What must government’s mental health and wellbeing plan achieve for adults leaving hospital and in communities?
Government has published a consultation and call for evidence to accompany its mental health and wellbeing plan discussion paper. The discussion paper sets out to ask questions about promoting positive wellbeing, preventing the onset of mental ill-health and improving the quality of treatment for mental health conditions. The sector’s list of demands will be extensive, but what must Government’s mental health and wellbeing plan achieve for adults leaving hospital and in communities?
What’s the plan?
Government has committed to improving mental health and wellbeing, and is encouraging a wide demographic to respond to its plan: people who have experienced mental ill-health; people who have cared for someone affected by mental ill-health; and people who work or volunteer in health and social care services.
According to a Freedom of Information request from the mental health charity, Mind, one in 10 people still haven’t been followed up a week after leaving hospital following a mental health crisis. In addition, Mind understands that one in 20 people who have been discharged will end up back in hospital within 30 days and people who aren’t followed up within a week are twice as likely to try to take their own life.
It is clear then that Government’s mental health and wellbeing plan has its work cut out to enhance the experience of adults leaving hospital. The Social Care Institute for Excellence (SCIE) reports that commissioners have an important role in supporting effective social care systems so people can be discharged at the right time, to the right place with the right support. This includes governance and market shaping to ensure the capacity and choice of quality provision upon discharge.
Therefore, it seems logical for Government’s mental health and wellbeing plan to target reform concerning the actions of those responsible for funding discharge programmes.
Calling upon communities
Ensuring that meaningful community support is in place for adults leaving hospital is another key ambition that Government’s mental health and wellbeing plan must achieve. Current Government guidance appears to already promote this, insisting that, upon discharge, community health and care services, including GPs and social care providers, should communicate with the individual and, where relevant, their unpaid carer/s.
This is to track and manage the individual’s recovery, and ensure that any change in the support needs of the individual (or their carer/s) takes place at an appropriate time. However, the sector will be eager for Government’s mental health and wellbeing plan to flesh out this guidance and put it into practice to facilitate visible change for adults drawing upon services. It is also fundamental that community mental health services are designed to cater to individual needs to prevent re-admission to hospital, or worse.
This should be achieved in part through greater knowledge sharing between the NHS and Voluntary, Community and Social Enterprise (VCSE) organisations due to the emergence of Integrated Care Systems (ICS).
Government’s mental health and wellbeing plan must tap into the potential of ICS to ensure that community mental health services put the needs of individuals at the centre of planning and delivery.
People must lead their own care and support
We all experience challenges to our mental wellbeing at different times of our lives. The Government’s consultation on the new 10-year plan for mental health places a particular and welcomed emphasis on the people who experience worse outcomes than the general population.
As the oldest mental health charity in the UK working alongside people experiencing mental distress, we have gained many insights about what works for people. There are three things that the new plan must achieve for people leaving hospital and in our communities.
Firstly, we must provide care and support services that respond to the whole person. People do not experience mental distress in isolation to other challenges in their life. Having a safe and comfortable place to live, particularly on leaving hospital, being able to access opportunities of employment, financial security, fulfilling relationships and feeling valued in their local communities are all important. All of these elements play an integral part in a person’s journey towards positive mental health and wellbeing. Secondly, people’s experiences of mental distress are deeply personal and unique. We must build in to service design and systems the precious element of time. Providing that adequately allows staff who work alongside people to develop trusting relationships and provide the practical and emotional support that people want and need.
Without the person feeling secure in the basic needs of life, their ability to engage with and focus on their mental and emotional wellbeing will be compromised. To do that, the Government’s plan must also invest in a skilled and resilient workforce of people who see working in mental health as a fulfilling and vocational career.
Finally, if we are to truly transform the care and support of people experiencing mental distress over the next 10 years, we must ensure that people lead their own care and support. They are the experts of their experiences. We cannot underestimate the healing power of a person having a voice in what matters most to them. When people have agency about how they are treated and supported, they are empowered to make decisions and determine their own futures.
Linda Bryant, Chief Executive, Together for Mental Wellbeing
A real opportunity to re-focus on people
For this mental health and wellbeing plan to succeed, it must surely build on the work of the ‘Community Mental Health Framework’, published in 2019.
The framework, with its place-based community mental health approach, and its aims to deliver new models of integrated primary and community care, provides a real opportunity to re-focus on people living in their communities with long-term severe mental illness.
I believe the mental health and wellbeing plan provides the opportunity to promote significant system change in across several areas, such as how supported community mental health care and support services, including housing, can:
- Accelerate the smooth transition for individuals from hospital to the community.
- Provide seamless continuity of care between hospital care and community-based care and support.
- Ensure access to services, both VCSE and NHS, to assist adults in maintaining good mental health.
- Help to manage the increasing pressure on NHS services, through helping people whose needs could be better met in other environments.
- Deliver significantly improved health outcomes and financial savings through partnership working.
- Prevent people who have complex needs and who are multiply disadvantaged from slipping through the net.
In order to truly achieve this framework at a placed-based level, we must consider the breadth of services our 300 members across the VCSE sector provide for citizens, including working age adults and families receiving a range of care and support services. For example, our members provide vital community social care services, including counselling and advice, advocacy, supported living and housing, forensic and crisis services, carers’ support and personal assistants, employment support and much more.
We must continue to make sure the views and voices of providers delivering services and the people being supported are informing this framework implementation. This is equally true for all other key Government policy developments impacting the mental health and wellbeing of individuals and the services we provide to communities.
Kathy Roberts, Chief Executive, Association of Mental Health Providers
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