Although a formal committee of Brighton & Hove City Council, the Health & Wellbeing Board has a remit which includes matters relating to the Clinical Commissioning Group (CCG), the Local Safeguarding Board for Children and Adults and Healthwatch.

 

Title:

 

Brighton & Hove Mental Health Joint Strategic Needs Assessment

Date of Meeting:

 

8 November 2022

Report of:

 

Director of Public Health

 

Contact: 

 

Bernadette Alves and Anne Foster

Tel: 01273

Email:

 

Bernadette.alves@brighton-hove.gov.uk and anne.foster5@nhs.net

Wards Affected:

 

All

 

FOR GENERAL RELEASE

 

Executive Summary

The Health and Wellbeing Board approved the undertaking of an all-ages mental health and wellbeing joint strategic needs assessment (JSNA) for Brighton & Hove in July 2021. As a result of Covid19 pandemic, this needs assessment was undertaken in 2022.

 

The aim of the JSNA is to provide evidence to increase population resilience​, improve the range and quality of support for those with mental health problems​ and address inequalities.

 

The needs assessment describes current and future mental health needs of the Brighton & Hove population, with consideration of inequalities and the impacts of the wider national and global crises on mental health need.

 

It describes the impact on mental health and wellbeing of the building blocks of health such as education, income, housing, and other socio economic factors;  protective and risk factors that affect mental health and wellbeing and focuses on groups facing greater risks and higher levels of mental health needs.

 

The needs assessment takes a life course approach, following the approach in the city’s Joint Health and Wellbeing Strategy.

 

The JSNA was overseen by a steering group made up of commissioners, providers, community and voluntary sector organisations and academic experts.

 

The voices of those with lived experience were sought through established engagement and co-production forums, review of recent consultation events, reports and JSNAs.

 

The steering group reported to the Mental Health Oversight Board and Children and Young Person’s Health Oversight Board. Delivery of the recommendations will be overseen by the Brighton and Hove Health and Care Partnership with actions specific to Children and Young People or Adults directed through the relevant place based oversight board.

 

This paper presents the final draft version of the needs assessment to the Health and Wellbeing Board. It has seven recommendation areas.

 

The reports will be proof read and checked to meet the accessibility standard before being published. In addition, a four page designed summary version will be produced which can be disseminated widely.

 

 

1.           Decisions, recommendations and any options

 

1.1.       That the Board note the report and its findings.

 

 

2.           Relevant information

 

2.1.       The JSNA aims and governance

 

2.1.1.   This JSNA is a snap shot in time and pulls together the big picture. Some of the issues will be already known to some or all parts of the system, others will be new. The JSNA provides the opportunity to work with partners to develop a shared understanding of the city’s challenges and assets. And based on that shared picture, to identify strategic actions and recommendations.  

 

2.1.2.   Taking account of what the system is already doing to improve outcomes and reduce inequalities, the recommendations are intended to have the greatest additional impact.

 

2.1.3.   The aim of this JSNA is to provide evidence to:​

·          Increase the resilience of the whole population of Brighton & Hove​

·          Improve the range and quality of support for those with mental health problems​

·          Address inequalities.

 

2.1.4.   This needs assessment will shape:

·          City wide approaches to mental health and wellbeing including commissioning, prevention, and mental health and wellbeing promotion; 

·          NHS Sussex and Brighton & Hove City Council commissioning plans and investment decisions.

 

2.1.5.   A Steering Group, comprised of the City Council, NHS commissioners and providers, Community and Voluntary Sector organisations and academic experts oversaw the needs assessment, agreed the key findings and recommendations. A small project group produced the JSNA.

 

2.2.       The findings of the JSNA

 

2.3.       The key findings are set out in the Executive Summary and full report of the JSNA. There is also a data profile, which will be updated annually to give an up to date picture of mental health and wellbeing in the city.

 

2.4.       Mental health problems are common – almost two thirds of us will experience a mental health problem during our lives, and 1 in 6 of us is managing fluctuating levels of distress each week. Mental health problems can shorten lives, are subject to stigmatisation and may be kept hidden. They affect, and are affected by, our relationships with family, friends and communities. They are costly and are both a cause and a consequence of inequalities.

 

2.5.       The mental health of each individual is influenced by multiple factors past and present - by the environment in which we are born, grow, live, work and age, by our family relationships especially when we are a child, life experiences, trauma, and our genetics. Differences in these factors can lead to unfair and avoidable differences in mental health within and between populations. Brighton & Hove faces significant risks for poor mental health in terms of housing, unemployment and areas of the city and groups facing poverty. But, as a city we also have protective factors (assets) around access to parks and open spaces, strong arts and cultural opportunities, social capital and a large community and voluntary sector supporting individuals and communities.

