourage and listen to people’s real life stories
• Help them tell their compelling stories
• The media are our greatest friend and powerful communicators
• ‘Mental health’ is not one homogenous mass, its personal
• Support the families who advocate with practical voice for their loved ones with their many
different types of mental illheath
• Know the facts about the evidence for why to invest: the 3 minute ‘pitch’
• Show real money facts for individuals, organizations, cities, agencies
How can we apply population health approaches for the development of mental health & for the effective treatment of the
different types of mental ill-health at each stage of the Life Course …..
2. When people develop ill-health, a treatment model of
1. Developing Mental & physical healthy individuals and
communities and primary prevention at all ages
• Partnership with SUs
• understanding ‘together, what’s happening to you’
• Health promotion for mind and body
Education & health promotion for individuals, families & • Early recognition and intervention services
communities
• in primary, community, acute & specialist mental health
• Communities Asset building ( Thrive) • 24/7 expert Crisis response, preferably in the community
• Developing Local leadership and assets to help local
citizens have healthy, happy, thriving lives
• Anchor institutions for affirmative equalities action, • Recovery focused, holistic, planned, effective, GIRFT
workforce innovations & philanthropy treatments & care
• Primary Prevention of all avoidable ill health • Coproduction for secondary and tertiary Prevention
through universal and targeted ROI prevention
interventions for those most at risk of illhealth • Using the dynamic power of digital & scientific innovation to
• Improve access, decision support & safety
• Using the dynamic power of digital • Help people access care at home and reduce institutionalization &
• To educate & mobilise peer support networks restrictive practices
• Integration of mind/ body care in all NHS settings
• Develop Big data to identify the prevention opportunities
in the Integrated care systems • Innovations in ‘workforce’
6
Population mental health information at your Fingertips for many types of mental health
Information is the
key to informed
decision making &
continuous
improvement &
learning
We developed population profiles for every area
• to help leaders understand the needs, levels of access to care & quality in each local area
• to give clinical teams the information they need to understand the contexts in which their patients and staff live, the opportunities for
recovery for their patients and the services that are needed for happy, healthy population ……
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
7
Population health starts with understanding the key
socio determinants & common root causes of mental ill-health in the place you live and work
Bullied children
In school & home
Young carers
CYP with Dyslexia/
dyspraxia
Teenage pregnancies
CYP who are gang
culture Victims
Dr G Strathdee leadership modules Introduction Oct 2017 8
The Knowledge Guides provide information on how to respond to local need and inform the
Local Joint strategic needs assessment planning in every area for each life course generation
9
Population health means building Community Assets Integrated partnership vision, plans, open transparent evaluation : ZSA Digital ‘Go to’ resource The Zero Suicide Alliance is keen to get your expert views on how we can best help you
Case study: Population mental health for a 250,000 population in one of the most deprived areas in London
the Lambeth Alliance for affirmative action & Thrive community using data & evidence
Population health data showed that
BAME community & need for Lambeth Alliance set out to
universal and targeted action
Lambeth’s • Improve housing (Lambeth
Housing Standard)
BAME community
• Education (Attainment of Black
- Live in poverty Caribbean pupils)
- In poorer housing • Decent jobs and training (Brixton
- Underachieve academically Business innovation development)
- More excluded from school • Parenting support (Sure Start &
- More victim/perpetrator of crime LEAP
- Suffer worse physical ill health • Lifestyle education (risky
- Lower life expectancy
behaviour)
• Pride (Black Cultural Archive,
- Not take up early intervention or
psychological therapy services Windrush Square, Black War
Memorial, Mary Seacole)
Slides C/O Councillor Ed DavieLambeth Population Alliance : evaluated health & wealth successes
Integrated Alliance Contracts
Successful affirmative community Changing model of mental health
services with Red lines between the key agencies
asset building & prevention action
• Open access Hub with proportionate GP sector
• Retained all Sure Start centres 95% of BME users
schools are ‘good’ or ‘outstanding’ with • Perinatal integrated care
exam results in country’s top 10% • Early Intervention Psychosis &
• Early Intervention eating disorders Specialist MH
• Created most affordable homes Local Council
• Talking therapies provider
• Created more jobs and new businesses • Training of community leaders in trauma
informed approaches
• Reduced child obesity against trend • Social prescribing in primary care
• London Living Wage employer with • More representative staff in local Anchor
10/1 pay ratio institutions
• Mosaic Clubhouse for Recovery
• Evening Sanctuary Specialist Care and
• Development of shared information for Housing housing
