Mental wellbeing policy DH policy – New Horizons 2009 recognises more needs to be done to promote population mental health and wellbeing:  To build resilience in individuals, families and communities;  To create flourishing, connected and sustainable communities;  To prioritise mental health as much as physical health and recognise the links between them;  To work collaboratively across sectors to achieve this.  To identify agreed measures of mental wellbeing to support local improvement.

Mental wellbeing policy  Foresight 2008: improving mental wellbeing could have very high economic and social returns  WHO Mental Health Action Plan 2005: commitment to develop new indicators and data collection methods for mental health promotion. Information needs to be available about the current state of mental health across populations that is standardised and allows comparison locally, nationally and internationally.

Mental wellbeing intelligence.. The NW survey provides new data:  an important new baseline;  comparability & consistency across localities;  better understanding of our mental wellbeing, its determinants and relation to physical health and health inequalities;  recognising mental wellbeing as an asset – to our productivity and resilience;  new intelligence to support commissioning, needs assessment, service development and evaluation of practice.

The NW Mental Wellbeing Survey  Sample 18,500 residents  18 PCTs bought a boost of 500  Face-to-face interviews: April–June 2009  Computer Assisted Personal Interviewing  Validated scale – WEMWBS + 44 other questions  Largest survey of its kind in UK

WEMWB Scale None of the time Rarely Some of the time Often All of the time I’ve been feeling optimistic about the future I’ve been feeling useful I’ve been feeling relaxed I’ve been dealing with problems well I’ve been thinking clearly I’ve been feeling close to other people I’ve been able to make up my own mind about things

Explored some key determinants of mental wellbeing… Where people live Health and Lifestyle Finance Feelings and relationships Life events

Warwick and Edinburgh Mental Wellbeing Score (WEMWBS) NW mean score = 27.7 Scotland mean = 25.5 England mean = health survey 2010

Mental wellbeing distribution:  Gender – there is no difference between men and women;  Age – high mental wellbeing is highest among year olds, but then decreases and is significantly lower among year olds;  Deprivation – mental wellbeing reduces as deprivation increases.  Ethnicity – lower amongst white than non- white;

Locality mean WEMWBS scores

Low, moderate & high wellbeing

Age  Mental wellbeing highest among year olds;  Lowest among year olds;  Despite them more likely to have job;  40-54, in full-time employment also less likely to report satisfaction with personal relationships; ore likely to have had a recent divorce or separation; less likely to meet with or talk to people from outside their own home;

Age & WEMWBS Key: LowModerateHigh

Deprivation & WEMWBS Key: LowModerateHigh Least deprived Fourth most deprived Third most deprived Second most deprived Most deprived

Ethnicity & WEMWBS White Non-White Key: LowModerateHigh

Health  Strong associations between general, physical health, lifestyle and mental wellbeing.  Those with high mental wellbeing 3.5 times more likely to say they were in good health.  Low mental wellbeing 6 times more likely to self report ‘not good health’.  Strong relationship with mobility, self care, pain, anxiety & depression.  Significant proportion who are not anxious or depressed have low levels of mental wellbeing.

Healthy lifestyle  People with high mental wellbeing were  more than twice as likely to be meeting the physical activity target (30%);  People with low levels of mental wellbeing were  four times as likely to be sedentary for more than 8 hours a day;  more likely to smoke (30%)  Significantly more likely to be drinking at harmful levels and significantly less likely to be drinking at sensible levels;

Work is good! Those who are permanently sick or disabled are significantly more likely than average to have low levels of mental wellbeing. Those who are in full-time employment or education or who are self-employed are significantly more likely than average to have a high level of mental wellbeing.

Money worries  3 out of 10 adults said they had worried about money quite often or almost all the time during the last few weeks;  Half of all those with poor mental wellbeing had;  Males and those in most deprived most likely to have worried;  People aged 65+ far less likely to have worried;

Money worries  People with high mental wellbeing were 2.4 times more likely to have never worried about money in the last few weeks;  1 in 5 adults were finding it difficult on their present income – and were 5 times more likely to experience this if they had low levels of mental wellbeing;  Over 25% of those in the most deprived areas were finding it difficult on their present income – significantly more non-whites.

Low levels of mental wellbeing by feelings towards income

Place Matters People with higher levels of mental wellbeing :  More likely to have lived in a local area 10 years or more (3/5 had);  Satisfaction with the local area as a place to live (55yrs +, white);  5% of adults were dissatisfied with their area as a place to live;  Much stronger sense of belonging to their immediate neighbourhood (women, older, less deprived, white);  20% didn’t have a strong sense of belonging;

Place matters People with higher levels of mental wellbeing :  More likely to feel safe in their local area. (males, younger, less deprived)  97% felt safe when outside during the day, 74% after dark;  Had stronger agreement they can affect decisions about their area (3x definitely agreed);  Those in lower deprivation  Aged  Over half of adults felt they couldn’t influence decisions in their local area:  Lowest for 65+  white

Relationships matter Strong relationships and good social networks are strongly associated with high levels of mental wellbeing:  Long-term relationships  High satisfaction with relationships  Social networks and contacts outside home  Contact with neighbours

Relationships: those with low mental wellbeing  Nearly three times more likely to have not spoken to someone outside their household in the last week - 3% hadn’t;  Over 3.5 times more likely to never speak to their neighbours – 3% don’t; those more likely to are female, age 55+, white, 3 rd most deprived;  More likely to never meet friends or relatives – 1% don’t;

Five Ways to Wellbeing  ‘Connect’ - regularly meeting friends and neighbours  ‘Be Active’ - reporting recommended levels of physical activity  ‘Take Notice’ - strong feelings of belonging in the immediate neighbourhood  ‘Keep Learning’ - having the time do things you enjoy  ‘Give’ - regularly participating in local groups and organisations All five ways to wellbeing are strongly associated with the WEMWBS categories.

Recommendations “achieving a small change in the average level of wellbeing across the population would produce a large decrease in the percentage with mental disorder, and also the percentage who have [low levels of mental wellbeing]”. (Foresight)  Increase the mean baseline score;  Sustainable investment in improving population mental wellbeing; Tackle inequalities in wellbeing;  Address & improve mental health as a determinant of physical health;  Build community resilience and relationships;  Work and income;  Behaviour change – segmentation & five ways to wellbeing;

Recommendations  Inform needs assessment and outcome focussed commissioning;  Align wellbeing policy;  Mental Wellbeing Impact Assessment;  Collaboration;  Further analysis:  Mid-life  Deprived communities that thrive  Physical health & health behaviours  Unemployment  Ethnicity