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Towards a Mentally Flourishing Dundee

Towards a Mentally Flourishing Dundee. Mentally Flourishing.

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Towards a Mentally Flourishing Dundee

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  1. Towards a Mentally Flourishing Dundee

  2. Mentally Flourishing We wish to see a Scotland where we all understand that there is no health without good mental health, where we know how to support and improve our own and others’ mental health and wellbeing and act on that knowledge and where our flourishing mental health and mental wellbeing contributes to a healthier, wealthier and fairer, smarter, greener and safer Scotland. TAMFS Scottish Government 2008

  3. Wellbeing - 3 dimensions – emotional, social and psychological This includes our ability to cope with life’s problems and make the most of life’s opportunities, to cope in the face of adversity and to flourish in all our environments: to feel good and function well, both individually and collectively. Mental wellbeing ranges from good or high mental health, or flourishing, at one end of a continuum to poor mental health, or languishing at the other end of the continuum. TAMFS Scottish Government 2008

  4. It’s great news – we have a lot of new evidence and initiatives to fit together

  5. Evidence • National Mental Health Indicators Group • WEMWEBS • Mental Health Promotion Building an Economic Case • Social Prescribing • Recovery Network Study • Positive Steps • Review of national programme

  6. Initatives • Delivering for mental health • Tayside action plan includes wellbeing • Work with community and voluntary sector • With inclusion in mind • Healthy Dundee • CHEK/community led health • Stepped care • Wellbeing at work in NHS Tayside • Towards a Mentally Flourishing Scotland

  7. National Mental Health Indicators Group • Part of national programme • Effective interventions • Validated measure WEMWEBS • Population approach

  8. Flourishing Mental Health Diagnosed disorder but copes well; has POSITIVE MENTAL HEALTH No illness or disorderPOSITIVE MENTAL HEALTH Maximum Mental Disorder Minimum Mental Disorder POOR MENTAL HEALTH and diagnosis of disorder POOR MENTAL HEALTH but no diagnosis of disorder Languishing Mental Health

  9. Population Approach

  10. Population Approach Flourishing Languishing Disorder Moderate Population mental health: emotional, psychological, social (Keyes, 2002; Rose 2003; Huppart 2005)

  11. Invest to Save: Best Buys in Economic Research 2007 • Supporting parents and early years: parenting skills training/pre-school education • Supporting children and young people: health promoting schools and continuing education • Improving working lives: employment/workplace • Positive steps for mental health: lifestyle (diet, exercise, sensible drinking and social support) • Supporting communities: environmental improvements

  12. Social Prescribing • Pressure on 1° care • No alternatives • ‘Reach for the prescription pad’ • Well evidenced approach

  13. “The gist of Kirsch’s analysis of published and unpublished data from studies of anti-depressants in adults was that only a very small subset of patients seemed to benefit to a clinically significant degree.”Lenzer and Brownlee, BMJ, 8 March 2008“Kirsch and colleagues recommend that if anti-depressants are to be used at all they should be used only when alternative treatments have failed to provide benefit”Turner, BMJ, 8 March 2008

  14. ‘Depression rating scales used in clinical trials seldom measure quality of life, which has been suggested to be a reasonable measure of clinical significance’Turner, BMJ, 8 March 2008 “It seems unfair that pharmacological and not psychotherapeutic treatment has become the usual first line approach to depression merely for economic reasonsTurner, BMJ, 8 March 2008

  15. Positive Steps • Supportive contact • Activity • Nature • Creativity • Good diet • Alcohol sense • Life-long learning

  16. Recovery Network Study • Same positive steps as everyone else • Hope is crucial • Plan to be better when you start

  17. “Poor mental health is both a cause and a consequence of social, economic and environmental inequalities. Multi-level intersectoral action is required that will address the structural determinants of mental health.” Review of Scotland’s National Programme for improving mental health and wellbeing in 2007

  18. Initatives • Delivering for mental health • Tayside action plan includes wellbeing • Work with community and voluntary sector • With inclusion in mind • Healthy Dundee • CHEK/community led health • Stepped care • Wellbeing at work in NHS Tayside • Towards a Mentally Flourishing Scotland

  19. Working with the Voluntary and Community Sector • Positive working • Empowerment and respect • The resource available • Support and empower this

  20. With inclusion in mind • Local authority role in promoting wellbeing and social development • Builds on 2005 guidance • All local authority services

  21. With inclusion in mind • “The most efficient way to reach all the people included under the Act is to focus upon universal services, rather than just specialist mental health provision.” • “Mental health and wellbeing are everybody’s business.” • “Releasing people’s gifts and building social and economic capital.” • Work in partnership • Hits all targets

  22. Healthy Dundee • Considered - Better Health Better Care - Well-being approach • Enthusiasm to bring it all together • Priority for this approach • Should be a consideration in each initiative

  23. CHEX/Community Lead Health • Work in Tayside • Well evidenced approach • Communities as the Focus for Change • Empowerment

  24. TAMFD • Events around Tayside • What people said • Response to Scottish Government • YES PLEASE!

  25. Response 1:-Local shared objectives and actions-Deliverable, measurable and valuable • Partnerships • Community focus • Targetting • Approaches • Training • Stigma • Build on what we have

  26. Response 2: National Supports • National lobbying for priority for wellbeing • Research and evidence base • Sustainable resource • Media work and national campaigns (See me and choose life) • Support use of WEMWEBS • Embed in all sector training • Legal issues and benefits • Support local training

  27. Response 3: How to track and assess progress • Structures and mechanisms • Indicators • Need new targets • Suit local situation • Outcomes may “benefit” another partner • Whole community

  28. What we said on 1 November • Exemplar pilot in each area • Get well-being into the strategies • Get well evidenced change

  29. Shifting the Balance • In the review of of 2004 • Need to believe it • Need to resource it

  30. Shifting the BalanceExample - Polio • More iron lungs • Develop a vaccine • Hard choices to make • What happened next?

  31. Strategy • Emerging • Look at whole picture • The elephant in the room • Making change happen

  32. “This is really about the kind of community we want to belong to”. Allyson McCollam 2008

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