The clinical proposition for mental health improvement across North Cumbria is also an integral part of a Cumbria-wide Mental Health Transformation programme, focused on the delivery of a whole system vision for mental health improvement and has identified five priority areas for improvement:
• Implementation of the Crisis Care Concordat and improvement in services to support people experiencing a mental health crisis;
• Primary care mental health provision, including the need to address health inequalities;
• Increased involvement of the third sector as providers of a wide range of services;
• A system of care that supports and actively promotes recovery;
• Review and implement the dementia pathway for Cumbria.
Models of care that work well in an urban environment do not easily translate (and deliver benefits) into Cumbria’s rural geography. Small numbers of people requiring highly specialised services travel out of area because it is not always feasible to provide these services in Cumbria and it is difficult to recruit to vacancies in some essential and specialist roles. Workforce recruitment is challenging across the county, especially in the areas of qualified staff, and medical staffing.
What will we do?
The recently published Five Year Forward View for Mental Health makes 58 recommendations to be implemented by 2020/21. The national commission for the review of psychiatric inpatient care for adults makes a further 12 recommendations. This compelling evidence reinforces the need to make whole-system step change in how we deliver mental health crisis support, putting it on a par with other emergency services 24/7, and providing a greater range of care and support close to home, as alternatives to mental health hospital admission.
To support the development of a co-produced whole-system model of care for mental health across Cumbria, we are using a framework to allow us to quantify the balance of investment made across the full range of mental health provision and support, so that we can make informed choices about how we will shift the balance of resource into more locally accessible alternatives to hospital care. This is an all age approach and includes dementia and support to children and young people where there are clear interdependencies.
We want to see:
• Improved mental health wellbeing by increased awareness, prevention, resilience and support available more widely and accessibly.
• Reduced deaths from suicide.
• Improved treatment and recovery options delivered innovatively within community assets and local based services including primary care.
• Improved crisis prevention, responses and enhanced options for sustained recovery.
• Improved longer term health outcomes for people living with severe mental illness in our communities; such as increased life expectancy through enhanced opportunities for employment, suitable housing and rehabilitation to prevent mental ill-health related disability.
• Enhanced diagnosis, advice, treatment and support for people living with dementia in our communities.