Avon, Gloucestershire and Wiltshire Wellbeing and Mental Health Engagement Event - Notes

Avon, Gloucestershire and Wiltshire Wellbeing and Mental Health Engagement Event

Peter Hale

Tuesday 21 October – Bristol

Health Protection and Health Improvement – Public Health hasn’t embraced Mental Health Agenda – Needs improvement for Parity of Esteem – Premature Mortality. Unless more input won’t get the benefit of improved public health. What would help to improve mental health? Learning and listening, what can Public Health England do to support communities, how can they help local communities and organisations. Some of measurements and terminology can get in the way. Significant challenges. Don’t want to see silo approaches between Mental Health and Physical Health.

In my opinion why no-one here from DWP, ATOS etc, Work Programme etc?

So much work on mental illness but need for more on mental health and mental illness, stigma, and physical health and joining up physical and mental health. Some progress in last two decades but not enough, for parents, schools, workplaces, needs more work, policy advocacy. Encouraging evidence on what to do. Growing examples of good practice in local communities. Desire for more integrated approaches. Still pejorative discussion of mental illness and cost. Not acceptable to talk of financial ‘burden’ of mental illness to country. Can people with mental health issues get work, be free of discrimination, companionship, freedom from debt. Compelling story for how and why to improve mental health – evidence base. Separates mind from body, lack of co-ordination, lack of implementation of policies to improve mental health. Next 18 months will be a lot of discussion, local needs assessments, strategic plans, co-ordination, must include agenda for mental health. Must engage with community. Public Health England PHE has priorities – mental health and illness to be included as part of all strategies.

Public Health England (PHE) Action in Public Health

Things like Mental Health First Aid Programme, annual summits, progress and approach for 2020.

Immediate plans for more emphasis on prevention of mental health issues to be embedded in services. Key programme areas for service user involvement.

October 29^th wellbeing – Gus O’Donnell to Launch in morning Employment and Learning, Exercise, Art. Independent report – CMO report: Public Health England (PHE) reflections – Use of World Health Organisation (WHO) Framework.

Later – Happy City Bristol Launch.

Keynote Session 2

What is wellbeing – mental health – Why is it important?

Issues

This statement is untrue – ‘Mental illness population affects a well defined group discrete from the rest of us.’ of the – This does not accord with the facts.

Dual Continuum Model – To address wellbeing as well as illness.

Mind and body are one system - Descartes was wrong!

Autonomic Nervous System

Fight or Flight (or Freeze)

Systems approach needed and plan.

Need to invest in many places.

I raised issue of Public Health Ringfence. Answer from Public Health England that councils must embed mental health investment within their spending. What are the needs of the community?

Keynote Session 3

Mental Health First Aid (MHFA) – I’ve done this training and many other people I know

Prevention not cure – Diminishing resources

Paramount to –

a)      Educate ourselves

b)      Empower individuals to spread message

c)       Collate robust evidence

Hard to get funding for things that aren’t evidence based. Mental Health First Aid (MHFA) has evidence. Includes supporting employers to promote workplace wellbeing, and help staff to cope. Help to lessen stress at work. What would you do if someone is in a mental health crisis?

Imagine a workplace without physical fist aid?!

Health professionals still need MHFA.

Still lots of stigma and discrimination.

1/3 of GPs have never had mental health training but 1/3 of patients visit because of their mental health issues.

5 ways to wellbeing

Question from service user whether DWP will offer MHFA to people who are claimants.

Question about keeping stress management within workplace ongoing – champion in Workplace to ensure MHFA is ongoing.

Assist ASIST - Applied Suicide Intervention Skills Training - See more at: http://www.elament.org.uk/training/asist-applied-suicide-intervention-skills-training.aspx#sthash.mN5zlIkR.dpuf

Workshop Discussion

Separated into tables for different areas (2 for Bristol)

Bristol tables - requested more accountability on spending (Councils’ Public Health, and Public Health England). More voluntary sector and service user involvement, and joining up of services. Also role of sports, exercise, faith and community groups in promoting good mental health. Asset rather than deficit approach looking at what we have. Need resources for mental wellness, not just illness. The point was made that points such of this were made some time ago, progress? Importance of getting in early for children’s mental health. MHFA is a good example – LIFT Psychology works well but not for all people. Happy City works well with some people, but some people miss out. Reframing narrative – including people with lived experience. Talking to people with mental health issues – what goes well? Evidence base – need for models that aren’t just numbers based, as mental health is complex. Issue of tendering being competitive, does that encourage collaboration?