 

2.6.       There are several crises unfolding at national and global level that impact on mental health and wellbeing and/or the ability to help those with mental health needs, including:

·          The COVID-19 pandemic

·          Cost of living crisis

·          Climate change

They all increase the risk of mental ill health and deepen inequalities, with more vulnerable groups being disproportionately affected. These are compounded by ongoing national challenges around recruitment and retention of workforces that impact on quality, capacity and ability to address the unmet need in the B&H population. The data in this document does not fully reflect the impact of these crises and may therefore underestimate both current and future need and the extent of inequalities.

2.7.       Some groups are more exposed to the unfavourable social, economic and environmental circumstances which lead to higher risk of mental health problems. These groups, interrelated with gender and age, are at higher risk of mental health problems: black and minority ethnic groups; LGB+ (lesbian, gay, bisexual) people; transgender people; people living with physical disabilities; people living with learning disabilities; people with sensory impairment, neurodiverse people, children in care and care leavers,  carers; people experiencing homelessness; people with harmful alcohol and/or drug use; people with multiple complex needs; refugees, asylum seekers and stateless person; prison population, offenders and victims of crime; In Brighton & Hove many of the groups identified as being at greater risk of poor mental health make up a greater proportion of the population than elsewhere.

 

2.8.       The number of people who would benefit from support can be very much higher than the number of people known to services.

 

2.9.       Brighton & Hove has higher estimated overall need than England with 1 in 5 of the adult population estimated to have a common mental health condition in the city compared to 1 in 6 for England – equating to over 46,000 adults.

 

2.10.    As part of the needs assessment, we commissioned a summary of effective preventative interventions across the life course, that have the potential to promote good mental health or wellbeing, prevent mental illness and reduce the impact of mental ill-health for those with mental health problems. A summary is included within each life course.

 

2.11.    The JSNA makes recommendations across seven key areas. Recommendations under these areas are presented in the Executive summary and full report:

·          Area 1: Population prevention. Develop and promote a population wellbeing approach encompassing the building blocks of health

·          Area 2: Communities. Co-production and co-design of mental health services with people with lived experience, community development and VCSE sector provision

·          Area 3: Whole System working. Develop pathways that encompass all levels of mental health need with a focus on early intervention. Develop trauma-informed pathways that support individuals in a holistic way

·          Area 4: Transform mental health services to take account of current unmet need and predicted growing future need and to improve accessibility (in context of Area 4 – Whole System Working)

·          Area 5: Children and Young people. Improve the care and support offer for young people ensuring that they and their families are at the heart of an integrated service approach

·          Area 6: Information sharing. Improve monitoring and information sharing across the system to improve quality of care, planning and decision making.

·          Area 7: Inequalities, influence and implementation

3.      Important considerations and implications

 

Legal: The Health and Social Care Act 2012 (s196) requires the function of preparing a JSNA to be discharged by the Health and Wellbeing Board. Specifically, from April 2013, local authorities and Clinical Commissioning Groups have equal and explicit obligations to prepare a Joint Strategic Needs Assessment (JSNA) which provides a comprehensive analysis of current and future needs of local people to inform commissioning of services that will improve outcomes and reduce inequalities. The Health and Care Act 2022 replaces CCG’s with Integrated Care Boards. S26 of the 2022 Act inserts new provisions into the 2012 Act requiring the formation of an integrated care partnership [comprising the Local Authority and Integrated Care Board] and for that partnership to develop and review its own integrated care strategy in light of local needs assessments, including the JSNA.

 

Lawyer consulted:        Sandra O’Brien                        Date:           11/10/2022

 

 

Finance: The resources required to support the production of the Joint Strategic Needs Assessment are funded by public health ring-fenced grant. This Joint Strategic Needs Assessment provides the mental health needs assessment for the city. Future commissioning plans and the integrated care strategy will need to reflect on these recommendations.

 

Finance Officer consulted:     Sophie Warburton        Date: 07/10/2022

 

Equalities:

 

The JSNA has taken into consideration protected characteristics and vulnerable groups at each stage of the process and details relating to needs of different groups are detailed in the main report, as are gaps in evidence and recommendations to improve evidence for vulnerable groups. The voices of those with lived experience were sought through established engagement forums, reviews of recent consultation events and views expressed in recent reports and JSNAs.

 

Supporting documents and information

 

Appendix1: Brighton & Hove Mental health Joint Strategic Needs Assessment Executive Summary

 

Appendix2: Brighton & Hove Mental health Joint Strategic Needs Assessment Full Report

 

Appendix3: Brighton & Hove Mental health JSNA data profile (online) Mental health JSNA profile - Infogram