Mental Health Strategy and How it Affects the Wirral
The government’s No Health Without Mental Health strategy was published in
February 2011, aiming at nationwide reforms in how mental health is viewed and treated. An
especial emphasis was placed on local authorities being given the freedom to improve their
services but a review the following year shows that funding and budget cuts have hindered
these reforms having a positive effect. Locally, Wirral Borough Council has been
implementing measures to improve mental health in the region, including making mental
health a priority area in their Health and Wellbeing Strategy.
In February 2011, under the coalition government, a nationwide mental health
strategy was published called No Health Without Mental Health. This document set out
shared objectives to improve mental health and wellbeing across the country. It also stated
that 1 in 4 people will suffer from mental health issues and that these mental health problems
cost the country around £105 billion a year. To try to reduce this, the government set out
several targets and reforms to mental health care. These reforms include the ‘no decision
about me without me’ initiative, which encourages easier access to information about
treatment and to allow the patient to play a large part in decision making, and to make sure
that those with mental health problems have good physical health, as it is believed there is a
link between them. The government also intended to work with Time To Change to challenge
stereotypes and stigma about mental health and to give local organisations and practitioners
the freedom to make what they view as the right improvements to services in their area. To
measure mental wellbeing, the document sets out the ‘Five Ways of Wellbeing’:
1.
2.
3.
4.
5.
Connect – with family, friends and the community
Be active
Take notice of the would around you
Keep learning
Give – help the local community or the people around you
To evaluate how well these initiatives are working, the government focuses on measurable
outcomes and NICE quality standards (Department of Health, 2011).
Despite all of these objectives and reforms, evidence from the Mental Health
Foundation suggests that this mental health strategy is not having a significant effect. From
data collected both from a survey and a mental health summit collected a year after the
mental health strategy was published, the organisation found that the demand for mental
health services is increasing significantly and this has been linked to rising unemployment
levels. The MHF has found that the biggest problem with mental health services is a lack of
funding and budget cuts (Mental Health Foundation, 2012), despite a government pledge to
invest £400 million of 4 years of psychological therapy (Department of Health, 2011). SANE
has found that, due to lack of funding, 72 services (most of them for people with mental
health problems) have closed in 11 months. Funding is what directs decisions rather than the
strategy and any innovation local authorities have is hindered by budget cuts. The findings
that that, though mental health services have not been disproportionately targeted by budget
cuts, they have not been protected either. In particular, voluntary sectors are facing significant
funding problems and Youth Access has stated that, though the demand for services for
young people has increased, 42% of agencies face the threat of closure. There is one positive
result of the strategy, though. Liaison psychiatry has been implemented in hospitals as a
result of the established link between physical health and mental health (Mental Health
Foundation, 2012) and has shown to reduce hospital costs by as much as £5 million a year
(Parsonage, Fossy and Totty, 2012).
On a local level, the Wirral Borough Council have published their first Health and
Wellbeing Strategy in 2013. In April 2013, the Health and Wellbeing Board became a
statutory committee of Wirral Council and the strategy set out a framework for achieving
better health and wellbeing across the Wirral. The document states that unemployment, the
aforementioned factor that drives us the demand for mental health services, is at a higher
percentage on the Wirral than the national average, as is the percentage of 18-24 year olds
claiming job-seeker’s allowance. During a public and stakeholder consultation, mental health
was considered to be a key priority issue and, so, the Health and Wellbeing Board placed this
as a priority area. This is due to the fact that the Wirral has a lower mental health wellbeing
score than the North West average and a significantly higher hospitalisation rate for mental
health conditions than across the rest of Merseyside. The latter is also more than twice than
the national average. Dementia, in particular, is deemed a key local priority. The four ways
the board intends to address these challenges are:



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Addressing social isolation
Develop stronger links with housing providers
Promote employment opportunities for people with mental health issues
Promote accessibility to community based interventions
The strategy will be reviewed every six months by the board and revised annually when
appropriate (Wirral Health and Wellbeing Board, 2013).
The ways in which the Health and Wellbeing Board intend to fulfil these
aforementioned goals are as follows. To fulfil the first goal of addressing social isolation,
Wirral Council intends to work with Time to Change to reduce stigma of mental illness and
promote early diagnosis, as well as raising awareness in frontline and community staff. They
also intend to ensure that social support is appropriately signposted and that parenting support
services and the health visiting services are identifying and addressing social isolation. In
regards to the recent welfare reforms, the council will be reviewing changes to Incapacity
Benefit in reassessing people as fit for work and that health partners are fully aware of the
changes. The council also wishes to ensure that links between mental health services and
financial inclusion services are maintained so that mental health services will be invited to
working groups such as the Wirral Credit Union where they are able to help those in financial
difficulty (Wirral Health and Wellbeing Board, 2013).
To fulfil the second goal, Wirral Council intends to develop working relationships
between health and housing providers to understand how government housing policies affect
people with mental health issues. To fulfil the third goal, the council will support employers
to work towards achieving the title of ‘Mindful Employer’, as well as review and evaluate
existing employability projects such as Advocacy in Wirral and Reachout. The council will
also promote volunteering and work experience volunteering to help people with mental
health conditions back into employment. Finally, to fulfil the fourth goal, the council will
work with clinical commissioning groups to improve the uptake of physical health checks for
people with mental health problems. They will also work with the CWP to support mental
health service uses to quit smoking and to understand how they can be supported effectively
(Wirral Health and Wellbeing Board, 2013).
In conclusion, though the government are setting objectives for the improvement of
mental health services, government budget cuts are making it difficult to implement practical
improvements. Wirral Borough Council, however, have made mental health a priority on the
recently established Health and Wellbeing Board and have set out a framework, suggesting
what strategy must be taken to promote better mental health.
BIBLIOGRAPHY
Department of Health, 2011, No Health Without Mental Health: A cross government mental
health outcomes strategy for people of all ages [pdf] Available at
<https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213761/dh_1
24058.pdf> [Accessed 27th July 2015]
Mental Health Foundation, 2012, The Mental Health Strategy, system reforms and spending
pressures: what do we know so far? [pdf] Available at
<http://www.mentalhealth.org.uk/content/assets/PDF/publications/mental_health_strategy_w
hat_do_we_know_so_far.pdf?view=Standard?> [Accessed 27th July 2015]
Parsonage, Michael, Fossy, Matt & Totty, Carl, 2012, Liaison psychiatry in the modern NHS
[online] Available at <http://www.centreformentalhealth.org.uk/liaison-psychiatry-nhs>
[Accessed 27th July 2015]
Wirral Health and Wellbeing Board, 2013, Wirral: Health and Wellbeing Strategy 2013/2014
[pdf] Available at
<http://info.wirral.nhs.uk/document_uploads/health%20and%20wellbeing%20Board/WirralH
WBStrategyLateMay.pdf> [Accessed 27th July 2015]