Agenda item

Report of the Borough Director Harrow Mental Health.

The Sub-Committee received the CNWL Mental Health – update from Dr Deepti Shah-Armon, Harrow, and Trust-wide Clinical Perinatal Director which summarised mental health services available in Harrow to explain the pathway for service users.

The following keys points were reported on:

·                 Harrow Talking Therapies

·                 Community Mental Health offer

·                 Perinatal Mental Health Services

·                 Crisis Care

·                 Inpatient Services

·                 Older Adult Mental Health Services

·                 Community learning disability services (LD)

Officers outlined the content of the report.

Following the presentation Members asked the following questions.

·                 Apart from pregnant women and new mothers with mental health issues, clarification was sought as to the other kinds of mental health conditions addressed and their causes – The Sub-Committee was advised that a variety of mental health services were addressed such as anxiety, depression, and reactions to major life events.  These conditions were quite common, and many people experienced periods of feeling low or anxious in their lives.  Generally, these issues improved either on their own or with support from friends and families, and the voluntary sector.  The service also offered Talking Therapies, including behavioural therapy for anxiety and depression.  Additional support for more severe conditions such as psychosis, schizophrenia, and entrenched depression was advised.  As for the causes, whilst there was a psychosocial and biological aspect, there was an increased understanding of the role of adverse events in peoples’ lives.  These events, whether extreme abuse or traumatic experiences like migration or isolation, could have an impact on and a person’s ability to cope.  Economic crises also played a big role in mental health and, as such, suicide rates tended to increase during such periods, affecting both individuals with and without prior mental health histories.

·                 Information about the support offered to older people and their families was sought and Members were advised that in addition to the services for the older people, the service offered support for their families and carers.  There was collaboration with voluntary partners to provide the support.  However, the memory services faced challenges as they had limited staff and were primarily commissioned for the diagnosis of dementia.  While advice was offered to diagnosed individuals and families, the service lacked the resources to provide further assistance.  Admiral Nursing funding had been sought, but unfortunately recruiting Admiral Nurses proved difficult, although this had improved in Harrow in the last couple of months.  The service identified that a crucial need for support for the funding of Admiral Nurses.

·                 In response to a question in relation to the approach of the pilot high integration service – The Members were advised that the mental health service operated as one system, whether its acute services or community care.  Meetings were held on a weekly basis where they discussed complex cases with GP’s, police, and non-state agencies, ensuring a collaborative approach.  The service aimed to minimise hospital admissions and put on emphasis on community support, following a recovery model to enhance individual lives.  Although hospitalisation was necessary, the services focus was on developing robust community support.  The service had observed that long term hospitalisation was generally not beneficial, so effective community programmes had been established, particularly for individuals with complex emotional needs, achieving successful discharges.  This integrated approach marked a positive direction for the service.

·                 In terms of statistics regarding self-referral to mental health services and current waiting times, it was explained that self-referral was possible for Talking Therapies and perinatal services with a 28-day target for comprehensive assessment and support in secondary mental health services, which was consistently met.

·                 In response to a question it was explained, the Single Point of Access (SPA) service assessed urgent cases and directed them to appropriate services, including home treatments teams or inpatient admission if necessary.  Non-urgent cases were referred to community mental health team or Talking Therapies.  A triage team within community mental health teams reviewed referrals to determine the best support or intervention.

·                 In terms of where were specific pathways for people with language or cultural barriers, Talking Therapies service was multicultural and diverse.  There were translators and staff proficient in various languages to ensure everyone had access to the service.  Additionally, the service were addressing disparities in access, particularly for young black men.  Despite being aware of the need for improvement, the service was actively working to enhance access to Talking Therapies for this demographic.

·                 In response to a question as to how mental health issues were addressed in schools –Talking Therapies had expanded their age range and were now accepting clients as young as 16.  While CAMHS primarily served those under 16, this adjustment allowed for earlier intervention and support for adolescents experiencing mental health challenges.

·                 An update on the recent transition of the Mind contract to CNW was sought including, how would its success be monitored and what are the expectations moving forward.  The transition of the Mind contract to CNW was a recent development at the beginning of the year, there was a mutual agreement between CNW and Mind.  While it was still in its early stages, the service anticipated that this transition will ultimately prove beneficial.  The service maintained close collaboration with Mind and would monitor the situation closely to ensure its success.

·                 The Officers confirmed that the partnership with Hestia had been successful in Harrow.  They operated the Curves crisis drop-in centre, offering various support services.  It had been effective in managing cases and reducing A&E visits.  The service was hopeful for continued funding and expected to receive updates on funding status in a couple of weeks’ time.  The exact patient numbers and impact were not available, but they had served roughly around 100 patients in a year.  Hestia had been established for 1 year and their extended hours, including weekend, aimed to support A&E services.  The service had also established a mental health emergency centre at Northwick Park to further support patients needing assessments with admission, thereby easing pressure on A&E services.

·                 Members requested that the Childrens Mental Health Service, the number of operations cancelled due to junior doctor’s strike, and the impact on cancer and maternity patients due to the junior doctors strike be discussed at a future meeting.

RESOLVED:  That the report benoted.