Are We There Yet

1. Are We There Yet??? Mental Health Airth Castle � 20 October 2008

2. National Drivers Today Better Health Better Care Health Improvement Tackling Inequalities Improving Quality of Care Delivering for Mental Health Provides Direction with Commitments and Targets With Inclusion in Mind Promotion of Wellbeing & Social Development Mind The Gaps Towards A Mentally Flourishing Scotland

3. Guidance & Direction Integration Accessibility Recovery Wellbeing Physical Healthcare Employability Homelessness Commissioning Strategy 14 Commitments 3 HEAT Targets Review Implementation "Well, it seems to have a lot of momentum." Of course it has momentum. You gain momentum very fast when you're rolling downhill out of control. What I want here is not momentum. What I want is progress. - Elizabeth Zwicky

5. 5 Spectrum of mental health Broadly this is the terrain � languishing and the heroines of Victorian novels� Broadly this is the terrain � languishing and the heroines of Victorian novels�

6. 6 Scotland�s National Mental Health and Wellbeing Indicators

7. Holistic Approach Prevention better than cure One journey, with detours Lots of needs � complex and simple Person centred Recovery � be all you can be Support, not direct Shared care

8. Collaborative Commissioning

9. Our Identified Priorities

10. Consultation Outcomes

11. Positive Mental Health What is the role of the medical model? Why Shift the funding to level 4? Can we not keep Well rather than Make Well? Role of Social Prescribing? Talking � it helps? Exercise helps

12. Do We Really Need The Medical Model?

14. Burden of Disease in High Mortality Developing Countries 1) HIV/AIDS 2) Lower Respiratory Infections 3) Diarrhoeal Diseases 4) Childhood Cluster Diseases 5) Low Birth Weight 6) Malaria 7) Unipolar Depresssive Disorders 8) I.H.D. 9) Tuberculosis 10) Road Traffic Accident

15. Burden of Disease in Low Mortality Developing Countries 1) Unipolar Depressive Disorders 2) Cerebrovascular Disease 3) Lower Respiratory Infections 4) Road Traffic Injury 5) C.O.P.D. 6) I.H.D. 7) Birth Asphyxia/ Trauma 8) Tuberculosis 9) Alcohol Use Disorders 10) Deafness

16. Burden of Disease in Developed Countries 1) I.H.D. 2) Unipolar Depressive Disorders 3) Cerebrovascular Disease 4) Alcohol Use Disorders 5) Dementia & Other CNS Disorders 6) Deafness 7) C.O.P.D. 8) Road Traffic Injury 9) Osteoarthritis 10) Trachea, Bronchus & Lung Cancers.

17. Myth IMental Disorders are Preventable Partially Correct Genetic Factors are Important Public Health measures may reduce the incidence but will not prevent all cases Same Public Health measures as for prevention of major physical disorders

18. Myth IIMental Disorders are Untreatable There is a better evidence base for treatment of mental disorders than for the treatments of most physical disorders 25% of UK population suffer a Mental Disorder at some time in their lives 25% of UK population are not permanently disabled thereafter.

19. Myth IIIMental Disorders are not Life Threatening The suicide rate in severe depression is 15% The suicide rate in schizophrenia is 12% �15% The suicide rate in Bipolar Affective Disorder is 15% - 20% The Public blames suicide on failures in Mental Health Services

20. Myth IVMental Illnesses are not Real Illnesses Neurological Disorders Affect cognition, mood, thought processing and behaviour rather than movement Multifactorial in origin Genetic Factors are important

21. Stigma Is funding for statins and cardiac surgery... ..funding for diabetics services.. ..funding for COPD treatment.. ..funding for cancer services being cut pending the benefits from Public Health measures?

22. The Importance of Effective Treatment Ineffective Treatment is Inefficient Treatment Mental Health and Physical Health are inextricably linked Effective Treatments contribute to prevention Cost to the individual Cost to NHS Scotland Cost to Scottish Society