Mental Health and Learning Disabilities Priorities

The vision for the South Yorkshire and Bassetlaw Integrated Care System (ICS) Mental Health and Learning Disabilities (MHLD) workstream is to provide holistic services, delivering the right support and care, in the right setting, by the right people. This includes the increasing need for prevention services, the process of returning patients to a hospital that is closer to their home and to the least restrictive environments, appropriate to the patient's health.

Overview

The vision for the South Yorkshire and Bassetlaw Integrated Care System (ICS) Mental Health and Learning Disabilities (MHLD) workstream is to provide holistic services, delivering the right support and care, in the right setting, by the right people. This includes the increasing need for prevention services, the process of returning patients to a hospital that is closer to their home and to the least restrictive environments, appropriate to the patient's health.

In  2018 it was agreed the following six priority areas of work would be taken forward into 2018/19.

We have six overarching priorities in SYB these include:

  1. Out of area placements
  2. Perinatal mental health
  3. Children’s and Young People’s (CYP) mental health crisis pathways
  4. Autistic spectrum conditions (ASC) and Adult Attention Deficit Hyperactivity Disorder (ADHD)
  5. Mental Health and Employment
  6. Suicide prevention

These programmes of work have been identified as areas that could be delivered to maximum benefits and add particular value at system level. The MHLD work programme will also be focussing on our ability to deliver collaboratively with other ICS work programmes including collaboration with the Urgent and Emergency Care (U&EC) workstream; didgital, workforce and data and finance workstreams.

 

Out of Area Placements

This requires partnership work with many organisations, such as NHS England, Clinical Commissioning Groups (CCGs) and Mental Health Providers, so we can seek to reduce and work towards eliminating non-specialist/inappropriate out of area placements by 2021.

We are doing this so we can better support those mental health patients experiencing an acute or a 'crisis' episode during their mental illness. We are also identifying opportunities to reduce specialist out of area placements for complex dementia placements and those people with mental disorders, which make them a potential risk to others.

Providing high quality treatment and care, in the least restrictive setting, close to home can help people achieve better health outcomes. Reducing variation can also eliminate high costs.

Read more at a national level: https://www.england.nhs.uk/blog/transforming-services-for-forensic-patients/

Perinatal Mental Health

Perinatal Mental Health is about supporting women who are struggling with mental health problems while pregnant or have given birth within the last year. Support to Dads is also included within this service offer. It was announced in May 2018, that South Yorkshire and Bassetlaw would receive £880,000 to improve in hospital and home mental health services for new and expectant mothers. The funds, which have been made available will mean women will benefit by having access to specialist treatment in community services closer to home or inpatient mother and baby units when they need it. Specialist community perinatal mental health teams can offer psychiatric and psychological assessments and care for women with complex or severe mental health problems during and after pregnancy. They can also provide pre-conception advice for women who are planning a pregnancy and have a current or past severe mental illness. Helping women who are expecting a child or have just given birth to overcome, or better manage, mental ill health will go a long way to improving the lives of those women at what is a crucial time for them.

Children’s and Young People’s (CYP) Mental Health Crisis Pathways

It is important that we standardise and improve services for children and young people with serious mental health problems. We aim to ensure that those who need it will be able to receive the best care and treatment at home or as close to home as possible. In order to achieve this ambition we endeavour to work closely with our Local Authority partners. It remains an NHS priority to stop children and young people reaching crisis point by diagnosing and treating them at the earliest opportunity. This has long been a government concern. It is however an area where SYB performs well compared to counterparts across the country where instances reported are much higher. A national case for change can be read here: https://www.england.nhs.uk/2017/03/nhs-acts-to-cut-inappropriate-out-of-area-placements-for-children-and-young-people-in-mental-health-crisis/ Across SYB the main focus of our work will be to lead on the development on a new care model for Children and Young People’s mental health, including the re-configuration of acute in-patient mental health beds. The primary purpose is to configure resources across the geographical footprint in the most effective manner, to better support Children and Young People at the earliest possible stage, in a community setting and as such reduce episodes of acute difficulties. The ultimate aim is to improve outcomes for Children and Young People.

It is important that we standardise and improve services for children and young people with serious mental health problems. We aim to ensure that those who need it will be able to receive the best care and treatment at home or as close to home as possible.

In order to achieve this ambition we endeavour to work closely with our Local Authority partners. It remains an NHS priority to stop children and young people reaching crisis point by diagnosing and treating them at the earliest opportunity.


This has long been a government concern. It is however an area where SYB performs well compared to counterparts across the country where instances reported are much higher.


A national case for change can be read here: https://www.england.nhs.uk/2017/03/nhs-acts-to-cut-inappropriate-out-of-area-placements-for-children-and-young-people-in-mental-health-crisis/


Across SYB the main focus of our work will be to lead on the development on a new care model for Children and Young People’s mental health, including the re-configuration of acute in-patient mental health beds. The primary purpose is to configure resources across the geographical footprint in the most effective manner, to better support Children and Young People at the earliest possible stage, in a community setting and as such reduce episodes of acute difficulties. The ultimate aim is to improve outcomes for Children and Young People.
 

