MHPF and the Mental Health Voluntary Sector (MHVS) welcome the very candid Mental Health Task Force report and findings spanning the variety of system, culture and service delivery issues affecting the lives of people with mental health needs. We look forward to further detail regarding the implementation of the recommendations and resources to support this. There are a number of areas listed below that the MHVS would seek to see strengthened in either recommendation or as focus for task group work:
- The Care Act 2014 is a major lever in supporting change since it is rooted in the principles of ‘wellbeing’ in its broadest sense and organising support around the individual. Therefore we believe it needs primary prominence moving forward.
- We believe there needs to be a greater focus on personalised commissioning and strengthening the value of personal budgets – not as an end in themselves but as a mechanism to increasing the critical need for more individualised approaches to sustaining wellbeing and recovery. There is mention of the Integrated Personal Commissioning (IPC) agenda in context of Vanguards but we believe this requires more detail in relation to its primary focus in supporting people better with long term conditions, (of which mental health is a primary area). IPC work on capitated budgets would also potentially have some synergy with the recommendations on population based budgets.
- Understandably this report has a significant health pathway focus but we would seek to see more of the social determinants of mental health issues and increased emphasis on social care and targeted community support as a key enabler to wellbeing. There needs to be some acknowledgement of the impact and value of this and also the current funding constraints that councils are experiencing. Councils work with the voluntary sector to deliver innovative and creative community solutions that are cost effective and deliver best outcomes for people with mental health needs. The MHVS can give lots of examples of best practice that has improved life chances such as family support as a critical area in preventing admission to acute psychiatric services and support in crisis where there is a coexistence of health and social need.
- We particularly welcome the recommendation to involve the voluntary sector in Care Navigator work and would like to see this expanded further, to include the established work that the MHVS does to improve quality assurance processes, evaluation and service delivery monitoring.
- It is pleasing to see greater emphasis on coproduction and we would seek to expand the recommendation to ensure it builds on existing good practice in this area as opposed to reinventing it as a pilot. There is a multiplicity of guidance and live good practice examples around this which the MHVS would be pleased to share and engage with further. In addition NHSE Coalition for Collaborative Care and People Hub should be included in this work if not already.
- Workforce continues to be a major challenge cross sector in terms of capacity, retention and skills development so we would add into the recommendations on workforce, the requirement for a shift towards roles that are reflective of changing cultures, expectations and direction of mental health support. These are social responses, self management and community assets based approaches. This fits with the recommendation on social work which we would like to see given further traction as a key professional role that is shifting much more towards assets based models to support sustained recovery. In addition we believe there should be further emphasis on the value of peer support and an expansive programme to employ workers with lived experience.
- We are delighted that there is a key recommendation on housing and its key role in sustaining people with mental health needs in their communities. The added value that housing brings, particularly within neighbourhood models is critical for hard to place groups such as young men with enduring mental health needs. However there are contradictory government policy decisions requiring a highlight, that may threaten the thrust of this recommendation, such as the recent announcements around Local Housing Allowance and its impact for social landlords.
- The MHVS has numerous examples of great practice around prevention and crisis support with emphasis on small scale recovery houses, short term family placement and key ring services, to name a few. We want to share these to add value.
- Areas that need some further emphasis also include the use of new technologies as a health and social support mechanism, the criminal justice system and impact of physical health on mental health.
In summary, the MHVS are enthused and excited by this report and seeks to be engaged in further work moving forward to support implementation which would include:
- Housing via the National Mental Health Housing Forum
- Prevention and crisis support
- Integrated approaches to long term sustainable solutions
- Impact of physical health on mental health and wellbeing.