This week the Centre for Mental Health, along with five other national mental health charities launched their mental health challenge to councils in England. Islington Council in north London was one of the first 10 local authorities to sign up. As this borough’s mental health champion, I have pledged to support better mental health by promoting mental health issues in all areas of the council’s business and in the wider community.
Islington is well known, indeed perhaps infamous, for having very poor health outcomes, including having the country’s highest rates of serious mental illness and suicide by young men. This is a borough which also sees extremes of wealth; apparently a three bedroom house is on the market at present for just under £6m. Our Fairness Commission, set up shortly after Labour took the council in 2010, revealed some shocking health problems: about one in six people has a disability or long-term illness that affects their day-to-day activities. People with mental health problems are likely to die several years earlier than those without, exacerbated by their not looking after their physical health.
Despite the government’s ill thought out, generally disastrous and incredibly expensive changes to the health service, they did introduce one reform which I welcomed: health and wellbeing boards, which bring together GP commissioners and councillors with the overall task of improving health outcomes in their area.
In Islington both GPs and councillors went into this new role with enthusiasm, and mental health became one of our four priorities (the others being giving children the best start in life, long-term conditions, and of course the ubiquitous best value services). We quickly agreed that long-term conditions and mental health are inextricably linked.
One of the Fairness Commission’s recommendations was to increase the number of people accessing support for depression and anxiety, and we have achieved a continued annual increase in the number of people accessing psychological services with 3,523 patients accessing the service in 2011/12, compared to 2,992 in 2010/11.
Mental health inequality is an ongoing issue in Britain, with BME groups, particularly young black men, particularly at risk from mental health problems. We have put in place targeted initiatives to promote awareness and to tackle stigma and discrimination, and now we are pleased that the historically under-represented groups, such as men, people living in deprived communities and people from black Caribbean groups, are now well represented amongst service users.
We also run a mental health first aid training programme, designed to improve understanding and awareness of mental illness and encourage early identification, which has been embraced by many council staff such as our park guards and housing staff. We also have a new suicide prevention action plan as a local priority and a local suicide prevention group has been formed.
In our neighbouring borough of Camden sits an NHS Trust that delivers mental health services for both boroughs. We work closely with Camden and have recently merged our public health departments as it returned to local authority control. Working together in this way not only achieves savings (something that councils are obsessed with in these economic times) but also shares expertise and staff resources.
Public health is leading a review of the quality, content and scope of mental health awareness training within schools. The aim is to develop better quality, more co-ordinated and systematic coverage of mental health awareness in schools (pupils and staff) in order to reduce stigma and increase early identification and referral of young people. The children and adolescent mental health service (CAMHS) is highly valued by schools and one that we are determined to continue.
We also work closely with the voluntary sector: for example the Islington Mental Health and Poverty Networking Forum and Islington Faiths Forum held a packed conference earlier this year at Islington Town Hall to examine the impact of poverty and welfare reforms on mental health. The conference made a strong case for the link between poverty (poor housing, childhood and life experiences) and mental ill health, and also between mental ill health and poverty (low income, troubled life and poor outcomes).
Remploy have been commissioned to deliver a comprehensive employment and training support service that assists those with mental health needs to become ready for work or to retain work and to access training and educational opportunities. We know that working can be a real help to people with mental health problems, and the support of Remploy’s local partner, Hillside Clubhouse, is proving that more people can be helped into work with proper support.
Physical health is linked up with mental health, and in Islington we aim to encourage more people to exercise. We have a strategy for physical activity in partnership not only with our local sports providers (including Arsenal) but also the mental health trust and the voluntary sector to promote wider and more inclusive participation in sports.
The challenge is enormous – meeting it will be difficult, but essential.
All views expressed are those of the author.
You can follow the Challenge’s progress and hear news from some of their champions on Twitter