Skip to main content
Access keys Home News Site map Site help Complaints Terms Contact us

10.1 Key findings by chapter

Chapter 3: South Gloucestershire Population Profile

  • The population age structure in South Gloucestershire is very similar to the national average with 58.4% of the population aged between 20 and 60 years and 17.5% aged 65 years and over
  • The black and minority ethnic (BME) population has doubled from 2001 to 2011
  • Although South Gloucestershire is a relatively affluent region, there are six localities known as Priority Neighbourhoods with high levels of deprivation and which face the greatest health inequalities: Cadbury Heath, Filton, Kingswood, Patchway, Staple Hill and West Yate/Doddington
  • The population will continue to grow; the elderly population in particular will grow rapidly

Chapter 4: Determinants of Mental Health and Wellbeing

  • In South Gloucestershire, vulnerable groups at high risk of mental ill health include people living in Priority Neighbourhoods, the unemployed, people with disabilities, prisoners, the Lesbian, Gay, Bisexual and Trans (LGBT) group, Gypsies and Travellers, substance misusers (including alcohol misusers), smokers, people with long term conditions and victims of domestic abuse
  • There is an increasing trend in the reporting of dual diagnoses of mental illness and substance misuse in South Gloucestershire, possibly due to better integration of drug and alcohol services with mental health services, better data recording or increased confidence of service users in reporting

Chapter 5: Mental and emotional wellbeing in South Gloucestershire

  • For self-reported wellbeing, South Gloucestershire scored marginally better than the English average. Nationally, lower levels of subjective wellbeing were seen in men, people aged over 80 years, people from Black ethnic groups, single men and women, people with poor health and people with disability
  • There are no local data regarding stigma and discrimination in relation to mental illness. However, nationally, attitudes towards integrating people with mental illness into the community have improved and more people would be willing in the future to continue a relationship, work with, live with or live nearby someone with a mental health problem. Service users’ views on stigma and discrimination are described in Chapter 9
  • 1 in 2 adult carers in South Gloucestershire have as much social contact as they would like which is better than the national average
  • Two thirds of respondents to the South Gloucestershire Viewpoint Survey indicated that they had as much social contact as they would like
  • Respondents with a disability were more than twice as likely to feel socially isolated compared with those who did not have a disability

Chapter 6: Prevalence of mental health conditions

  • The prevalence of all common mental health conditions such as anxiety and depression will increase, based on projections until 2020
  • The highest rate of mental health admissions to hospital were from GP practices located in Priority Neighbourhoods
  • With the exception of eating disorders, the prevalence of mental health conditions was higher in people from the most deprived socioeconomic quintiles and those from Priority Neighbourhoods
  • The prevalence of depression based on patients on the Quality and Outcomes Framework (QOF) depression register was higher for South Gloucestershire GP practices than nationally
  • Although South Gloucestershire had better achievement results than England for all of the QOF depression indicators, achievement results for some of the depression and mental health indicators were worse for GP practices where the majority of patients were from Priority Neighbourhoods compared with other GP practices
  • Hospital admissions for depression have increased in the last 5 years
  • The QOF prevalence of patients on the mental health register (i.e. people with schizophrenia, bipolar disorder and other psychoses) was lower in South Gloucestershire than nationally
  • South Gloucestershire patients on the QOF mental health register were less likely to have a care plan than nationally
  • There were no local data on the prevalence of people with personality disorders
  • In South Gloucestershire adults with learning difficulties were less likely to live in settled accommodation, more likely to live in non-settled accommodation and less likely to receive community or day care services from the local authority
  • Main reasons for hospital admissions for people with learning difficulties included mental illness, challenging behaviour, autism spectrum conditions, personality disorders and self-harm
  • The number of people with autism spectrum conditions is expected to increase
  • On average people waited 10 months before they were seen for diagnosis of an autism spectrum condition in South Gloucestershire. Waiting time was less (3 months) for people with adult attention deficit hyperactivity disorder (ADHD)
  • Hospital attendances and admissions for self-harm have increased in the last 10 years; young females have the highest risk. Self-poisoning was the most common method and paracetamol was the most frequently ingested poison. Most patients presenting to hospital for self-harm had a previous history of self-harm or a history of previous psychiatric treatment
  • Three quarters of suicide deaths occur in males. The male suicide rate in South Gloucestershire was higher in 2010 than 2001. Although men aged 25-44 had the highest proportion of deaths, suicide rates were highest in older men. Suicide rates were highest in the most deprived quintile. Hanging was the most common suicide method, followed by poisoning

Chapter 7: Findings from Public Health England’s Mental Health Intelligence Network and the Care Quality Commission’s (CQC) Thematic Data Review Report

  • South Gloucestershire was lower than England for the following MHDN indicators: depression QOF incidence in adults, depression and anxiety prevalence, QOF prevalence of mental health problems, spend on mental health in specialist services, percentage of secondary care funding spent on mental health, carer assessments for people who care for an adult with a mental health condition, carers of mental health clients receiving services, emergency hospital admissions per 100,000 individuals for self-harm, depression and neuroses, rate of new social care assessments per year for mental health clients and social care mental health clients receiving home care during the year.
  • South Gloucestershire was higher than England for the following MHDN indicators: depression QOF prevalence, percentage of mental health service users in hospital, percentage of patients with severity of depression assessed, percentage of Care Programme Approach (CPA) adults in settled accommodation, percentage of CPA adults in employment, percentage employment of people with mental health disorders.
  • Key findings from the CQC’s Thematic review are as follows. South Gloucestershire’s performance was worse that England for the percentage of people with severe mental illness with a comprehensive care plan in place. Compared with national figures, in South Gloucestershire there was higher bed occupancy compared to expected standards and higher numbers of emergency admissions for mood disorders, schizophrenia and self-harm than expected. More people in South Gloucestershire gave negative responses to questions about the quality and effectiveness of mental health services on group surveys.

