Agenda item

To present progress made and plans for improving mental health service provision.

Ms Helen Lammond-Smith, Head of Commissioning, Blackpool Clinical Commissioning Group and Blackpool Council presented progress made and plans for improving mental health service provision.

Also present was Ms Elaine Walker, Emotional Health and Wellbeing Manager, Blackpool Teaching Hospitals and Ms Michelle Sowden, Head of Mental Health and Learning Disability Services, Blackpool Teaching Hospitals.

Representatives were present from Rethink (national mental health support charity) and the Blackpool Carers’ Centre and Sergeant Peter Hannon, Lancashire Constabulary whose role incorporated mental health liaison within Blackpool.

Ms Lammond-Smith reported that three broad elements were being presented. There was a full review of current mental health service provision and proposed mental health integration of primary care (New Models of Care) across the Fylde Coast area as part of the ‘Vanguard’ programme linking in with community/ neighbourhood hubs.

The two parallel elements were the children and young people’s mental health provision developments and a directory of Fylde Coast mental health services (part of Vanguard) aimed at GPs and other professionals / the voluntary sector.

She explained that the main areas of primary and community integration being considered included Improving Access to Psychological Therapies (IAPT) which recognised that many people had long-term physical conditions and developing a pool of ‘connecting people’ trainers (bringing public and professionals closer together). There were a number of challenges including accommodation with a shortage of beds.

A wide range of work was being pursued including creating multi-disciplinary teams for a genuinely ‘single point of access’, home treatment, investing in crisis support services and developing ‘Core 24’ support (24 hours per day, seven days per week). The work would help create better pathways of support including access to beds.

The Chairman cited an example of a patient from over one year previously being given medication for depression but then told there would be a wait of over one year for any further treatment. Members felt that waiting times for Child and Adolescent Mental Health Services (CAMHS) were also too long. Members were informed that Blackpool services were currently performing well with 100% of people being assessed within target time (twelve weeks for CAMHS) and next stage targets had also been met. There was also support through YouTherapy and ‘walk-in’ options. The Transformation Plan for Children and Young People’s Emotional Health and Wellbeing Members was developing the support options.

Members emphasised that it was important that young people were aware of the support available. They were concerned that the directory of mental health services was too complex to follow. It was explained that it was a comprehensive directory which had been developed after consultation with stakeholders who had given positive feedback. Target users of the directory found printed versions useful. The directory linked in with the recently launched public ‘For your information’ directory of wider public and community services/groups. The directory would evolve with feedback. The Rethink representative added that he had found the directory a good approach and that it would help him better support and signpost his members.

Ms Walker reported that she had just attended a parallel children and young people’s event with around sixty young people present. They wanted access to services including making use of directories and digital information.

Members enquired what work was taking place with schools. They were informed that the Head Start Programme (emotional resilience and health and wellbeing for 10-15 year olds) included trained mental health coaches and that school nurses were another resource. Links with the various resources including CAMHS and YouTherapy were being developed within the neighbourhood hubs.

Members were informed that the patient experience survey (friends and family) covered a short period of time. In response to queries, it was explained that people could self-refer for support and this would be advertised through mediums such as Facebook.

The Committee expressed concern that the ‘Men in Sheds’ support concept bringing people together to share conversations and activities would have limited impact in preventing suicides. They were also concerned that stigma about mental health still existed. Members were informed that there were a range of options to support people and raise awareness, e.g. Mental Health Week was taking place later that month including tackling stigma through the ‘Time to Change’ work and that other activities and events were being promoted across wards.

The Chairman referred to the Committee’s recommendation made at its meeting on 24 January 2018 (Public Mental Health item) that the Suicide Prevention Oversight Group for Lancashire and South Cumbria should consider introducing an aspirational target of zero suicides.  Feedback from the Group had been that whilst the aspiration was commended, there were concerns that the zero focus created a negative climate for families of victims. Members noted the feedback but added that other areas such as Bolton Council’s Public Health leads had recommended introducing the ‘zero suicide’ target and were confident that it would have a significant impact. The Committee re-iterated the recommendation and that it needed to be escalated.

The Rethink representative added that it was important to improve the Crisis support available to people. He reported that the Rethink network was developing with more members able to attend local mental health meetings so was active resource, e.g. Rethink could help with service user surveys. However, he expressed concerns that some of his members had found communications from the Lancashire Care Foundation Trust difficult. Councillor Amy Cross, Cabinet Member for Adult Services and Health added that the Trust had not been attending Mental Health Partnership Board meetings which she chaired and Rethink attended. Members were informed that the Trust were usually good attendees at Scrutiny Committee meetings and participated well. It was suggested that the Trust’s Director of Engagements and Partnerships, who had good involvement with Scrutiny, would be contacted and sent the meeting minutes to help resolve the concerns over communications and Partnership Board attendance.

Sergeant Peter Hannon explained that mental health issues presented a number of risks such as people going ‘missing from home’. The police were working well in partnership with both the acute trust at Blackpool Victoria Hospital and mental health trust at The Harbour.

He cited the example of a shared mental health vehicle pilot with a police officer passenger, mental health professional (Crisis nurse) and also, if necessary, a paramedic.  They had been able to respond to issues during unsociable hours where vulnerable people with apparent mental health issues had been involved. By sharing resource and good information at the scene they were able to ensure that people were supported appropriately, diverted from needing to attend accident and emergency or a police cell. The outcomes were better for vulnerable people and saved significant resource time and cost. For a standard evening shift, five people had bene diverted from accident and emergency saving an estimated £10k and also multiple hours of officer time.

Sergeant Hannon added that the police were getting more practical mental health training and having the Crisis nurse on-board was essential. He concluded that a simple solution of talking to people in good time, rather than accident and emergency assessments led to the best outcomes for all involved.

The Committee agreed:

1.   To re-iterate the recommendation that a ‘zero’ suicide target should be adopted within Blackpool; and that Ms Judith Mills, Consultant in Public Health, Blackpool Council would raise the proposed target again at the Suicide Prevention Oversight Group for Lancashire and South Cumbria and, if required, escalate to the parent body providing a written response by the Committee’s next meeting on 11 July 2018.

2.   The Lancashire Care Foundation Trust’s Director of Engagements and Partnerships would be contacted to resolve the concerns over communications with Rethink members and ensure good attendance at Mental Health Partnership Board meetings.