Pan-Lancashire Public Mental Health Steering Group Large Scale Change Project

1. Pan-Lancashire Public Mental Health Steering GroupLarge Scale Change Project “Positive Well-being in Our Lancashire – Making Our Communities Connected and Resilient”

2. Key Drivers • Education • Housing • Employment • Economy – Social and Personal • Environment • Involvement/connectedness/inclusion • Physical Health • Ages – Children, Adults and Older Adults • Safety/Crime, Fear of Crime • Personal Resilience • Perception • Evidence • Care Pathways • ABCD

3. Elevator conversation Not only is there no health without mental health, but there is no true citizenship. We all have individual and collective responsibility for own well-being and for actions that impact on those around us. We aim to raise awareness of what well-being is, and what it’s determinants are, and encourage uptake of well-being promoting activity, such as the five ways to well-being, and by sharing skills and opportunities to influence determinants. Increasing need and reduced resources mean we need to do things radically differently now – there is both an imperative and a willingness to do this, so we can sustainably improve the well-being of the population of Lancashire.

4. Education • Schools, colleges, universities • Ofsted framework – incorporating H & W-B into that – PHSE • Adult – non-vocational (diminishing) • Pre-school • Epigenetics (Mark Swift) • Community pathway into education – • Peer mentoring • Workplace training - resilient workplaces • Redefining success in education

5. Housing • Social landlords – community development workers – clear role • Town planning – quality of built environment – sustainable development • Quality of housing –recognising the impact of housing stock • Empty homes strategy • Mental health supported accommodation (Sue Hird) • Approved list of housing for prisons (standards) • Housing benefit cap • Long term social regeneration of specific estates • Homelessness – overt and hidden • Rural isolation • Adaptation of housing to maintain independence, telecare etc

6. Employment • Business incubation for sole traders – link to housing improvement, empty homes. • Workplace health and wellbeing – award schemes • Good quality volunteering and time bank approaches. • Employee volunteering schemes – linking employees to community schemes • Chamber of commerce etc

7. Economy – Social and Personal • Building social capital -Time banks , social prescribing, ABCD etc. • Credit unions, Welfare rights, trading standards, payday loans etc • Supporting micro-economies in local communities • Influencing large scale developments to ensure opportunities for local people – MWIA, Health Equity Audit • Community buying - Fuel poverty, renewable energy, electricity, target inequalities

8. Environment • Eco-therapy, green gyms • MWIA on Environment policies and initiatives • Healthy Streets, 20 mph • Lancs community recycling network • Community food growing and land share • Parks and green spaces – friends of.. • In Bloom, Best Garden, Yard, Alley contests • Safe playing areas, parks etc • Community clean ups, beach cleans

9. Involvement/connectedness/inclusion • Attachment of place and pride in your community • See above • Participatory budgeting • Mental Health Social Inclusion • Co-design and co-production of services • Identification of community talent and skilling people up to be community activists • Community reporters and journalism • Intergenerational work, sharing stories • Buy in from Elected Members – county and district

10. Physical Health • Health professionals have a better understanding of the link between physical and mental health. • Influencing screening to include MH in screening programmes and care pathways • Linking Help Direct with GPs • Develop sub-clinical pathways in primary care • Improving physical health of people with serious mental health problems • Improving mental health of people with long term conditions and physical illness

11. Ages – Children, Adults and Older Adults • Transitions between ages – i.e. 16-18, 64-65 and differences in very old age • Lifecourse approaches • “Older Adult services” – illegal under the Equality act?

12. Safety/Crime, Fear of Crime • Asset approaches to improving community safety, vibrant, thriving neighbourhoods • Turn whole Community Safety Partnership thing on its head • Youth worker perspectives in crime and safety • Media coverage and bad press

13. Personal Resilience • 5 Ways to Wellbeing • Workplace initiatives • Positive experience of education • Psycho-social education • Mental Health First Aid • Reducing stigma of mental health and illness • Celebrate and learn from “failure” – redefine success and optimism • Wanting what we have, not getting what we want

14. Perception • Create a vision/definition of what we mean by a happy and successful life • Stigma – esp, serious mental health problems, within particular communities, workplace culture, mindful employers • Return to work, managing sickness and absence due to MH problems • Local perceptions of culture, identity, aspiration,

15. Evidence • NW Wellbeing survey 2012 • Generate and learn from personal and community narratives – meta-narratives • Social Return on Investment • Dig out useful tools and methods that can be distributed and shared • Addressing the issue of how the dept/service making the investment aren’t the ones to make the savings – e.g. housing invests, social care saves.

