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It is estimated that 1 in 4 adults experience at least one diagnosable mental health problem in any one year, and 1 in 6 people experience this at any given time. Housing provides the basis for individuals to recover, receive support and, in many cases, return to work or training. Lack of housing can impede access to treatment, recovery and social inclusion, and accessing mental health services and employment is more difficult for people who do not feel settled in their accommodation. Over the last 5 to 10 years there has been a growing movement in the implementation of recovery strategies in the development of mental health services and supported housing. All service providers, across the NHS and the independent sector, need to be innovative in responding to the market and the aspirations of service users around their recovery plans. Housing associations should recognise this as an opportunity to demonstrate to NHS providers not only our skills and expertise, but our capital and access to finance that can enable NHS trusts to transform existing services.
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• Andy Bell, Deputy Chief Executive, Centre for Mental Health
• Patrick Vernon, Health Partnerships Project Coordinator, National Housing Federation
Sharing the learning from our health project: mental health
Mental health policy: challenges and opportunities
Andy Bell, 9 September 2014
Why mental health matters
Mental ill health affects 23% of us at any timeIt costs £105 billion to society each year75% of those affected get no treatment4.6m people have long-term physical and mental health needsPeople with schizophrenia die 15-20 years early
Current mental health policy
No Health Without Mental Health, February 2011Implementation Framework, July 2012Closing the Gap, January 2014
Broader health policy
Health and Social Care Act, 2012NHS MandateFrancis ReportCare Act, 2014
Specific mental health policies
Improving Access to Psychological TherapiesCrisis Care ConcordatReview of Sections 135 and 136Choice regulationsLiaison and diversionAccess and waiting
Crisis Care Concordat
National agreement among key agencies (eg. police, ambulance, MH services)Sets out expected standards of treatment:
To prevent crisesAccess to urgent careQuality of care and treatmentSupport to recover
Implementation by local Declarations
Key themes in policy
‘Parity of esteem’Prevention and early interventionRecoveryEmploymentIntegrationCriminal justiceEquality
Prevention and early intervention
Perinatal mental health supportPositive parentingEarly Intervention in PsychosisAccess to psychological therapy
Recovery oriented services
Peer supportRecovery CollegesSafer inpatient wardsEmploymentWelfare adviceHousing support
Employment
10% people using mental health services are in employmentMore than half would like to workIndividual Placement and Support can achieve 50-60% work outcomes
IPS
Key features of IPS:No exclusions, no compulsionRapid, assertive job search based on preferenceCo-located with health supportBenefits adviceTime unlimited support in work
Integration
Physical and mental healthPrimary and secondary careHealth and local governmentMental health and substance misuseCAMHS to adult mental health services
Criminal justice
Bradley Report 2009 called for national coverage of ‘criminal justice mental health teams’Coalition Government implementing national liaison and diversion development programmeCurrently working in 10 pilot sites – one per region in EnglandExpected to complete in 2017
Equality
Children and young peopleBlack and minority ethnic communitiesMultiple and complex needsPersonality disordersLater life
Thank you
For more information: Contact [email protected] us @CentreforMHvisit: www.centreformentalhealth.org.uk
Health Partnership ProjectPatrick Vernon
Health Partnerships Coordinator
Developing the Housing Offer to a Mental Health Trust or Commissioner
The Case for Social Housing &
Mental Health
• Good housing is critical for good mental health.• The Department of Health mental strategy No Health without Mental
Health stresses the importance of housing for mental health.• Without a settled place to live, recovery can be significantly impeded.• Financial pressure increases the need to innovate and deliver services
in more cost effective ways.• By working in partnership, mental health providers and housing
associations can deliver better outcomes for service users.• Addressing housing need within the care pathway can contribute to
meeting The Quality, Innovation, Productivity and Prevention(QIPP)challenge (approach taken by the NHS to improve quality whilst boosting productivity in redesigning services)
Process of Developing an Housing Offer
• Have you assessed and evaluated your current services?
• Do you have an understanding of local health pressures & priorities and plans?
• Do you want to contribute to improve mental well being of tenants in general needs or targeted interventions?
• Do you the time, investment, and resources to position offer NHS?
• Do you have a engagement strategy?
Commissioners or Providers
• Commissioners have played an important role in shaping the market over the last two decades using pathways of care approach by using PbR and The Quality, Innovation, Productivity and Prevention (QIPP) to pay and provide incentives NHS Trusts
• The 58 Mental NHS Health Trusts ( 41 have Foundation Trust status) are under pressure to innovate and deliver services in cost effective ways with increasing regulation
Budget for NHS funded Adult Mental Health
£6.45 billion (2011/12)• Secure services and Psychiatrist Intensive Care
( PICU) (£1,056 million)• Clinical Services (£972 million)• Community Mental Health Teams (£756 million)• Continuing Care (£644 million)• Access and crisis services (£588 million)• Accommodation(£528 million)• Psychological Therapy Services (IAPT) (£213 million)
CARE PATHWAYS
• Common mental health conditions• Complex psychological conditions• Psychoses• Acute and Crisis• Dementia• Addiction/substance misuse • Secure services• Learning disability
N.B. Child and Adolescent services (CAMHS) have their own path way covering 4 tiers of service provision
Learning from Mental Health & HousingLeaders event in London /Manchester
• The NHS needs to understand the size, scope, strengths and serious commitment of housing associations as providers /developers
• A strong steer from NHS that associations need to understand their objectives and work to their priorities
• The need for facts/figures to highlight the reach and impact of housing associations to health audiences .e.g. 1in10 households lie in social housing which will match health inequality and demographic profile of the biggest users of NHS services.
• Recognition that housing associations do much more than just build and supply homes; youth services, care and support, employment and training agency, benefits and financial inclusion
• Establishing strong personal relationships and developing trust as meaningful partners along with sharing values and commercial objectives
Learning from Mental Health & HousingLeaders event in London /Manchester
• Housing associations need to ‘get the right people in the room’ to engage with health or find better ways of setting up strategic networking opportunities between health and housing.
• Housing associations still trying to understand and engage with the new NHS ‘architecture’ and structures
• Both sectors need to build a common narrative based around the whole person and recognise that housing is part of the integration agenda
• Data sharing and information sharing is an important process to promote effective partnership working
• Need to explore examples of preventative funding/social bonds which have been approved and supported by the Treasury such as the work programme on troubled families which has a strong health and housing focus
• Achieving the ambition of transferring care out of hospitals cannot happen without appropriate housing
