Agenda item

The report updates the Committee on the development of the Medway Mental Health Strategy. It is proposed that that the draft Strategy be brought to the Committee for consideration in June 2017.

Discussion

The Interim Assistant Director of Adult Social Care introduced the update on the development of the Medway Mental Health Strategy. She apologised that the Executive Director of Commercial Development and Transformation at Kent and Medway NHS and Social Care Partnership Trust had been unable to attend the meeting.

A mental health workshop had taken place in October 2016 with there being a specific stream of the Kent and Medway Sustainability and Transformation Plan (STP) to address mental health. Although the STP covered the whole of Kent and Medway, the Mental Health Strategy being developed would be specific to Medway. There would be an emphasis on seeing mental health as being of equal importance to physical health and wellbeing. Work was being undertaken to develop the shape of local care provision for people with mental health needs and for this to be delivered in conjunction with meeting physical health and environmental needs, such as suitable housing. Integration was required between these pathways.

Mental health was particularly important given that one in four people would experience a mental health issue during their lifetime. There was a need to ensure that local people were able to effectively access the services available locally and to enable them to access appropriate information and services so that they were best able to support themselves. Other challenges identified included making effective use of the voluntary sector, raising awareness amongst clinicians and having a local workforce able to effectively meet the mental health needs of the population. Enabling people to leave acute care provision as quickly as was safe was also important given accepted medical opinion that providing care in the patients’ own home was preferable.

The Three Conversation Model was being used to have initial conversations with patients, building on what was working in peoples’ lives. The focus was on conversation rather than assessment. There was a need to better understand the needs of people who frequently presented to services with mental health issues, in particular to understand the underlying reasons and to ensure that people were not moved from one care pathway to another.

There had been an increase in the diagnosis of personality disorders in Medway. The support needs of this group could be particularly complex, which required specialist service provision. Child and adolescent mental health services (CAMHS) were also noted to be an area requiring improvement.

A Case for Change would be developed by the end of March with it being proposed that the draft Strategy be presented to the Committee in June 2017.

The Committee raised a number of points and questions as follows:

Mental health provision– A Member felt that there was insufficient sharing between organisations of how people with mental health issues could be supported and that issues were being missed. The Member welcomed the Three Conversations Model and said that there was a need to work with housing associations to address mental health issues. In relation to personality disorders, the Member considered that the specialist personality disorder unit had been working well prior to its closure. The service provided since had not been good enough, with this having previously been acknowledged by the Chief Executive of KMPT. There had been a rise in people in Medway with personality disorders since the closure of the unit. The Member also asked whether  the funding for Street Triage was secure rather than being a pilot and was concerned that homelessness caused by mental health issues was not being adequately addressed.

The Director of Children and Adults Services said that specific concerns would be addressed through the development of the Mental Health Strategy. It was understood that Street Triage was not a pilot but would be subject to review. This would be clarified. An engagement workshop had taken place, which had been facilitated by a national leader of the Time to Change Programme. It was recognised that a dedicated resource was required following the closure of the personality disorder service. There was a need to redouble efforts with homeless people who had mental health issues. Further work to develop the Mental Health Strategy would be undertaken between March and May with a view to having a draft Strategy for the Committee to scrutinise in June 2017. The Interim Assistant Director of Adult Social Care added that there was a need to develop an understanding of why some individuals were particularly high users of blue light services.

CAMHS, service continuity and homelessness – A Member said that the waiting list for CAMHS provision remained too long and emphasised that the parents and carers of the children and young people accessing the service also needed support. There also needed to be a continuity of provision of all mental health services to ensure that service users knew how to access a particular services. Many people with mental health difficulties found it hard to sustain a tenancy with the result that they could end up homeless. Early intervention was required to stop problems escalating.

The Interim Assistant Director of Adult Social Care said that people with mental health difficulties were sometimes reluctant to engage with support services. Mental health providers needed to persevere in these cases. Work was being undertaken to address social isolation with there being a need to join up existing networks. It was confirmed that the CAMHS service was being recommissioned to provide a service specific to Medway. There was also a need to increase the number of family therapy interventions.

Decision

The Committee noted and commented on the progress made on the development of the Medway Mental Health Strategy and agreed that the draft Strategy be brought to the Committee for consideration in June 2017.