Gaps in the services
Programme budgeting data for Manchester demonstrate that the City invests high levels of resource in mental health services. Programme budgeting data indicate that we spend £252 per head of population but with relatively poor outcomes. Currently most investment is in secondary care and focussed on those with moderate to severe mental health problems and much less is spent on prevention and low level interventions that can improve emotional resilience and reduce the risk of the development of more severe problems.
The Manchester Mental Health and Wellbeing Commissioning Strategy 2009-14 seeks to address this by identifying plans to shift the focus of investment to prevention and community based services and to develop a recovery based model for those experiencing mental health problems. This approach complements the public mental health agenda well.
Wider partners can support these aims by engaging with this agenda and also supporting evidence based initiatives such as 'social prescribing' in order to develop more resilient communities.
Children and Young People
The most significant gap is how to engage families who do not want to access services, this is an issue that is much wider than CAMHS and is impacting upon education, social care and housing. These are often families who have been identified for a significant period of time but there is limited success in engaging them with services who could meet their needs. From a mental health perspective it is further complicated by the fact that families often need to be relatively settled before a therapeutic intervention can be meaningful.
There is also the issue of frontline staff's knowledge of mental health issues and when to refer into services. Despite there being comprehensive tier 1 training across the city uptake from key professionals is patchy particularly from an education and social care perspective.
Services are equally distributed across the city though our largest voluntary sector organisation, 42nd Street, is located in the city centre but will take referrals citywide
We do not have a clear view of how loneliness impacts on different areas of the city and therefore of how local services currently need to respond. In 2012 a new Loneliness Project will be one of the pieces of work which will form the new Age-Friendly Manchester initiative. The main aims and objectives will be:
- Raising awareness of the nature of loneliness and what can be done to overcome it
- Influence services and organisations to consider how they can reduce loneliness
- Raise awareness amongst older people of loneliness, services and activities available and self-help
- Contribute loneliness 'perspective' to strategic and commissioning plans.
- Produce guide to loneliness and other relevant resources
- Link with, and promote, the national Campaign to End Loneliness
- Promote practical interventions which reduce loneliness
- Organise a day event to promote the project
People with dementia often experience a reduced quality of life owing to late diagnosis, the stigma and discrimination associated with the condition and exclusion from social outlets. There is a need for a shift in societal awareness and understanding about dementia, and a move towards the development of dementia friendly communities. (Dementia 2012, A National Challenge).
There is a particular need to work with the aging population of Manchester's black and minority ethnic communities where there is a greater challenge in relation to stigma and access to services for people with dementia, and an opportunity for preventive work in relation to the higher prevalence of vascular dementia.