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10.2 Recommendations

The following recommendations should help guide the development of the local mental health strategy and action plan. It is important to note that the World Health Organisation (WHO) defines Public Mental Health as consisting of (i) mental health promotion, which is primarily concerned with the determinants of mental health (ii) mental illness prevention, which is concerned with the causes of disease and (iii) treatment and rehabilitation, which is concerned with medical and non-medical interventions that can lead to recovery and rehabilitation. Too often, mental health strategies focus solely on treatment and rehabilitation, such that opportunities for mental health promotion and mental illness prevention are missed. Our recommendations cover all three areas in addition to presenting overarching themes to enable a more integrated patient/service user experience:

Mental Health Promotion

  • Raise whole population mental health awareness and reduce stigma
  • Increase involvement of local people with lived experience of mental ill health in awareness campaigns
  • Reduce institutional stigma in local organisations and GP practices, for example by providing workforce training on mental health, promoting mental health campaigns and encourage workplaces to sign up to a Mental health charter
  • Work with employers and workplaces to support current and potential employees who are experiencing mental ill health
  • Work with schools and colleges to raise awareness of mental health issues
  • Develop a cohort of local mental health champions in senior public roles
  • Promote individual resilience, self-management and positive mental health including the 5 ways to wellbeing
  • Increase feedback opportunities for service users, carers and parents on local services and ensure that feedback is acted on
  • Improve signposting to mental health and wellbeing services
  • Work in partnership to influence wider determinants of mental health and wellbeing e.g. housing, transport, schools and colleges

Mental Illness Prevention

  • Improve access to information on currently existing mental health and wellbeing services
  • Focus on co-production of services with service users, carers and the VCSE sector
  • Proactively work with communities likely to be at higher risk of mental ill health in South Gloucestershire including people living in Priority Neighbourhoods (defined in Chapter 3), the unemployed, people with disabilities, prisoners, Gypsies and Travellers, substance misusers (including alcohol misusers), smokers, people with long term conditions, people in the┬áLesbian, Gay, Bisexual or Trans (LGBT) community and victims of domestic abuse
  • Promote joined up working so that mental health is included in strategies and action plans for the previously listed vulnerable groups
  • Develop a more co-ordinated approach to commissioning services which impact on mental health and wellbeing at all tiers and levels of the care pathway. Ensure this is joined up and easily accessible to the public and health care professionals
  • Support VSCE organisations to build and sustain capacity in mental health and wellbeing services building on an asset based approach
  • Support mental health service users to access preventative services such as exercise on prescription, smoking cessation and substance misuse services
  • Support the development of more peer support groups within the community
  • Develop a suicide prevention strategy

Treatment and Rehabilitation

  • Improve the co-ordination of care between agencies supporting individuals with complex needs with improved information sharing and better communication with carers
  • Deliver a more effective IAPT programme, reduce waiting times and increase recovery rates
  • Review the effectiveness of services for people with learning difficulties including autism spectrum services and those with ADHD
  • Improve support for people who are post crisis to prevent further crises
  • Examine the provision of care in AWP services with an aim to reduce delayed transfers of care in AWP services and address the high bed occupancy levels for adults and older adult AWP services
  • Reduce delays in assessment for Section 136 referrals and minimise the use of police vehicles in transfers to the place of safety. A review of Section 136 referrals should be undertaken to compare performance with quality standards
  • Continue to support the self-harm register and work in partnership to reduce hospital admissions for self-harm
  • Undertake further work to understand the reasons underlying the increasing spend on antidepressants, hypnotics, CNS stimulants and drugs used for ADHD in South Gloucestershire

Overarching themes

These should include:

  • Communication
  • Workforce development
  • Service user and carer involvement
  • Agreed and jointly owned local indicator set to measure ongoing impact of the mental health strategy and action plan