Like-minded mental health services in NW London – the story so far

Almost one in four adults will experience a diagnosable mental illness each year. That’s more than one million Londoners, and one-in-10 children and young people.

However, many people do not seek help for their mental illness and, for those who do seek help, most mental health care is delivered by a complex web of different organisations who have not always been joined up. This has resulted in confusing care for some of North West London’s most vulnerable people, while 75% of people with anxiety or depression don’t receive any treatment at all.

To improve mental health and wellbeing across North West London, we’ve established a new strategy called ‘Like Minded’. The strategy has been co-produced with patients, carers, doctors, voluntary organisations and charities and other experts. It’s about everyone who provides any aspect of mental health care joining together so that we can all learn best practice and share innovative approaches.

By working together, our vision is for North West London to be a place where people say:
“My wellbeing and happiness is valued”
“I am supported to stay well”
“My care is delivered at the place that is right for me”
“The care and support I receive is joined up”
“As soon as I am struggling, help is available”

 

We are continuing to build on the measures already in place by beginning a wide-ranging ‘Case for Change’ review, looking at the mental health and wellbeing needs of different populations groups, such as children and young people, and beyond solely illness to consider the wider determinants of health and wellbeing.

We have identified eight major issues that we currently face in North West London and will need to tackle if we are to improve mental health services. We have also set out our ambitions for each of these issues.

1. Too many people face mental health needs alone, are afraid of the stigma or don’t know where to get help 

Mental health needs are experienced by many of us, with depression and anxiety affecting around one in six of the adult population in London. However, only a minority receive treatment and in North West London we estimate that two out of three people living with mental health needs are not known to health services.

Our ambition: We will ensure that mental health needs are better understood and more openly talked about and we will improve the range of services for people with mental illness in North West London.

2. Not enough people know how to keep mentally well

What makes us feel good is different for everyone but will often include things like relationships, work, housing, exercise, money and friendships. Whilst we don’t always know exactly what causes mental illness, we know that certain things can put us at risk and looking after our personal wellbeing can help that.

Our ambition: We will improve wellbeing and resilience, and prevent mental health needs where possible by:

  • supporting people in the workplace
  • giving children and young people the skills to cope with different situations
  • reducing loneliness for older people

3. We need to improve the quality of care for those with serious and long-term mental health needs

Around 23,000 people in North West London have been diagnosed with schizophrenia, bipolar disorder and/or psychosis, which is double the national average, but the demand on existing services means sometimes people wait too long to receive the routine care they need for such conditions.

Our ambition: For people with serious and long-term mental health needs we will:

  • make their care journey simpler and easy to understand
  • develop new, high-quality, services in the community
  • focus care on community based support rather than just in-patient care so people can stay closer to home

4. Too many people experience common mental illnesses, such as depression and anxiety, in silence

Common mental health needs – such as depression, anxiety, obsessive compulsive disorder and post-traumatic stress disorder – are experienced by nearly a quarter of million people in North West London. Too many people do not seek help and, when people do, often the mental illness is missed or the quality of community-based services is not always good enough.

Our ambition: For those people experiencing depression and anxiety we will:

  • Improve how quickly we identify, especially when people are not currently receiving other healthcare
  • Improve the quality and quantity of therapy that doesn’t require medicines

5. Three in four of lifetime mental health disorders start before you are 18

And around half of all mental health needs start before the age of 14. However less than 10% of CCG mental health spend is invested in care for young people – something we are keen to change.

Our ambition: We will ensure that implementation of the national strategy for children and young people responds to our local needs.

6. New mothers, those with learning disabilities, the homeless and people with dementia do not get the right mental health care when they need it

  • Depression affects many thousands of new mothers across North West London and, tragically, suicide remains a leading cause of death for expecting and new mothers.
  • 25-40% of people with learning disabilities have mental health needs and the prevalence of schizophrenia in this group is three times that of the general population.
  • People who are homeless often have both physical and mental health needs as well as substance misuse needs. Their situation means they often cannot manage their own condition.
  • Dementia is a rising challenge for North West London and many people remain undiagnosed.

Our ambition: We will improve the care for specific groups in our community and support available to those who don’t always get the mental health care they need within existing services.

7. Too many people with long-term physical health conditions do not have their mental health taken into account… and vice versa

People with mental health needs are at higher risk of developing significant, preventable physical health conditions such as respiratory disease. For example, people with schizophrenia are twice as likely to die from cardiovascular disease. Conversely, too many people with long-term conditions do not have their mental health needs properly taken into account despite being two-to-three times more likely to have a mental health need than the general population.

Our ambition: We will make sure that physical health and mental health are supported for people with existing physical or mental long-term conditions, learning from other work in North West London around the importance of joining up care.

8. Our systems often get in the way of being able to provide high quality care

Ensuring we have the right number of staff and that their skills are developed, that more people – including nurses, social workers, police, housing officers, and teachers – have awareness of mental health issues, that there’s better information sharing, and there are better buildings in which to care for those needing mental health support.

Our ambition: We will make sure that our systems help, rather than hinder, joined up care.

In developing our understanding of the challenges we have listened to our residents, professionals and other interested parties. We have been heartened to hear great examples of sensitive care where our teams go the extra mile. Our plans described here draw on these great examples to help us improve where we can do better.

We will continue to listen to feedback to make sure that we have identified the right issues and ambitions to be able to improve mental health care and support in North West London.

Perinatal Mental Health workshops

Like Minded brought to together a range of key stakeholders across Central and West London, to develop an agreed path of care to meet the perinatal needs of the local population, and to identify any gaps/barriers. The Perinatal Mental Health workshops were held on 16 December and Tuesday 19 January 2016. You can find out more about the perinatal mental health workshop here.

Written records of past Like Minded workshops