Chapter 8: Mental Health Services

  • There was a 6.3% increase in caseload to the Avon and Wiltshire Mental Health Partnership (AWP) Community Mental Health Services from 2009/2010 to 2013/2014. The most frequently used services were the Memory Service, Complex Intervention and Treatment, Recovery, Psychology service and Primary Care Liaison Service
  • Emergency admissions to AWP services increased in 2013/2014 and were highest in three age groups (35-44 year olds, 25-34 year olds and 75-84 year olds). Most readmissions occurred more than 1 year after the original admission
  • The highest numbers of emergency admissions to AWP services were from wards in Priority Neighbourhoods
  • The number of adult acute beds per 100,000 population was less for all six AWP CCGs (Swindon, Wiltshire, North Somerset, Bath and North East Somerset, Bristol, South Gloucestershire) than nationally
  • Inpatient usage for adult acute services exceeded 100% bed occupancy for most of October 2014; out of trust placements were also high
  • Inpatient usage for older adult acute services was at or above 100% bed occupancy for 13 days in October 2014; out of trust placements occurred throughout the month
  • South Gloucestershire exceeded the national target of 7.5% for delayed transfers of care (DTOC) from August 2013 to January 2014. The number of DTOC service users in South Gloucestershire increased from January 2014 to July 2014. Most of the South Gloucestershire DTOCs occurred in AWPs Later Life service (Laurel Ward at Callington Road) where 10% of beds were closed due to concerns regarding the safety of staff and patients driven by difficulties in caring for a small but growing number of increasingly challenging patients
  • In South Gloucestershire, the number of people entering the Improving Access to Psychological Therapies (IAPT) programme increased from November 2012 to September 2014. However, the number of people waiting >28 days to start treatment also increased. Although the number of people completing treatment showed an increasing trend the recovery rate has decreased over time. At the end of September 2014, the recovery rate was 32.8%. The national target of 50% was not achieved throughout the entire time period from December 2012 to September 2014
  • There were a small number of Section 136 admissions from February to April 2014 (32). Most were male, of White British ethnicity and aged 26-45 years. All were transferred to the place of safety via police vehicle. The majority of admissions were out of hours. Almost 50% of patients waited >12 hours until assessment and 53% stayed longer than 12 hours overall
  • The allocated average spend per head for mental health in South Gloucestershire in 2011/2012 was £147 compared to the English average of £183.This was estimated as the worst spend in England. Using newer 2014 data the mental health spend in South Gloucestershire was £153 per head, compared with a national spend of £210 per head
  • According to the Spend and Outcome Tool (SPOT), South Gloucestershire had lower spend on mental health with better outcome
  • There is increasing spend on antidepressants, hypnotics, CNS stimulants and drugs used for ADHD in South Gloucestershire

Chapter 9: What do local people think? Perspectives from service users and local community and voluntary organisations

Service users’ perspectives

  • Voluntary Community Social Enterprise (VSCE) organisations were felt to play an important role in promoting recovery
  • Peer support groups were mentioned in positive terms and should be better resourced
  • There were ongoing problems with the consistency and continuity of care received by mental health service users
  • Post crisis support in primary and community care needed to be improved
  • There were issues around talking therapies, particularly with respect to access and referrals. The difficulty in receiving 1:1 appointments was highlighted
  • Service users found it difficult to access services and be referred to services
  • There was uncertainty regarding access to VSCE services. GP knowledge regarding how to access these services varied. Places suggested as good locations for dissemination of information included GP practices, churches, sports centres, shopping centres, one stop shops and libraries. Service users felt that information should be available as hard copies in addition to the internet. The important role of GPs in signposting to services was emphasised
  • Service users identified a need for improved joint working across agencies and better coordination of services
  • Service users wanted greater involvement and the ability to actually influence and play a role in commissioning new services. They wanted this role to be sustainable
  • All service users experienced stigma and felt that the general public had negative attitudes towards people with mental illness. They felt discomfort in telling employers about their history of mental illness. In some instances family members and GPs were unsupportive and dismissive of their mental health issues
  • Service users were generally unaware of the Direct Payment Scheme

Perspectives from VSCE organisations

  • VSCE organisations identified problems in sustaining their current funding and services. It was difficult to obtain funding for core roles such as evaluation, workforce development, policy development and safeguarding. In addition reduced funding impacted on innovation
  • VSCE organisations would like more co-production of services to meet explicitly agreed and co-owned aims