South Gloucestershire table – raised issue of joined up services, and services for young people.

Other tables – discussions – shifting conversation from – things can’t be done for lack of money to identifying what community assets are already available. Issue of 7 minute GP appointments. Employers need to be at forums like this.

Relevant News Stories

BBC News - Public mental health spending in England too low, says Mind - http://www.bbc.co.uk/news/health-29792386 - Local authorities spend "unacceptably low"

Councils spend less than 1.5% on mental health, charity finds - http://www.theguardian.com/society/2014/oct/28/mind-charity-mental-health-council-spending-less-than-1-point-5-per-cent?CMP=twt_gu via @guardian - Mind charity

Munch and the Balloon - Children's story with a message of tolerance

Once upon a Munch Time, there was a cow called Munch. Today was Munch’s birthday, soon after Christmas. Munch the cow had a party with Robbie the Robin and Sally the Squirrel, and all the other cows and pigs and sheep. One of these was a shiny blue balloon with ‘Happy Birthday Munch the cow’ written on it in nice shiny orange writing. The balloon was on a string.

Munch was grateful for the balloon and all the other presents.  Munch the cow stood on the string and enjoyed tapping the balloon with her nose. But Munch enjoyed this game so much that she let go of the balloon. Her hooves did not hold the string well. Munch could only hold wider things like books. That caused Munch to lose the balloon.

The balloon floated up and the string got stuck around a high up door handle. The balloon was stuck in the window of the barn. Munch the cow cried. She could still see the balloon but could not get it. This gave her hope of getting the balloon, but no way of reaching it.

Sally the squirrel said to the cow, “why don’t you climb and get the balloon”, but Munch could not climb.

Robbie the Robin said “why don’t you fly up and get the balloon”, but Munch could not fly.

Munch the cow cried and cried. She knew the animals were trying to help but she could not do these things. She felt sad.

Then Robbie the Robin said “I will fly up and get the balloon”. Robbie was good at flying. Robbie was good at flapping against the balloon to knock the balloon free from the window. Robbie was good at picking things up with his beak. But when Robbie picked up the string and tried to fly down he could not, as the string was still stuck around the handle.

Robbie felt bad because he couldn’t get the balloon, Robbie cried.

But then Sally the squirrel said “I can’t fly but I can climb and chew”. So Sally climbed to get her teeth into the string. Robbie kept hold of the string at the top. When Sally chewed through, the balloon came free. Robbie flew down with the balloon.

The animals felt good. They all cheered and barked and mooed and chirped and squeaked.

Munch the cow felt better but was still worried because she had hooves. Though she felt better that she could not fly, she still felt bad that she could not hold the string.

The farmer looked out the window to see what had happened. The farmer was pleased the animals were having fun.

Colin the Collie had an idea, he ran under a gap in the hedge to get the farmer to ask him to help.

The farmer wanted to help Munch the cow. The farmer has hands so can hold things. So the farmer tied the balloon string around a little post.

Then Munch felt better and the farmer felt better, and all the animals felt better because the farmer had helped.

Munch the cow felt better but was still a bit unhappy. As the other animals could all do useful things and the Munch could not do any of these things so well. Munch wanted to do something but could not fly or climb or hold things, or run through the little gap in the hedge.

Munch did not feel like doing her game again. But then Munch thought of something she could do and the farmer realised how he could help.

The farmer liked Robbie the Robin but did not like that Robbie often flew in the window of the barn and pecked at the milk bottles. The farmer did not like telling Robbie off though.  The farmer wanted to help Munch and Munch wanted to help Robbie the robin and the other animals. With the farmers help, Munch was milked and this meant everyone could have milk.

The farmer had lots of nuts left over from Christmas and gave this to Sally the squirrel. This helped Sally to eat her favourite food and snuggle indoors for the cold winter.

The farmer and Munch put some of her milk every day in a bowl near the post. This meant that all the animals that liked milk had milk every day. Robbie the Robin did not need to peck the bottles in the window . Robbie drank from the bowl instead.

And Munch the cow had lots of company who all joined her game, and they all had fun every day. They all felt good that they all knew how to do things and how to help each other.