Parity of Esteem and Prevention Improving Population Mental Wellbeing Jude Stansfield Programme Lead Mental Wellbeing DsPH across CM have prioritised MWB Also a new national programme for the 100 organisations that have come together under PHE

Mental Wellbeing matters Wellbeing is associated with a 19% reduction in all cause mortality in healthy populations (29% reduction in CVD mortality) Subjective wellbeing can add 4-10 years to life Survival of more than 9 years is associated with enjoyment of life in older adults Wellbeing can protect against developing illness, aid recovery and survival Wellbeing is associated with (and underpins) healthy behaviours Staff wellbeing impacts the quality of care delivered DH, 2014, Wellbeing: why it matters to health policy Promoting mental wellbeing not only prevents mental illness but also physical illness. Not only do we need to do more to promote mental wellbeing, as much as physical health, but we need to do it holistically.

A dynamic model of well-being Experience of life Functioning well e.g. happiness, satisfaction, interest, boredom and distress e.g. to be autonomous, competent, and connected to others Functioning well and satisfaction of needs Enabling conditions Psychological resources We know what mental wellbeing is and what influences it. Feeling good and functioning well Need to address social conditions and opportunities AND psychological resources TOGETHER e.g. opportunities and obstacles, inequalities, social norms, culture e.g. resilience, optimism, self-esteem

Figure 2a. Mean WEMWBS scores, local areas. North West, 2012/13. ..and…We can measure it monitoring population change and baseline for intervention outcomes *Wirral boost sample, most deprived quintile **Heywood, Middleton and Rochdale, boost sample of 3% most deprived LSOAs North West Mental Wellbeing Survey 2012/13: Slide Set

North West Mental Wellbeing Survey 2012/13: Slide Set Figure 3. Proportion of respondents with low, moderate or high mental wellbeing by local areas. North West, 2012/13. Understanding the characteristics of people with low, moderate and high wellbeing – helps to target interventions to shift the mean *Wirral boost sample, most deprived quintile **Heywood, Middleton and Rochdale, boost sample of 3% most deprived LSOAs North West Mental Wellbeing Survey 2012/13: Slide Set

Figure 6. Mean WEMWBS scores by perceived health status, 2012/13.  ONS data but also our local survey data shows the same associated between wellbeing and perceived health status. How is your health? Is a good mental health question – how do you feel about your health, is it troubling you, are you coping with it, how are you in yourself….   Error bars represent the 95% confidence intervals. Don’t know responses = 11; mean WEMWBS score 23.94 (95% CI; lower limit, 19.24/upper limit, 28.63). *North West mean WEMWBS score 27.66 (95% CI; lower limit, 27.56/upper limit, 27.75). North West Mental Wellbeing Survey 2012/13: Slide Set

Figure 7. Mean WEMWBS score by reported medical conditions, 2012/13. people with LTC have lower wellbeing – all below the mean – Lowest depression & anxiety, liver disease and stroke Having a condition is stressful/ worrying… but it is an opportunity to enable people to manage that stress, to not ignore it because they haven’t got time Error bars represent the 95% confidence intervals. *North West mean WEMWBS score 27.66 (95% CI; lower limit, 27.56/upper limit, 27.75). North West Mental Wellbeing Survey 2012/13: Slide Set

Figure 18. Mean WEMWBS score by alcohol consumption, 2012/13. Factors for wellbeing are sometimes different to health. Mustn’t ignore what motivates people’s wellbeing above all, to feel good and function well Alcohol and socialising, relaxing Sir Bruce Keoghs work into cosmetic surgery – may improve wellbeing…sunbeds… Error bars represent the 95% confidence intervals.*North West mean WEMWBS score 27.66 (95% CI; lower limit, 27.56/upper limit, 27.75). North West Mental Wellbeing Survey 2012/13: Slide Set

Figure 22. Mean WEMWBS score by social interaction, 2012/13. Error bars represent the 95% confidence intervals.*North West mean WEMWBS score 27.66 (95% CI; lower limit, 27.56/upper limit, 27.75). North West Mental Wellbeing Survey 2012/13: Slide Set

Social contact & premature mortality Meta analysis: comparative odds of decreased mortality Source: Holt-Lundstad et al 2010 UNCLASSIFIED

Figure 40. Level of social capital by age group, 2012/13. Also important to look at the assets within our population. The survey is mainly assets focussed e.g. social capital high in older adults. How can we strengthen and maximise that? Error bars represent the 95% confidence intervals. North West Mental Wellbeing Survey 2012/13: Slide Set

Commissioning for mental wellbeing outcomes Brief Intervention Champs programme Commissioning for mental wellbeing outcomes Brief Intervention Integrated Wellness Services Social Prescribing Leadership & Workforce Development Public awareness PH role in reducing burden of mental illness Mitigating the impact of welfare reform 12 12

Sefton results: 5 point improvement on a 35 point scale from 20 to 25 Moving from low wellbeing to moderate wellbeing 13

Five Ways to Well-being Brief Intervention Use the grid to discuss and record current activity and personal plans for the Five ways to wellbeing. Activity may cut across a number of the five ways. What am I doing on the five ways? 1 A good start 2 A bit more 3 A fair amount 4 Quite a lot 5 Loads Connect Be Active Take notice Keep learning Give

simple and clear access to support to live healthy and well addressing not ‘what’ people are doing but ‘why’ – psychological and social factors – wellbeing as central rather than multiple single issue and siloed services that cause confusion to referrers and patients.

Client receives phone contact & brief intervention within 48 hours by hub, 6 week follow-up Holistic approach, joined up delivery, addresses multiple needs, person-centred support, outcomes fed back to GPs

Life Balance Assessment 17

Public Awareness Have a Better Day Brighten your mind DIY Your Mood Five things that can help you feel better about life - one day at a time Positive thinking Might someone you know be a little down and benefit from a bit of a lift? Brighten your mind DIY Your Mood Five steps to feeling healthier in your head Five simple tools you can use every day to improve how you feel

www. champspublichealth. com www. nwph. net/MWBProfiles www. gov www.champspublichealth.com www.nwph.net/MWBProfiles www.gov.uk/government/publications/wellbeing-and-health-policy www.ons.gov.uk/wellbeing Contact: judestansfield@wirral.gov.uk