Public sector equalities duty and for provider provider
shared clinical care and coproduced
Crisis response plans
NHS 70 exemplar for the future population healthWho do we value? Population health needs aligned strategies across organizations
When people feel worthless
and powerless they get ill. Information for improvement
& building Trust between
Celebrating local role models is partners
important Building integrated working
requires shared information &
coproduced improvementsCase Study: Population health at scale needs information & trusting, focused relationships
London successes through use of Integrated information, services & partnerships
Shared information to build Trust & plan high impact improvements across organizations with Digital capability
Thrive London aims
• London now has a shared information dashboard between MH commissioners and providers & other partners joining
• A city where individuals
Improving crisis response & Reducing police cells use for the mentally ill and communities take the
• In London detention rates in police cells fell over 4 years from 4000 to less than 20 a year now lead
• British Transport police identified the impacts of mobile populations & mobilized for suicide prevention with training, safety plans,
joint hubs
• A city free from mental
• London has ‘at scale’ evaluated purpose built ‘at scale’ mental health crisis suites for 1 million population ( Slam health stigma and
https://www.healthylondon.org/wp-content/uploads/2017/12/SLaM-Centralised-Health-Based-Place-of-Safety-Evaluation-Nov-2017.pdf
discrimination
Shared ‘win win’ targets across organizations : • A city that maximises the
• London CEOs have a ‘compact’ : No 12 hour breaches, No 24 hour S 136 breaches, no cancelled community assessments, shared potential of children and
winter pressure funds
• Liaison teams in every Eds, but now aiming for Core 24 standards and Rcpsych PLAN accreditation
young people
https://www.rcpsych.ac.uk/improving-care/ccqi/quality-networks-accreditation/psychiatric-liaison-accreditation-network-plan • A city with a happy, healthy
Integrated physical and mental health into 52 long terms conditions pathways is progressing in South London and productive workforce
• 52 integrated depression and anxiety assessments in long term conditions pathways • A city with service that are
Pan city network of SUs, carers, doctors, nurses, pharmacists, psychological therapists, 3rd sector charities drive there when, and where
rapid improvements & Innovations needed
• 56% reduction in the use of antipsychotic prescribing in dementia
• A zero suicide city
Digital First pathways for Digital ‘native’ generations
• Digital First ADHD pathways between children, parents and schools in Oxleas NHSFTCase studies of Digital First :
Swindon consultation with the younger generations are very clear what information they want to codesign ( see below)
what they want to be physically and mentally healthy & they want digital services blended with face to face
Oxleas Greenwich CYP, parents, Teachers Digital ADHD service with Health Foundation evaluation
Berkshire Eating disorder programme
Must have topics
Ability to
Anxiety/Depressi Anger How to Help
understand Self harm
on Management
Bullying
Others
your health
assessment
Wider than Information
just mental on specific
health topics
Should have
Online
Relationships Domestic Violence Drugs Parents Section
Offer
Your rights
Links to
– what to
help
expect
Could have
Methods of
coping Eating disorders School Life Coping with Parents
Thanks to Angela Snowling , Swindon public heathThe Zero Suicide Alliance membership and stakeholders are looking at Digital futures to
• Faster education and customized knowledge
The Zero Suicide Alliance is
developing a Go To digital
• Game changing access & blended digital and traditional care
platform based on what our
• Game changing continuity and safer home care through digital monitoring members and stakeholders tell
• Game changing sharing of information us they need
• Game changing digital care records decision supports
Come to Bristol on July 9th and
• Transformations in safety of care
tell us your views
• Zoom skype multi site healthcare developments
• ‘Big data’ informatics to target high impact system opportunities for prevention
• Virtual ‘Sim city’ digital design for therapeutic Estates and GIRFT pathways
• Digital economic modelling to drive ROI care
• Priority starter is primary care decision supportsThe NHS plans towards population health & integrated care & systems : integrated, modern, therapeutic designed estates with digital enablers are key to improved safety, effectiveness, aligned care & ROI
National audit of Psychosis care in England : evidence based integrated care, access standards, routine outcome measurement : why is our commissioning and clinical practice not improving faster ? The National Audit of Psychosis & several studies found: • Major variation in the commissioning and provision of evidence based NICE care • Lack of consistent medicine safety and medicines optimization • Co produced care plans with advance decisions needed to reduce repeat admissions & detentions • Only 11% supported to get education, training, employment • 20 year premature mortality with the current levels of primary care physical health care • 18 How| will this most inequitable of all care provision be addressed in our new planned ICS world
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