To receive the above paper and presentation from Cllr Stuart Carroll, Hilary Hall and Darrell Gale.

a)    Context and Overview – Cllr Carroll

b)    The Year of Mental Health Action Plan – Hilary Hall

c)    The DRAFT Berkshire Suicide Prevention and Self Harm Strategy / Action Plan – Darrell Gale / Hilary Hall

As part of the Borough’s Year of Mental Health, the Chairman agreed to amend the agenda slightly to allow a question from the public to be asked as it fit within the remit of the Year of Mental Health.

Dr Hayter responded to the question from a member of the public regarding Dementia and how treating and looking after those affected was being paid for and if funding was to be made available. Dr Hayter stated that the CCGs had been doing a lot of work around Dementia and had been looking at it as an initiative with partner agencies. Funding proposals were being worked on and the local authority and the CCG were working together. The initiatives included having two Dementia Advisors which compliment other services and means the borough was in a better position than ever when it came to looking after those with Dementia. He added that they were also working with providers in the Borough and had launched a programme for carers of those with Dementia.

Dr Hayter stated that the Borough was leading on developing programmes in 17 practices and had been working on diagnosing Dementia, they had also implemented tests to help identify those with dementia. Dr Hayter confirmed that the CCG was looking to work across the sphere for Dementia and also working on education in homes on Dementia to support nurses. He continued that it was not about one individual and that nurses were on the ground supporting programmes.

Dr Hayter confirmed that the CCG and the Borough were planning to work sustainably and long term on proposals to see how Admiral Nurses could offer wider support. He added that the CCG had also been working with younger people with a diagnosis of Dementia.

Context and overview

Cllr Carroll introduced the item on the Year of Mental Health and highlighted the following main points:

Ø  Context – the Health and Wellbeing Board had already placed mental health as a priority within the JHWS. The priority this year was to build on initiatives.

Ø  Local Authorities had signed up to Priority Berkshire which was designed to create awareness and best practice.

Ø  It was a dynamic campaign and the Borough was planning to take on an active role within the initiative.

Ø  The initiative would use a communications platform to share ideas.

Ø  An action plan was being implemented.

The Year of Mental Health action plan

Hilary Hall, Head of Commissioning for Adult, Children and Health stated that the Borough had put together the Year of Mental Health Plan and it was not a plan that was restricted to just one year of activity; it would be an ongoing strategy. There was three pillars to the action plan which were listed within paragraph 2.6 on page 18 of the agenda pack.

The Head of Commissioning for Adult, Children and Health stated that there was a whole series of activities undertaken and all Borough managers had taken on mental health awareness training including suicide prevention. The Borough was now more able to signpost services to residents more effectively. She added that all the relevant mental health policies were listed in the appendix and that the screening tool was just a starting point.

The draft Berkshire Suicide Prevention and Self Harm Strategy / Action Plan

Darrell Galle, FFPH gave a brief presentation on the draft Berkshire Suicide Prevention and Self Harm Strategy and highlighted the following main points:

Ø  Berkshire had led the way in the suicide prevention and self harm action plan with work that had been ongoing for two years.

Ø  Suicide prevention was part of the wider mental health service.

Ø  As the new national strategy was introduced, it was likely that localised action plans would need to be updated.

Ø  The Borough wanted a focus on self harm as a sub-section of suicide prevention

Ø  It was well known that all suicides were preventable. However, the strategy would introduce stretch targets. The Sustainability & Transformation Plans was already working towards 0 suicides within the Berkshire area.

Ø  2015 total suicide figures were just published in December 2016, so it was difficult to see a smoothing of trend lines just yet. The figures would be included within the strategy.

Ø  The local picture showed that the Berkshire area was below the level of suicides for all of England.

Ø  Overarching recommendations included that the Berkshire Suicide Prevention Steering Group revisit their terms of reference and membership; with the aim of providing governance to the strategy and its action plans.

Ø  That organisations represented on the Berkshire Suicide Prevention Steering Group considered nominating a suicide prevention champion from within their membership – that would enable leadership and ownership on policies and act as a spokesperson on suicide prevention.

Ø  The recommendations for high risk groups included to implement the NICE guidelines on self-harm, specifically ensuring that people who present to Emergency Departments following self-harm receive a psychosocial assessment and also to evaluate the Berkshire CALMzone and recommission targeted suicide prevention work for younger and middle aged men.

Ø  Recommendations for specific groups – work to provide and commission interventions which improve the public’s mental health. Assist training in suicide prevention and the BHFT undertaking specific training also.

Ø  Recommendations – reduce access: that local authority public health teams take the leadership for liaison with any escalation process in their area, and report on progress to the Steering Groups – Railtrack had introduced a programme that identified places on the railway lines where suicides occurred to see what could be done to prevent them. Another recommendation was that the Steering Group seek a named Highways England officer to act as a liaison link and group member, and to share real-time intelligence of highways network incidents; and that local authority public health teams work with other council departments such as car parks and open space services to identify local actions to prevent suicide including staff awareness training – basic reaching out could be enough to prevent suicide.

Ø  Recommendations – support bereaved: ensure bereavement information and access to support is available to those bereaved by suicide; working with Thames Valley Police in specifically reaching out to those around the suicide person to ensure they get support.

Ø  There were also recommendations for support media, support research and the next steps for the action plan.

Hilary Hall, The Head of Commissioning for Adult, Children and Health stated that the recommendation of the report was for a Task and Finish Group to be set up with Councillor Carroll to pool the action plan together so it is specific to activities within the Borough. Dr Hayter welcomed the strategy and queried the difference between male and female suicides. He stated that as a GP, he had two patients commit suicide and a colleague, all of which were male. He felt there was more to be done in getting men talking about suicide and thoughts that led to suicide. There had been an article in a construction news magazine titled ‘Dying to Talk’ which was focused on getting men to talk and promoting talking. Dr Hayter felt that was something that could work well with media reporting.

Councillor Airey said she was seeing suicidal thoughts resenting regularly in universities and youth services. She added that transgender statistics of suicide were higher. Darrell Gale confirmed that CALMzone and data received was difficult to separate transgender issues. It was a male oriented group but, further evaluation would be carried out and specific questions would be asked. He had seen higher figures of transgender suicides in the UK and there were groups that could help in Reading but, more people needed to made aware of them.

Councillor Airey asked if debt issues featured in suicide statistics and if the Borough was receiving anonymised data so that services knew how to meet needs. Darrell Gale responded that the coroner picked up on that and the Borough got information from them. He added that real-time data did not always show reasons for suicide. However, coroners were getting better at more real-time information, perhaps a month after death. Some coroners did not always record deaths as suicide. The most robust information received was captured from an audit. Councillor Airey commented that she was looking to make it a holistic service and she wanted to work together with community groups and develop a mechanism which helped prevent suicide. Darrell Gale responded that the Borough had an excellent action plan and with the Task and Finish Group, he was hoping that other Local Authorities would follow in the Borough’s footsteps.

Mike Copeland, Healthwatch queried the budget for mental health services. Councillor Carroll confirmed the Borough were planning awareness events but, there were no other budget implications at that time. He added he had been in touch with Crossrail who said they would provide a response on suicide prevention.

RESOLVED UNANIMOUSLY: That the Health & Wellbeing Board noted the report and:

      i.        Recognised the Brighter Berkshire Campaign and collaborative role played by the Royal Borough in supporting the partnership

    ii.        Endorsed the Royal Borough’s Year of Mental Health plan.

   iii.        Endorsed parity of esteem between mental health and physical health and the need to raise awareness and reduce stigma.