Better physical health support for people with mental health conditions

The leaders of more than 50 organisations will meet this month at the Royal College of Nursing in London to sign an historic Charter for Equal Health and launch a new nationwide collaborative, Equally Well UK | story via Centre for Mental Health

The Charter for Equal Health offers a vision for improved physical health support for anyone living in the UK with a severe mental illness. It sets out how organisations working nationally and locally will tackle one of the biggest inequalities in health anywhere in the UK.

Today, people living with a severe mental illness such as schizophrenia have a life expectancy that is up to 20 years shorter than average. Equally Well UK will bring together organisations that have a part to play in reducing this inequality to take concerted action to achieve significant and sustained change.

Equally Well UK has been set up by Centre for Mental Health in partnership with Rethink Mental Illness and Kaleidoscope Health and Care. It is supported by the Royal College of GPs, Royal College of Psychiatrists, NHS England, Health Education England, Public Health England, NHS Improvement, Royal Collage of Nursing and many more.

More than 50 organisations have already come forward to commit to take action to ensure people with a severe mental illness get the help and support they need for their physical health. They are coming together at the Royal College of Nursing to sign the Charter for Equal Health and make their own pledges for the action they will take.

Further detail at Centre for Mental Health

 

 

CQC calls for new national guidance to improve sexual safety on mental health wards

Care Quality Commission | September 2018 | Sexual safety on mental health wards

The Care Quality Commission (CQC) report -Sexual Safety on Mental Health Wards report- shares  findings and recommendations after reviewing incidents related to sexual safety on mental health wards. 

Their analysis of almost 60,000 reports found 1,120 sexual incidents involving patients, staff, visitors and others described in 919 reports – some of which included multiple incidents. More than a third of the incidents (457) could be categorised as sexual assault or sexual harassment of patients or staff.

Safety
Image source: cqc.org.uk

 

Providers and people who use services told CQC:

  1. People who use services do not always feel that they are kept safe from unwanted sexual behaviour
  2. Clinical leaders of mental health services do not always know what is good practice in promoting the sexual safety of people using the service and of their staff
  3. Many staff do not have the skills to promote sexual safety or to respond appropriately to incidents
  4. The ward environment does not always promote the sexual safety of people using the service
  5. Staff may under-report incidents and reports may not reflect the true impact on the person who is affected
  6. Joint-working with other agencies such as the police does not always work well in
  7. practice (Source: CQC)

Read the press release in full from CQC 

The report is available as a summary, easy to read format or in full from CQC

Of interest:

The BMJ  CQC: Trusts must do more to protect mental health patients from sexual abuse

Nursing Times CQC warning on sexual incidents in mental health settings

In the media:

The Guardian NHS care regulator says sexual incidents ‘commonplace’ in mental health units

Striking increase in mental health conditions in children and young people

University of Exeter |September 2018 | Striking increase in mental health conditions in children and young people

The first national-level study in over a decade to investigate trends in mental health problems in children and young people in the UK reports that there has been a notable increase in mental health conditions in children and young people. This research involved academics at University College London, Imperial College London, Exeter University and the Nuffield Trust. Researchers analysed data from 140,830 participants aged between 4 and 24 years, in 36 national surveys in England, Scotland and Wales over time.

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They found since 1995 where just 0.8 % of children and young people (ages 4-24) had a mental health condition, by 2014 this figure had increased to 4.8 %. Data for this period demonstrates the increase in treatment in England (60%) , Scotland (75% )  and Wales (41%).

Key findings include:

  • Between 1995 and 2014 the proportion of children and young people aged 4-24 in England reporting a long-standing mental health condition increased six fold, meaning that by 2014 almost one in twenty children and young people in England reported having a mental health condition.
  • In 2008, when comparable data from the other two countries was available, 3% of 4-24 year olds in England and 3.7% in Scotland said they had a long-standing mental health condition, with 2.9% of 4-24 year olds in Wales saying they had received treatment. By 2014 these figures had grown to 4.8% in England, 6.5% in Scotland and 4.1% in Wales.
  • The age group with the biggest increases were young people aged 16-24, with young people in England almost 10 times  more likely to report a long-standing mental health condition in 2014 than in 1995 (0.6 vs. 5.9%).
  • Young boys aged 4-12 were consistently more likely to report a long-standing mental health condition than young girls. This was true across all countries. There was less of a consistent gender pattern in the 12-15 and 16-24 age groups.
  • Over the corresponding time period, the prevalence of total long standing conditions (both physical and mental) decreased slightly in England (20.3 to 19.5%,), increased slightly in Scotland (17.6% to 22.0%) and was broadly unchanged in Wales (13.1% vs. 13.5%).
  • Long-term trends in reported symptoms of mental health problems (as opposed to reports of a long-standing condition) showed no consistent evidence of an increase in emotional distress. However, the most recent evidence (from 2011-2014) showed concerning early signs of worsening emotional or psychological distress among young adults. For example, the odds of reporting above-threshold symptoms of emotional distress increased by 15% per year among young adults in Scotland.

Dr Dougal Hargreaves of Imperial College London and a Visiting Research Analyst at the Nuffield Trust said:

“We know that there is already a growing crisis in the availability of Child and Adolescent Mental Health Services, with many more children and young people needing treatment than there are services to provide it. Our study suggests that this need is likely to continue to grow in future. Without more radical action to improve access to and funding for CAMHS services, as well as a wider strategy to promote positive mental health and wellbeing, we may be letting down some of the most vulnerable in society.