Autistic Spectrum Conditions (ASC) and Adult Attention Deficit Hyperactivity Disorder (ADHD)

We are working to develop a standardised SYB pathway for autistic spectrum conditions and ADHD.

Autism spectrum conditions (ASC) is a common neurodevelopmental disorder characterised by persistent difficulties (since early childhood) across social communication and limited, repetitive interests and behaviours. There is increasing recognition that ASC is a lifelong neurodevelopmental disorder however, service provision for adults who receive a health diagnosis requires further development as pathways for post-diagnosis support remains limited and child focused.

Learning Disabilities (TILE)

The Transforming Care Partnership work focusses on improved quality of life, improved quality of care and reducing reliance on inpatient settings for people with a learning disability. More information can be found at Transforming Care Partnerships 

Mental Health and Employment

We know that being in steady employment offers many benefits not only to a person’s physical and mental health, but their entire wellbeing and this initiative is exactly the kind of thing that will help us as a region achieve our goal of ensuring everyone in South Yorkshire and Bassetlaw has the support to be healthy and live well, for longer.

300,000 people in work with a long term mental health condition lose their jobs every year. (Thriving at Work, October 2017). Being out of work or suffering from work-related stress can have a range of negative impacts, making it more likely a person will report ill health and worsening recovery from conditions like heart disease.

WorkingWin the health-led employment trial in the region is testing out a new form of employment support for people who have a mental health condition and/or a disability (e.g. MSK; Musculoskeletal Conditions ) with the aim of getting people back into work, continue working and improving our population’s overall wellbeing.

Health Professionals such as GPs, can refer to the programme but people are able to self-refer at www.workingwin.com

SYB ICS is also working to improve access to Individual Placement and Support (IPS) for people with serious mental illness (SMI). Doubling access to IPS for people with SMI by 2020/21 is one of the targets in the Five Year Forward View for Mental Health. IPS is an evidence based model of intensive employment support, aimed at rapidly getting people into work and continuing to support them for a time-limited period, alongside working with potential employers to improve the range of employment opportunities for people with health conditions.

Suicide Prevention

South Yorkshire and Bassetlaw is one of the areas of the country that has a high suicide rate, particularly among men between the ages of 30 – 50, but there are things we can do to reduce the rate of suicide and partners across the ICS are working collaboratively to help achieve a reduction in death by suicide and a reduction in self-harm.

In May 2018, mental health services received £555,000 in order to help in the fight against suicide across South Yorkshire and Bassetlaw. The money will be spent on a number of initiatives including training staff to understand the tell-tale signs and to improve communication systems between organisations, so medical professionals can understand whether a patient is at risk of suicide when they come into contact with them. The main aim of suicide prevention work is to reduce the number of suicides in South Yorkshire and Bassetlaw by 10 per cent.

Funding will be used to provide self-harm and suicide awareness training for all staff in GP practices which include how to intervene when suicide is suspected. Those who lose a loved one because of suicide will receive bespoke bereavement support. It is understood that those who have a family member who has taken their own life are more likely to do the same. 

A large scale campaign on emotional wellbeing in men across SYB will be developed and specific work around key risk factors for suicide in men; such as debt, housing issues, substance misuse, relationship breakdown and loneliness will be undertaken.

Our efforts to undertake this work across the SYB geography will be done by focusing on these areas of work:

-        Real time surveillance

-        Bereavement support

-        Work alongside the media

-        Retrospective coroners audit

 

Real time survelliance 

We recently held an event in association with the Innovation Unit about Real Time Surveillance. Real-time suicide surveillance is a system that enables consideration of interventions required after a death has occurred where the circumstances suggest suicide in advance of the coroner’s conclusion. This workshop involved a considerable number of partners from Trusts, CCGs, South Yorkshire Police and the British Transport Police. 

This potential development is an innovative and forward thinking move for SYB by helping better understand the reasons someone may have taken their own life; provide those affected or bereaved by suicide timely and evidence based support and provide localities access to information to enable them to learn lessons to prevent further loss of life.

Everyone’s Business

There are many individual risk factors for someone to take their own life. Research also indicates that deprivation, alcohol and drug usage can put someone at an increased risk. The fact is that not everyone who takes their own life is known to services or ever raised their mental health as a concern to a GP or Health Professional.

Of those that take their own life:

1/3 will have seen a mental health professional

1/3 will have seen their GP

1/3 will have seen no one

This really is everyone’s business and why partnerships with the voluntary and community sector, football clubs, prisons, workplaces and increasing community capacity is important to reach out to those who are potentially having mental health difficulties. No one should have no one, reducing loneliness and isolation and reducing the stigma around mental health difficulties should be everyone’s responsibility as part of their own wellbeing and that of others.

Helping Hands to offer support

-        Samaritans

-        Dealing with the guilt of suicide 

-        Loneliness in older age

 

Nation Resources and Publications 

Suicide Prevention Programme Newsletter February 2019

In May 2019 we held an event with local partners where we looked at the aftermath of suicide and the role of the media