Flourishing individuals, connected com m unities: I m plications for - - PowerPoint PPT Presentation

Flourishing individuals, connected com m unities: I m plications for local strategic planning

Catherine Reynolds Strategic Lead: Public Mental Health Liverpool PCT

Flourishing Individuals, Connected Communities

• Perceiving
• Articulating
• Acting
• New Horizons

– Population Mental Health & Wellbeing

• Professional
• Organisational
• Strategic Partnerships

A way of looking

Janus

• the gift to see both future

and past

• the god of the home

entrance (ianua)

• frequently used to

symbolize change and transitions such as the progression of past to future, of one condition to another, of one vision to another

The Clinical Gaze

• In the 1960s the French philosopher and

historian Michel Foucault questioned the wider implications of the methods developed by French physicians to understand disease. His work focused specifically on the social and political changes brought by the

• Revolution. He argued that doctors’ new

powers of diagnosis relied on their ‘gaze’ - a new type of medical perception and

• experience. Physicians who observed bodies

carefully could potentially penetrate the illusions of outdated theories and see the hidden ‘truth’ of disease. In the process, practitioners gained much power and status, because no-one could challenge their stories

• f illness. The patient’s own experience or

perception became less important than the doctor’s judgment. This trend within biomedicine continued until the second half of the 1900s, when efforts began to be made to look at the patient’s perspective on medical care.

• M Foucault, The Birth of the Clinic: An

Archaeology of Medical Perception (New York: Pantheon Books, 1973)

Bio-medical Bio-psycho-social

A way of articulating

“To live is the rarest thing in the world. Most people exist, that is all.”

Oscar Wilde (in Flourishing: positive psychology and the life well lived. Keyes and Haidt (eds) 2002.

Giving meaning. . .

Well- being

Well-being flourishing Quality of life Emotional well-being Positive mental health Happiness Mental well-being Mental Capital

?

Mental health

So, which of these resonate with you? nef

Definitions of well-being

New Horizons A positive state of mind and body, feeling safe and able to cope, with a sense of connection with people, communities and the wider environment. Foresight Mental well-being is a dynamic state, in which the individual is able to develop their potential, work productively and creatively, build strong and positive relations with other and contribute to their community. It is enhanced when an individual is able to fulfil their personal and social goals and achieve a sense of purpose in society.

A way of being

RECESSION UNEMPLOYMENT LABOUR MARKET MARGINALISATION

Low pay, job insecurity, Chequered work history,

STRESS POVERTY HEALTH BEHAVIOUR CHANGES

Social isolation, tobacco, alcohol, drug abuse, less exercise, etc.

PHYSICAL HEALTH EFFECTS

Bronchitis, Lung cancer, Heart disease Accidents, Low birth weight babies Infant growth retardation: General susceptibility

MENTAL HEALTH EFFECTS

Anxiety Depression Parasuicide Suicide

SUBNUTRITION FUEL POVERTY POOR HOUSING Work ethic stigma

Source: Smith, R (1987) Unemployment and Health: A disaster and a challenge, New York, OUP.

• Uncertainty. . .friend or foe?

Without a measureless and perpetual uncertainty, the drama

• f human life would be destroyed.

Winston Churchill

The desperation to maintain as sense of certainty can lead to mental health problems.

Dorothy Rowe

We are born into a world we know nothing about, and in which larger forces incessantly buffet us like a cork in an ocean.

Tim Lott

Health Literacy Related Skills

• Cognitive
• Behavioural
• Advocacy
• Existential

– Include the ability to make sense of life, live with uncertainty and avoid descending into depression, self-pity, hopelessness or helplessness.

Hope

Hope is sitting on a globe representing the world, her eyes are bandaged signifying that what is to be seen is not

• encouraging. She is playing on

a lyre of which all but one of the strings is broken; she leans over it to catch the very small sound that may emerge. It is the hope implied by the expression “hoping against hope”. It is the hope of those who refuse to submit to despair when it beckons. George Frederick Watts (1886) Walker Art Gallery, Liverpool

A way of responding

New Horizons: A new vision, a new language, a new focus?

“This is about more than preventing mental illness...it is also about helping individuals and communities to bring the best

• ut of themselves”.

Good mental health is more than just the absence or management of mental health problems; it is about our ability to cope with life’s problems and make the most of life’s opportunities. It’s about feeling connected with people and surroundings and being able to function well.

Aspiration & Realisation

A cross-government action programme, produced by the Department of Health and including commitments to action by 11 government departments.

– For the first time it sets out a new approach with the twin aims of

• improving people’s quality of life and well-being,

and

• improving the quality and accessibility of

services for people with poor mental health.

New Horizons: A shared vision?

The new strategy covers a number of areas to better address people’s mental health and well-being.

These include:

• making everyone’s mental well-being better
• helping everyone to understand mental health problems and not to treat people

with mental health problems unfairly

• making it easier for people to find and get the help they need
• spotting mental health problems early
• providing services and treatments in ways that meet people’s individual needs
• making sure people have a say in the treatment they get.
• making it easier for young people to keep getting help after they are 18
• carry on making services better and using resources effectively
• working with councils, the NHS and others to make sure people get services

that look after all their needs

Mental Disorder: 18% Languishing: 11% Moderate mh: 54% Flourishing: 17%

The gains from improving mental well-being

• Increased quality of life and overall well-being
• Improved educational attainment and outcomes
• Safer communities with less crime
• Reduced health inequalities
• Reduced mortality
• Improved productivity and employment retention
• Reduced sickness absence
• Reduced levels of poor mental health and mental

illness

A way of acting

Critical Questions: (nef)

• 1. What are the key levers and opportunities for

developing a local response to this well-being survey?

• 2. How can a case for promoting population mental

health and well-being be made, especially in the light of the current recession?

• 3. How can our knowledge, experience, skills and

good practice be built upon?

• 4. What does this well-being survey mean for local

partnership working?

Strategic implications: The local level

• The role of Local Government

– The power of wellbeing – Supporting the development of safe, sustainable, connected communities – Co-production of neighbourhood services

• The role of Strategic Partnerships

– Local Area Agreements – Strategic alignment and integration: wellbeing & inequalities – Total Place (Birmingham – Mental Health) – Commissioning for Wellbeing

• The role of Public Health & Stakeholder Engagement

– Articulating a strategic population approach – JSNA – Communicating the centrality of well-being ( nef’s Five Ways ) – Testing out, innovation, extending the evidence base

• Asset-based approaches: Social Prescribing, Timebanking, Volunteering,
• The role of Mental Health Commissioning

– Earlier intervention for child, young people and adults

• IAPT
• Suicide Prevention
• Physical health of adults with severe mental illness

– Recovery based approaches in secondary care and in community services

The Joint Strategic Framework for Public Mental Health aims to promote positive mental health and ameliorate mental distress by actions that:

• enhance wellbeing (i.e. increasing flourishing)
• prevent mental illness from occurring
• treat mental illness when it is present

Social Prescribing & Community Referral

• Establishment of Social

Prescribing Pathway across statutory and third sector providers in the Alt Valley Area as a model for neighbourhood working

• Connect community

service providers in primary, secondary care and the third sector to better meet people’s needs

– Debt management – Benefit Maximisation – Personalisation – Advocacy – Reading groups – Creativity & Arts – Leisure facilities – Opportunities for Learning, Volunteering etc

“Tend to the social and the individual will flourish” Jonathan Rutherford

Cited in ‘The Joint Strategic Framework for Public Mental Health 2009-12’