“But it’s not all bad news. The increase in reports of long-standing mental health conditions may also mean that children and young people are more willing to open up about their mental health, suggesting that we have made some progress in reducing the stigma associated with mental ill health.” (Source: University of Exeter)

Pitchforth, J., Fahy, K., Ford, T., Wolpert, M., Viner, R., & Hargreaves, D| (n.d.|  Mental health and well-being trends among children and young people in the UK, 1995–2014: Analysis of repeated cross-sectional national health surveys| Psychological Medicine| 1-11. doi:10.1017/S0033291718001757

Abstract

BackgroundThere is a growing concern about the mental health of children and young people (CYP) in the UK, with increasing demand for counselling services, admissions for self-harm and referrals to mental health services. We investigated whether there have been similar recent trends in selected mental health outcomes among CYP in national health surveys from England, Scotland and Wales.

MethodsData were analysed from 140 830 participants (4–24 years, stratified into 4–12, 13–15, 16–24 years) in 36 national surveys in England, Scotland and Wales, 1995–2014. Regression models were used to examine time trends in seven parent/self-reported variables: general health, any long-standing health condition, long-standing mental health condition; Warwick–Edinburgh Mental Wellbeing Score (WEMWBS), above-threshold Strengths and Difficulties Questionnaire Total (SDQT) score, SDQ Emotion (SDQE) score, General Health Questionnaire (GHQ) score.

ResultsAcross all participants aged 4–24, long-standing mental health conditions increased in England, Scotland and Wales. Among young children (4–12 years), the proportion reporting high SDQT and SDQE scores decreased significantly among both boys and girls in England and girls in Scotland. The proportion with high SDQE scores but increased in Wales. The proportion with high GHQ scores decreased among English women.

ConclusionsDespite a striking increase in the reported prevalence of long-standing mental health conditions among UK CYP, there was relatively little change in questionnaire scores reflecting psychological distress and emotional well-being.

 

The article is available in full from Psychological Medicine 

Related:

Read the accompanying blog on Nuffield Trust Striking increase in mental health conditions in children and young people

Involvement: what does it really mean for service-users in the mental health sector?

NHS Confederation | August 2018| What does ‘involvement’ really mean? An expert service user panel discussion

The Mental Health Network have created a new podcast which examines the current state of service-user involvment in the mental health sector, outlines opportunities for improvement and considers a vision for service-user involvement within a long-term strategy for the NHS.

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Listen via Souncloud 

Mental health therapists in GP practices could be the norm

NHS England | August 2018 | Mental health therapists in GP practices could be the norm

New guidance to support GPs, practice managers and commissioners integrate mental health therapists into primary care pathways has been created by NHS England. 

The guidance will enable therapists to become  integrated into primary care teams and focus on common mental health disorders such as anxiety and depression, particularly where this occurs in patients with a long term physical health condition such as diabetes, respiratory or heart problems.

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Evidence suggests 90 per cent of  adults with mental health problems are supported in primary care and broadening the range of services for patients, means local health services are better equipped to deal with patients’ physical and mental health needs (Source: NHS England).

See NHS England  Guidance on co-locating mental health therapists in primary care

NHS England news release Mental health therapists in GP practices could be the norm

In the media:

Pulse NHS England asks GPs to house mental health therapists within practices

GP Online GPs urged to bring mental health therapy services into practices

The Daily Mail Every GP surgery in England should hire a mental health expert to tackle depression that makes physical illnesses worse, experts say

How nurses can improve care for people with severe mental illness

Young, N. | 2018 | How nurses can improve care for people with severe mental illness| Nursing Times  [online] |114| 9| P. 34-36.

A new review  published in the Nursing Times considers how nurses can better support people with severe mental illness (via Nursing Times). 

Abstract

Severe mental illness is associated with reduced life expectancy and poor physical health. Early detection and intervention increases the likelihood of improved health and social outcomes, but people experiencing their first episode of psychosis often experience delays in accessing treatment. This article summarises a review of studies funded by the National Institute for Health Research that investigates support for people with severe mental illness, and highlights how nurses working in acute, primary care and community settings can improve patients’ access to effective support and care.

The article is available to Rotherham NHS staff to request here 

 

The link between exercise and mental health

Chekroud, S.R., et al | 2018 |  Association between physical exercise and mental health in 1·2 million individuals in the USA between 2011 and 2015: a cross-sectional study |The Lancet Psychiatry| Epub ahead of print | DOI:https://doi.org/10.1016/S2215-0366(18)30227-X

A study that looked at the relationship between exercise and mental health burden  has now been published in the Lancet Journal of Psychiatry. The research team studied over one million participants and found that those who exercised had 43·2% fewer days of poor mental health in the past month than individuals who did not exercise but were otherwise similar in terms of physical health and sociodemographic status . While all forms of exercise were associated with lower mental health burden this was particularly apparent for group sports as well as gym and aerobic exercise and cycling (Source: Chekroud et al, 2018).
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The research article is available to Rotherham NHS staff  and can be requested here 

In the news:

The Telegraph Exercising for 90 minutes or more could make mental health worse, study suggests 

BBC News  Regular exercise ‘best for mental health’

ITV News Regular exercise can help improve mental health – but don’t go overboard