Agenda item

To receive an update on Mental Health.

Presenting Officers

-       JinjerKandola: Chief Executive of Barnet, Enfield and Haringey Mental Health NHS Trust (BEH).

-       Darren Summers: Deputy Chief Executive at Camden and Islington NHS Foundation Trust.

-       Ian Prenelle: Consultant Psychiatrist at Camden and Islington NHS Foundation Trust

Jinjer provided the committee with an overview of the NCL mental health programme, which particularly focused on the mental health response to the pandemic, investments in services, transformation activities and mental health system challenges.

Jinjer updated the committee that services had been set up in St Pancras, with two hubs for children in the North and South in response to the pandemic. She said these hubs had been vital in the first stages of the pandemic, when the full impact was not yet clear. The long-term impact on mental health was now much clearer and the long exposure to isolation had significantly increased cases of anxiety and negatively impacted mental health across the country. It was noted that eating disorders had significantly increased, as well as a general increase on demand in services. One of the biggest challenges arising from the increased demand was securing an adequate workforce to enable the expansion of services.

Darren explained that Covid had made the inequalities people living with mental health issues faced far more pronounced. It was noted that the Covid vaccine uptake, in this cohort of people, was significantly lower than the average and that this cohort already had a lower life expectancy. He outlined that outreach work was taking place to improve both physical health and increase the vaccine uptake in this cohort. It was also noted that the community transformation project would significantly transform the way work was conducted in partnership with primary care, the Local Authority, and the VCS.

Ian explained there had been a shift in the mental health care system, in that it was moving towards a whole population approach. The principles would be that the system would be universal, person centred, with a new focus on prevention for both physical and mental health outcomes. He said that initiatives would not just focus on combatting issues when they arise but would ensure required interventions were in place. This new holistic offer would be delivered by new population health nurses, which would work alongside GP practices, peer coaches and the VCS. Ian explained that working more closely with general practitioners would help to deinstitutionalise mental health care and that working and embedding care into the community, would help move towards normalising and destigmatising mental health within the community. Ian said that during the early phase of the pandemic this type of work had already been in place, for example Camden Council had worked closely with the VCS to help those suffering with severe mental health who rely on both social and emotional support. Ian said that moving forward the model would look to share the approaches and practices across the boroughs, with the next wave of implementation due to take place in April 2022.

Councillor Tomlinson asked if any data surrounding the significant increase on demand could be circulated to the committee. He also asked if schools were being worked with to help address eating disorders and other mental health issues experienced by young people. Jinjer advised that further information on the increased number of referrals, which would include information about diversion hubs which people in crisis could turn to, could be circulated. She also explained that work in partnership with both Local Authorities and schools would be done to build up good working relationships.  Councillor Clarke raised a point that stigmatisation around mental health had not gone away and that conversations on the topic with young people needed to be done sensitively. She noted that often medication was used to resolve problems, which often did not address the underlying issues. Jinjer assured Members that work was being done with young people to move away from relying solely on medication as a resolution.

Darren explained that working within communities via the community model was key to normalising mental health care, especially for those from ethnic minorities who often came into the system very late into their stage of crisis. Ian updated the committee on work that had already been taking place in boroughs within this model, including discussions with the Somali community in Islington on ways to reduce stigma and crisis houses having been set up in both Camden and Islington, as an alternative to hospital care. He advised that similar provisions would be put in place in Barnet, Enfield and Haringey.

Ian advised that social prescribing and peer support initiatives would help provide better long-term outcomes, rather than relying on medication. He said that often people come into the system from GPs at the point where they have reached severe decline or relapse in terms of their mental health, so more needed to be done to catch people at earlier stages. He also advised that there had been an increase in refugees being referred for care and so the team was running a series of educational talks with experts who work with refugees to help inform the care they were offered.

The Chair enquired as to whether partnership working was being focused on and whether it was evident that the right teams were getting feedback to the appropriate people at the appropriate time. Darren acknowledged there was improvement required in terms of liaising with Housing departments and the Police, as there were incidents where individuals had fallen through the gaps in the system.

The Chair asked how recruitment into new roles was progressing. Darren advised that recruitment was going well, but there were always some challenges faced in terms of recruiting new nurses. He said the advantage with the community programme was that a different type of workforce was being looked for, which opened opportunities outside of the normal professional routes, to find those with lived experiences.

Members agreed to receive an update briefing paper in 6 months’ time, after which they would decide whether to request to bring back a full report to committee at that time or wait until a year had past for further scrutiny to take place. Members asked that wellbeing of staff as well as information on working with schools was included in the update report.

RESOLVED that the Committee noted the contents of the report.