We must all champion for mental health care

This week I have the privilege of meeting a group of Local Government mental health champions.

Along with thousands of other councillors across the country they see the impact of poor mental health first hand.

The champions are keen to improve the prevention and treatment of psychological illness and to work with NHS commissioners who are similarly committed in their own work and in the programmes they do with councils and Health and Wellbeing boards.

The potential for preventing unnecessary human suffering and financial waste is huge. Suicide, is the biggest cause of death in under 35-year-old men and poor mental health costs every upper-tier council area about £700 million a year – just two facts that show how much progress we could make.

As NHS England’s National Clinical Director for Mental Health I am focused on improving services for those that need them. But this cannot be done in isolation. There is also a compelling case for helping individuals and communities to develop positive mental health and resilience skills, which assist individuals maximise their own potential and helps communities to thrive.

Getting this right also results in people developing less physical health conditions and living longer. Everybody and every agency needs to play their part in supporting people to look after themselves and each other better.

By hosting health and wellbeing boards, public health and social services councils are often in the best position to lead on these improvements locally. These responsibilities are in addition to having a major role in many of the factors influencing people’s mental health from housing and education to community cohesion and employment.

In partnership with the NHS, other agencies and their residents, councils can use these areas of influence to help people improve their health and wellbeing from before birth to the end of life. With this life-course approach we can support people to enjoy the best mental health possible, able to fulfil their potential and contribute fully.

As 75 per cent of lifetime mental ill health occurs before the age of 24 it obviously makes sense for all of us to invest in supporting parents, children and young people.

A recent London School of Economics (LSE) study found that better support, commissioned locally as well as nationally, for expectant mothers could significantly reduce the £8.1 billion national, annual cost attributed poor mental health amongst this group.

Good parenting is absolutely fundamental to giving our children the best start in life and yet most of us don’t get any training to do this well. Some local authorities, like Surrey County Council, provide parenting classes, which the Centre for Mental Health estimates can save £200 in better outcomes for every £1 invested.

Another LSE study found that social and emotional education, like that provided by Leicester City Council schools, saved £84 for every £1 invested, as more resilient children do better in school academically and in employment and beyond.

Sexual, physical and emotional abuse of children is strongly linked to serious mental illness and all of us, with councils in the lead, must do everything we can to stop it from happening. When children do become unwell they need prompt access to the best care. Investing in child protection and early intervention pays dividends.

Work related stress can lead to mental ill health in adults, and councils, as major employers as well as commissioners and community leaders, can support people with mental health conditions into and at work. One example of good practice is North Lincolnshire councils working with Time to Change to create a supported employment strategy.

Many adults who get into trouble with the police or end up in prison have a mental health condition which can be made worse with a drug and drink problem. The Association of Directors of Adult Social Services (ADASS) has recently published new guidance on helping people with these kinds of complex issues to get better and stay out of trouble. The Warrington New Directions service provides integrated, early intervention involving more than 25 local agencies and health and social care services to meet the needs of adults in contact with the police.

I recognise that these are financially very challenging times for many councils, but by local leaders working together, investing in the right prevention, early treatment and effective support we can actually save money as well as helping people live happier and more productive lives.

Dr Geraldine Strathdee OBE,

Dr Geraldine Strathdee, OBE, MRCPsych, is the National Clinical Director for Mental Health, NHS England, a consultant psychiatrist in Oxleas NHS FT, and Visiting Professor, Integrated mental health education programme at UCL Partners.

For over 20 years she has held senior roles in mental health policy, regulation and clinical management, at national and London regional levels, and advises internationally on mental health service design and quality improvement, while working as a practising clinician. She has been involved in transformational large scale service development programmes, moving services from hospital based, to 24/7 home care and primary care models, in roles which have included: the Trust Director of Clinical services in Oxleas NHS FT (2005-2007), Director of Service development at the Sainsbury Centre for Mental Health and Senior Lecturer, UMDS ( 1995-1998). She was the National Professional Adviser in mental health to the Healthcare Commission and the Care Quality Commission (2005-2012).

Her particular commitment is to the translation of policy and best practice evidence into front line routine clinical practice, empowering service users to reach their potential, and staff to maximise their time to care. She is passionate about the development of leadership competencies and using information to enable informed decision-making.

As London SHA Associate Medical Director (2009-2013), with responsibility for mental health, she led transformational change through the development of clinical networks for dementia and primary care mental health CCG leaders, developed ground breaking commissioning support care pathway profiling informatics tools, and high impact educational programmes. She was awarded the prestigious RCpsych Psychiatrist of the Year award in 2012.

Clinically, she has worked in a wide range of primary care, inpatient and community services, and latterly with people with complex and multiple needs, as a Consultant Psychiatrist for the Bromley Assertive Community Treatment team in Oxleas. She is committed to providing services which enable services users to live in their own homes, develop their own personalised care plans and self management expertise to achieve recovery, while at the same time working with community agencies to deliver coordinated, responsive, care pathways.

Service evaluation and research interests: Her teams have won awards for their use of technology in improving care, using patients as experts in staff training and leadership awards for new Ways of Working, the redesign of roles. Her research interests have included the fields of primary care mental health, evaluation of community services and dual diagnosis. Current research interests include the evaluation of competency based leadership programmes and clinical networks to drive transformational improvements, and high impact educational programmes.

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