Integration of public mental health intelligence into JSNAs to inform priorities, strategic development and commissioning Jim McManus (Director of Public Health, Hertfordshire) Dr Jonathan Campion (Director of Population Mental Health, UCLPartners) 1 st April 2014 1
Authors Jonathan Campion is a Psychiatrist and Director of Population Mental Health for UCL Partners. Dr Campion undertook the Hertfordshire Jim McManus is Director of Public Health for Hertfordshire j.campion@ucl.ac.uk jim.mcmanus@hertfordshire.gov.uk 2
JSNA The Hertfordshire JSNA for Mental Health is in process of being updates since Prof Campion undertook it https://www.hertfordshire.gov.uk/microsites/jsna/jsna- documents.aspx?searchInput=&page=3&resultsPerPage=10&view=card#res ultsContainer You can find Prof Campion’s UCL JSNA for Hertfordshire in full here https://www.hertfordshire.gov.uk/microsites/jsna/jsna- documents.aspx?searchInput=UCL&page=1&resultsPerPage=10&view=card 3
Joint Strategic Needs Assessments • Provide information about the local levels of health and social care needs as well as information about broader determinants (DH, 2012) • Informs actions which local authorities, local NHS and other partners need to take to improve the health and wellbeing of their population. • Mental disorder accounts for at least 23% of the burden of disease in UK compared to 16% for cancer or cardiovascular disease (WHO, 2008) – therefore particularly important area • Only a minority of people with mental disorder receive treatment while provision of interventions to prevent mental disorder/ promote mental wellbeing is extremely limited - this unmet need requires representation in the JSNA. 4
The Golden Thread • Need, Outcomes • Priorities, Interventions Commissioning Marmot Outcomes Priorities JSNA (New Strategy CCG Plans Outcomes Frameworks) 5
National Public Health Dataset Information Local Commissioning Local Peoples Views and Experiences Intelligence Health & Social Research and Care Prevalence Trends Information Information Informing Joint Strategic Needs Assessment Informing Priority Setting Influencing Community Local Area Agreement Strategy PCT & PBC Business Plans Locality Plans Client Group / Issue Based Commissioning Plans Children & Housing / Supporting eg Mental Health, People Strategies Young People’s Older People, Obesity, Long term Conditions Plan 6
Commissioning Roadmap Health & Wellbeing Strategy Identify Priorities What Works JSNA Assess Need in delivery Commissioning Monitor and Plans Commission Evaluate 7
8
9
10
What mental health intelligence is required in a JSNA? Groups of 4-5 people (5 minutes) 11
Mental health intelligence required in a needs assessment • Level of risk and protective factors across the population • Numbers from higher risk groups • Local levels of well-being and mental disorder • Proportion receiving intervention including from higher-risk groups • Current levels of provision of effective public mental health interventions • Joint Strategic Asset Assessments augment JSNAs and identify local assets to improve health and social outcomes 12
Good public mental health commissioning • Prevents large proportion of mental disorder and promotes population wellbeing/ resilience • Enhances coverage of effective intervention to treat mental disorder, prevent mental disorder and promote mental health • Focuses on children and families • Effectively targets higher risk groups to prevent widening of inequality • Results in significant improvements in NHS, public health and social care outcomes • Facilitates joined up and collaborative working between different service providers 13
What is the current level of unmet need for integration of public mental health intelligence in JSNA’s? 14
Current level of integration of public mental health intelligence in JSNA’s • Inadequately and inconsistently covered often only in passing (UCLP audit of 23 JSNAs, initial findings) • Public mental health information within JSNAs often inaccessible, being both difficult and time consuming to locate • Mental wellbeing mentioned in 44% JSNAs • Child and adolescent conduct and emotional disorder mentioned in 50% JSNAs although often only in passing • Adult mental disorder: depression mentioned in 72% of JSNAs, SMI 67%, personality disorder 28%, dementia 89% 15
Current level of integration of public mental health intelligence in JSNA’s • Little information about impact of broader determinants on mental health required by DH (2012) or how poor mental health impacts on other areas e.g. tobacco • Poor coverage of higher risk groups, costs of mental disorder, savings from interventions • Lack of information about size or impact of unmet need 16
Current level of integration of public mental health intelligence in JSNA’s Review of child and adolescent mental health in JSNAs and JHWSs (Lavis & Olivia, 2013) assessed the content and quality of data intelligence of 145 JSNAs • Two thirds of JSNAs had no section which specifically addressed child and adolescent mental health needs • One third of JSNAs did not include an estimated or actual level of need for child and adolescent mental health services in their area 17
Possible reasons for PMH intelligence gap in JSNAs? 18
Possible reasons for PMH intelligence gap in JSNAs • Lack of awareness about the importance and impact of mental health • Lack of agreed set of PMH intelligence required for JSNAs - no standard template, format or mandatory data requirements • Lack of access to up to date public mental health intelligence • Lack of support to provide local relevant PMH intelligence • Lack of resources for a time consuming exercise (Burnham, 2012) 19
Steps to integrating public mental health intelligence into JSNAs Groups of 4-5 people (5 minutes) 20
1) Bringing together up to date local PMH intelligence • Identification of relevant intelligence Nationally collected data Locally collected data • Comparing against deprivation, national and other similar populations • Facilitating understanding of data such as through graphical representation 21
2) Agreeing most appropriate structure to integrate into JSNA • Currently no standardised structure for JSNAs or what mental health data is included (DH, 2012) • Share existing PMH intelligence with commissioners, CCGs, local government and public health • After consideration of intelligence, agree best way to integrate PMH intelligence into JSNA as Stand alone section Integrated into other sections 22
Communication of PMH intelligence to inform local strategic development, commissioning and Health & Wellbeing Board priorities Groups of 4-5 people (5 minutes) 23
Communicating PMH intelligence • Set of up to date PMH intelligence • Tables/ graphical representation which facilitate understanding of PMH intelligence • Current provision and impact of PMH interventions • Level, impact and cost of unmet PMH need at primary, secondary and tertiary levels 24
Communicating PMH intelligence with different organisations • Improved population mental health requires coordination between different organisations • PMH intelligence needs to take account of the activities of these organisations 25
Different organisations providing PMH interventions Highlights importance of knowledge of activities of different organisations to facilitate cross-sector coordination: • Primary and secondary care • Local government • Public health • Social care service providers • Third sector social inclusion providers • Education providers • Employers • Criminal justice services 26
Tailoring PMH intelligence for presentations and briefings for particular audiences • Presentations and briefings highlight local impact and cost of different types of unmet PMH need to different audiences • PMH intelligence needs to be made understandable for the audience and include local context • Different organisations have responsibility for certain areas which is often overlapping and requires coordination 27
Different sectors cover different PMH issues which often overlap • Public health Bringing together PMH intelligence Addressing risk factors such as abuse/ violence Promoting protective factors Enhancing population recognition of mental disorder • Primary care/ secondary care Detection/ treatment of mental disorder at earliest opportunity Addressing health risk behaviour/ physical health 28
Communication of PMH intelligence with range of stakeholders facilitates • Greater cross sector coordination • Greater transparency about decision making process • A more local needs approach to prioritisation • Closer link between needs assessments and commissioning 29
Recommend
More recommend
