People’s Board Meeting Summary 21/06/18
Clinical Commissioning Groups Equality Objectives and links to the Mental Well-Being Strategy
Pia Bruhn, Equality and Diversity Manager eMBED Health Consortium explained that the Clinical Commissioning Groups Equality Objectives have a large section on mental health within it. The People’s Board were being asked if they could contribute to this part of the Equality Objectives by advocating for protected and vulnerable groups.
Pia’s presentation to us on Health Inequalities started with an interesting diagram about the levels of inequality being closely linked to poverty. With the main components set out as three sides of a triangle, who you are, where you live and how you’re treated by other people and organisations.
Interestingly she also said that at different points you can be more vulnerable along each side depending on how each of those three things is affecting your life and the balance is important.
Pia explained that the Bradford District Care Trust, Bradford Teaching Hospitals Foundation Trust, Airedale Hospital Trust and the CCGs had all held workgroups with members of the public who looked at the equality delivery system, these panels brought out a range of concerns which the equalities teams in each organisation would be working on.
Pia then asked the People’s Board to break into working groups looking at three main questions:
- What key issues relating to health inequalities do you want to ensure the mental well-being strategy addresses?
- What can you in the People’s board offered to support this happening?
- Does this support delivery of the equality objectives? If so which ones?
This was a cause for much animated discussion as there is a broad range of experiences skills and backgrounds across the People’s Board. Pia will use the feedback from the People’s Board to help shape the action plan, and will share her report with the People’s Board when it is complete.
Here’s a summary of the discussions:
Most of the small workgroups had discussed poverty and linked issues of inequality that could make things worse. For e.g. access to services, costs of services, and the need to be mindful of the range of communities across the district.
The groups also felt that outside factors strongly affected people’s health; things they have no control over: e.g. the change from the multitude of different benefits to universal credit; changes to primary care and the reduction in voluntary and community sector services due to the diminishing budget available.
It was also felt that a key issue was young people’s mental health; perhaps there was less resilience and that young people were now more living their lives more publicly because of social media, and were peer group focussed.
Mental health waiting lists: these were still extensive – time between the introductory meeting with CAMHS and when you could actually be seen by any sort of support organisation or worker.
The group strongly felt that as part of the prevention and early intervention more focus needed to be on low-level mental health difficulties and that there were barriers to many people to asking for mental health. They also felt that for people with disabilities, especially young people, there was the stark difference between full support until your 18 to 25 and the transition to adult care.
The group also felt that mental health needed to be referred to as more than mental illness what about low level ill health feeling mentally unwell? The board felt there was a very clear difference. For example feeling mentally unwell could be, absence of well-being, feeling worthless, or bad physical health leading to low mood. All of these things lead to destruction of a person’s sense of identity.
People need to know what help is available they need good clear communication pathways and the People’s Board felt that advertising needed to be easier and less obviously around ‘mental health’. Members gave some examples; they felt that advertising needed to be clear and obvious perhaps on billboards, posters in public places, community centres, gurdwaras, mosques, doctors surgeries and community centres. There needed to be innovative accessible information and wider net of publicity, including digital.
It was also felt that we need to advocate the different supported services not obviously called mental health so that people would feel they can participate without having the label attached.
The conversations focused around people influencing their own care packages; being advocates of the style of service that was to be delivered and perhaps the wider aspects of mental health and the strategic change
There was discussion on the importance of supporting social connections; early intervention; and prevention which is a key priority that the People’s Board have identified.
All the members of the People’s board felt that early intervention was keen to services working together and promoting individual solutions was really important.
The focus on Mental Health continued during the next agenda item.
Sasha Bhat, Head of Commissioning Mental Wellbeing across the Bradford District and Craven area, gave an update on her previous discussions around Community Mental Health Teams. These can be seen in detail in our last minutes blog.
The Mental Health Partnership team had been to look at how other services across the country were working on Early Prevention and Intervention. She felt it reflected quite well on the progress that Bradford was making. They had been to Lambeth who have an ‘open door’ policy; Liverpool has ‘life rooms’, Sasha really wants more detail on how their commissioning model works. Groups from the services at Peterborough and Cambridge had been to Bradford and had been impressed with our work.
They had also been to the University of Essex and York and discussed the impact racial and ethnic harassment as well as disability and hate crime has on wellbeing. The team strongly felt that although there were national priorities we needed to link to the issues in Bradford District.
The People’s Board gave feedback to Sasha on her paper on how the Mental Wellbeing Strategy for Bradford District and Craven fits within the social model of health.
People’s Board will continue to work with Sasha and her team and receive updates on the plans for Community Mental Health.