Mental Health and Emotional Wellbeing
Understanding mental health needs in Somerset
To understand mental health needs across the whole population of Somerset and be able to make good decisions about policy and services we need to look at the picture from several different perspectives including:
- Wider protective factors, such as positive early years, education, employment, access to green space, housing etc.
- Wider risks factors, such as abuse, deprivation, exclusion
- The expected proportion of mental health conditions which a population such as Somerset should expect
- The current use of primary care for mental health support and the use of specialist mental health services
Data to inform this process is published by Public Health England in the Mental Health Fingertips indicator set which has sections on Children and Young People’s Mental Health, Community Mental Health, Suicide, Co-existing Substance Misuse and Mental Health Issues, Common Mental Health Problems and Severe Mental Illness. For example:-
- There were 4,207 Somerset patients on GP registers in 2014/15 diagnosed with a mental health condition.
- In Somerset, there were 2,326 people per 100,000 population in contact with mental health services, above the England average (Q2 2015/16)
- In 2014/15, there were 92 child admissions for mental health; at 84.5 per 100,000 aged 0-17 years, the rate is in line with the national and regional averages
- 7.7% of those aged 18+ are recorded on the GP register for depression.
- In 2015/16, there were 1,490 ambulance call-outs for mental health issues.
Further information relating to Children and Young People is available from the Children and Young People’s Health Benchmarking Tool.
The new Adult Social Care Indicator set also holds some information about mental health and employment and social isolation.
In 2014 the Local Authority Mental Health Profile was released by Public Health England. Generally, Somerset performs better or is broadly in line with the national average in respect of most indicators. However, Somerset scores significantly worse than the national average in terms of the percentage of adults with depression and the rate of emergency hospital admissions for self-harm. Key risk factors identified within the report include increased rates of those admitted for alcohol-attributable conditions and higher than average rates of statutory homelessness. This is also reflected in significantly fewer people with mental illness or disability in settled accommodation compared to rates in England.
Risk factors for poor mental health in adulthood include unemployment, low income, debt, violence, stressful life events, inadequate housing, fuel poverty and other adversity such as serving in combat. Risk factors disproportionately affect the mental health of people from marginalised groups. Targeted intervention for groups at higher risk of mental illness can prevent a widening of inequalities in comparison with the general population.
Protective factors include stable housing, strong, positive social networks and support; access to green space; feeling safe and having a good sense of meaning and purpose.
Early childhood is a time of particular importance, as children’s brains are quite literally shaped by their experiences. Abuse, insecurity and anxiety in the early years can be hugely detrimental to a child’s development. There is good evidence that investment in early years, preventing exposure to violence and abuse and investment in high quality parenting programmes and conduct disorder interventions can be highly effective in protecting children from the lifelong impacts of poor mental health.
Particular issues for Somerset include levels of self –harm and alcohol related incidents.
Positive Mental Health: A Joint Strategy for Somerset
In December 2014, the Positive Mental Health, a Joint Strategy for Somerset 2014-19 was published.
This strategy is about both children and adults. It looks at how to build positive wellbeing, how to prevent mental illness and what good services should look like. It sets out best practice which can be used to inform policy, commissioning and service delivery plans. Practical things we can do are listed in each section.
The document features sections on:-
- Mental health needs in Somerset
- Discrimination, exclusion and disability
- Tackling stigma
- Policy and planning
- Resilient people and communities
- Mental and physical health
- Children, young people and families
- Commissioning for quality and best outcomes
- Providing services for the people who need it where they need it
- A high level action plan can be found at the end of the strategy.
Taking action to support mental health and wellbeing
To support the delivery of Positive Mental Health for Somerset we have produced a short document for partners which lists useful, evidence based actions which could be taken by policy makers, employers, communities and individuals.
If you would like more advice on implementing any of the recommendations please contact: Louise Finnis, Mental Health Promotion Manager on LFinnis@somerset.gov.uk
Mental health and wellbeing is also a high priority for the Faculty of Public Health who have produced an excellent online resource – ‘Better Mental Health For All’ - which is a summary of the evidence, what wellbeing means, the economic case and where to start and how to begin planning or develop Public Mental Health Services.
Looking after your emotional and mental health
The Five Ways to Wellbeing are a set of simple, everyday steps that we can take as individuals, as communities and as organisations to promote and protect positive mental wellbeing.
- Be Active
- Take Notice
NHS Choices provides a practical summary of the 5 Ways to Mental Wellbeing
The NHS Confederation has produced a review of the effectiveness of Five Ways to Wellbeing as an intervention.
For more information about the 5 Ways to Wellbeing and how to use or promote these please contact: Louise Finnis, Mental Health Promotion Manager LFinnis@somerset.gov.uk
Loneliness and isolation
Loneliness and social isolation are harmful to our health. The Campaign to End Loneliness has been identified as a priority for the Somerset Health and Wellbeing Board. The effect of loneliness and isolation on mortality exceeds the impact of well-known risk factors such as obesity, has a similar influence as cigarette smoking, increases the risk of high blood pressure and has been linked to depression and cognitive decline. The Campaign to End Loneliness website contains more information about action for individuals, communities, policy makers and commissioners.
Putting Men into Mental Health
In October 2015, a conference was organised by Somerset County Council Public Health and the Men's Health Forum. The Conference Report includes key national and local issues affecting men, as well as possible solutions. The Men's Health Forum has developed a 'How To...' guide, incorporating 'Ten TopTips' for makng mental health services work for men.
In Somerset, it is recognised that questions need to be asked specifically on the subject of men's mental health:-
- How robust is our gender data?
- Should we develop different services to engage with men and women?
- Should we set targets around men and women’s use of services?
- How do our gender stereotypes get in way of promoting mental health?
- Should the focus be on getting men to use existing services or changing the services?
Mental Health and the LGBT+ Community
In its research with the LGBT+ community in Bristol ('Evidence for Change' (2016)), the Diversity Trust conducted qualitative engagement and an online survey involving 400 people regarding their health and wellbeing. Results indicated that LGBT+ people were much more likely than the population to:-
- have sought help for anxiety or depression
- have hurt or injured themselves (known as self-harm)
- have had thoughts about suicide or tried to kill themselves
- had a mental health condition expected to last 12 months or more
Also in 2016, 2BU-Somerset carried out a second survey of young people identifying as LGTBQ on the impact on their mental health of 'coming out'. Many findings support those in the Diversity Trust research above.
More information on these reports is available on our LGBT webpage.
National policy for mental health and wellbeing
The national policy document 'No Health Without Mental Health' (2012) sets out the priorities and actions which need to be taken by different agencies to promote good mental health across the whole life course. Updates are published regularly with progress reports and further guidance.
In 2014, the Chief Medical Officer published a report on mental health with key messages being that public mental health programmes should address the three areas of mental health promotion, mental illness prevention and treatment, recovery and rehabilitation.. Interventions should be based on the best available scientific evidence, some of which is summarised in the report:
"Good mental health and resilience are fundamental to our physical health, our relationships, our education, our training, our work and to achieving our potential."
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Author: Christina Gray
Next update: August 2016