16. Care Pathways • Fully integrated care pathways from sub-clinical to inpatient. • CCGs want to divert care pathways towards less clinical options • Think Family / Total Family • Mental health on the cardiac care pathway and other physical care pathway • Building recovery into mental health pathways • A&E self harm response.

17. Lifestyles • More integrated lifestyle approaches, rather than separate smoking, drinking, exercise, weight – life coaching • Better understanding of what drives lifestyle choices – more than Health Police • Give people the power back to do for themselves what we’ve been doing for them for years

18. Assets Based Community Development • Multi-agency, multi departmental pilots in chosen estates to explore asset approaches to economy, health, education pathways, housing, environment etc. Pendle, Preston, South Ribble, Morecambe, Freckleton, Skem, • Develop an evaluation/evidence gathering tool • Link to peer mentoring • Making better use of physical assets, connecting communities and services. • Testing issues of trust, legislation, fear of litigation, health and safety fears • Do something we’ve never done before and that we find uncomfortable • E.g. sort out that patch of land, empty property etc • Asset transfer – community ownership

19. Stakeholder Analysis - Education • Schools governors – thematic leads - PHSE • Lancashire Heads Forum • Infant Mortality Group • Further Education principles network • Individual unis • Work place learning providers • Unions relating to learning - workplaces

20. Stakeholder Analysis - Housing • Social housing providers • Network of district housing officers • Supported housing services • Supporting people – Sarah MacCarthy • Empty homes officers – • National Housing Federation – regional for a (Pete G has contact!)

21. Stakeholder Analysis - Employment • Job Centre plus • Workstart • Work programme providers • Workplace health leads _ on board!! • Occupational health – we ought to be exemplars • Economic development – LCDL – SMEs • Chamber of commerce

22. Stakeholder Analysis - Economy – Social and Personal • Faith Groups • Community resources – associations • Parish councils • Community Futures • MH Vol sector consortium • Young People’s Vol sector consortium • Surestart

23. Stakeholder Analysis - Environment • Kayt Horsley – Healthy streets • Local councillors • Groundwork NW • Recycling networks – county and district • Countryside rangers • Waterways

24. Stakeholder Analysis – Involvement/connectedness/inclusion • VCFS • Associations • Education partners • Volunteers – LCC and other orgs (Julie Sumner - One Lancashire – for consistency and avoidance of duplication) • Older people’s fora - • Sports Associations • Adrian Leather – Sports Lancs

25. Stakeholder Analysis – Physical Health • Integrated health improvement within Public Health • CCGs • Leisure • Community pharmacists • Libraries

26. Stakeholder Analysis –Ages – Children, Adults and Older Adults • Pre-school, school, leisure • Youth services/groups • Intergenerational activities - libraries • Workplaces • Associations • Older People’s Fora • Lunch clubs etc • Co-produced activities

27. Stakeholder Analysis –Safety/Crime, Fear of Crime • community safety partnership – local and county • Probation service – Andrew Cass and Emma/Jayne • Prison health improvement • Offender care pathway • Youth offending teams • Police – PCSOs • Victim support • Refuges • Media/communications • Neighbourhood watch • Care and repair • Lancs Fire and Rescue • Trading standards

28. Stakeholder Analysis – Personal Resilience • Help Direct • Social prescribing • Peer mentors • To promote 5 ways to well-being • Workplace resilience • Job Centre plus • Survivors networks – pro social modelling - expectations

29. Stakeholder Analysis – Perception • Media • Anti stigma leads and networks – strengthened • Provider services • Survivor movements – self stigma and challenging low aspirations • Employers • Health services

30. Stakeholder Analysis – Evidence • Creating shared menu of stories/case studies/reports • Send mental Elf link to group

31. Stakeholder Analysis - Care Pathways • CCGs • Karen Green - LCFT • CAMHS • Sharing good practice examples of above with above

32. Stakeholder Analysis - ABCD • CCGs • LCC commissioning • Community development network • CVS networks • Local Area coordination leads • Help direct • Social prescribing • Healthwatch • Young people’s networks