Attending: Jess Mookherjee of West Kent NHS and Jill Roberts, Chief Executive of Sevenoaks MIND.

The Chairman invited Jess Mookherjee to update Members on Mental Health and Well Being Services and Issues in West Kent.

Ms Mookherjee explained that she intended to talk about the Mental Health needs of people in West Kent, focusing upon Sevenoaks District where appropriate, and differentiating between the needs of adults and children. She explained that 1 in 6 people in West Kent had a diagnosable common mental health problem (typically depression or anxiety) but that only 1 in 26 people sought medical help for the condition. Likewise 1 in 100 people had a treatable severe mental health illness (such as bipolar disorder or schizophrenia)  but that only a quarter of these had an in-depth care package. This illustrated the lack of accessibility to services and the possible scale of unmet need. In terms of children aged between 5 and 15 years old it was felt that family coping processes had a greater bearing on their mental health rather than family structures and that there was a link between deprivation and mental health problems. This view was challenged by a Member who contended that greater support was available to the deprived and that mental wellbeing was more likely to suffer where someone was struggling to cope and support was not available. Ms Mookherjee accepted that whilst mental health was a complex issue where many factors came into play it was generally accepted that there was some co-relation between deprivation and poor mental health.

The scale of anticipated mental health disorders of children in Sevenoaks was outlined and it was noted that certain groups of children were at a higher risk of experiencing mental health problems with looked after-children 45% more likely to experience mental health issues, children with SEN 44% more likely and children with learning disability 22% and households without a working parent 20% more likely than average. It was explained that the categories of adults with the highest risk of experiencing mental health issues included prisoners, farmers, people with learning difficulties, the BME population, the homeless, carers and victims of domestic abuse. In terms of Mental Health inpatient admissions it was noted that Sevenoaks had a much lower level of inpatient admissions than the Kent average but that Swanley and Sevenoaks Eastern wards had some of the highest rates of inpatient admissions in the County. It was also noted that West Kent had a higher suicide rate than the national average and that the category of people most at risk were 35-55 year old white males and that only half of these had been in contact with mental health services. There were also clear links between other diseases and serious mental health issues and mental illness also had an impact on recovery from physical illnesses. Expenditure on mental health services in West Kent was £171 per person, broadly in line with the national level of spend and 63% of this was spent with NHS organisations and 37% with other organisations.

Ms Mookherjee explained the initiatives being carried by the Mental Health Services in West Kent. This included working with acute services and GP’s to manage care better and redesigning Community Mental Health Team’s to ensure that the right people receive high quality and timely treatment and increasing access to psychological therapy. Steps were also being taken to raise awareness of mental health, to promote understanding and reduce the stigma associated with mental health and to support social cohesion. Work was also being carried out on suicide prevention. A number of these actions were being undertaken through the Liveitwell initiative details of which could be found on the web by accessing www.Liveitwell.org.uk.

Members asked whether the NHS was measuring progress in improving the accessibility of mental health services and whether progress was being made. Ms Mookherjee admitted that mental health provision in West Kent had been poor in the past and that services put in place in response had not been working. Better services were now in place and the quality of these services was monitored however the numbers accessing these services could be improved. In response to another question she agreed that it was not acceptable that some people with acute mental health problems could be forced to take medication which might not be good for them. In terms of the high rates of inpatient admissions in the two Swanley wards it was felt that this could be as the result of the activity of particular doctors. The possible reasons for the high risk of farmers and prisoners suffering from mental health problems was discussed and it was felt that in the first case a sense of isolation might be one cause and that in terms of prisoners more people with mental health problems were being imprisoned than in previous years when they might have received care in different institutions. The relatively high risk of suicide and self harm for 16-25 year olds was raised and Ms Mookherjee explained the work that was being carried out with schools through the Healthy School campaign to address some of these issues.   

Jill Roberts, Chief Executive of Sevenoaks Area MIND, addressed the Committee to explain the work that MIND was undertaking in the District. She explained that she had over 15 years experience of working in the Voluntary Sector as well as experience of working in the private and public sectors. This experience had informed her approach to working on mental health issues in the community. Mental health was a complex area and one in which advances in terms of understanding and treating conditions lagged behind advances in treating physical ailments, partly because of a comparative lack of funding and research. Mental and physical wellbeing were closely linked and the work that MIND carried out focussed on promoting awareness, removing the stigma associated with mental health conditions and being there to help people and their families at a time when they felt most vulnerable and isolated. MIND sought to increase the take up of their services, develop a broad range of support and to make their services accessible to all sectors of society including hard-to-reach groups. Members were informed of the therapy and counselling services delivered by MIND’s volunteers, the self-help groups that had been set up and services such as the Move-on Service to provide support when clients were discharged from hospital. MIND focussed on community based activities across a wide range of subjects including sports, crafts and the arts. Particular attention was drawn to the Community Garden project and how this had assisted in breaking down barriers and challenging stereotypes as well as providing a community facility.   MIND had the advantage of being close to the people that it sought to help, was able to mobilise volunteers and could also operate flexibly and be more responsive to people’s needs than other more formal organisations but was keen to access additional resources and to work in partnership with other agencies.

A Member asked about the availability of counselling services and expressed concern that GP referrals to counselling services might be impacted if GPs were drawn into wider healthcare commissioning work as part of GP consortia arrangements. Ms Roberts explained that MIND’s counsellors were trained volunteers and that they were an additional source of counselling to the qualified counsellors that GP’s might call upon. Ms Mookherjee confirmed that there should be no issues around the availability of GP counselling services in West Kent. Another Member expressed the need for greater public awareness and understanding that mental health problems could be experienced by anybody and the implications of some of the treatments. Ms Roberts explained the work that MIND was undertaking to promote awareness and the involvement of some of MIND’s clients  in sharing their experiences and in particular the importance of promoting greater understanding of the issues among employers.

The Chairman thanked both speakers for their informative presentations and for attending the meeting.