Mental wellbeing policy DH policy – New Horizons 2009 recognises more needs to be done to promote...
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Transcript of Mental wellbeing policy DH policy – New Horizons 2009 recognises more needs to be done to promote...
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 ofthe time
Rarely Some of the time
Often All ofthe 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 andLifestyle
Finance
Feelings and relationships
Life events
Warwick and Edinburgh Mental Wellbeing Score (WEMWBS)
0%
2%
4%
6%
8%
10%
12%
14%
7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35WEMWBS score
Low wellbeing (16.8%)
Moderate wellbeing (62.8%)High
wellbeing(20.4%)
Mean score (27.70)
NW mean score = 27.7Scotland mean = 25.5England mean = health survey 2010
Mental wellbeing distribution:
Gender – there is no difference between men and women;
Age – high mental wellbeing is highest among 25-39 year olds, but then decreases and is significantly lower among 40-54 year olds;
Deprivation – mental wellbeing reduces as deprivation increases.
Ethnicity – lower amongst white than non-white;
31.79
29.97
29.59
28.58
28.57
28.37
28.34
27.77
27.70
27.68
27.59
26.85
26.70
26.60
26.50
26.20
26.17
26.10
25.69
20 25 30 35
Warrington
Halton and St Helens
Stockport
Cheshire West
Blackburn and Darwen
Heywood, Middleton and Rochdale
Central and Eastern Cheshire
Central Lancashire
North West
Wirral
Sefton
East Lancashire
Cumbria
Manchester
Tameside and Glossop
North Lancashire
Knowsley
Blackpool
Liverpool
Mean WEMWBS score
Locality mean WEMWBS scores
Low, moderate & high wellbeing
30.3%
25.0%
16.8%
21.6%
22.0%
23.2%
24.2%
23.1%
8.4%
11.2%
13.9%
16.8%
10.9%
13.0%
13.7%
11.1%
9.5%
5.0%
5.8%
64.0%
64.7%
76.9%
64.6%
63.6%
61.6%
61.9%
60.2%
82.0%
75.6%
66.2%
62.8%
68.7%
65.3%
61.1%
62.9%
53.9%
59.6%
34.0%
5.7%
10.3%
6.2%
13.8%
14.4%
15.2%
13.9%
16.7%
9.7%
13.2%
19.9%
20.4%
20.5%
21.7%
25.2%
26.0%
36.6%
35.4%
60.2%
Liverpool
Blackpool
Knowsley
North Lancashire
Tameside and Glossop
Manchester
Cumbria
East Lancashire
Sefton
Wirral
Central Lancashire
North West
Cheshire East
Heywood, Middleton and Rochdale
Blackburn with Darwen
Cheshire West
Stockport
Halton and St Helens
Warrington Low Moderate High
Age
Mental wellbeing highest among 25-39 year olds;
Lowest among 40-54 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
16-24
25-39
40-54
55-64
65+ 17.3%
18.2%
18.3%
15.5%
14.3%
63.5%
60.8%
63.1%
61.2%
65.7%
19.2%
21.0%
18.6%
23.3%
20.1% Mean score: 28.07
Mean score: 28.03
Mean score: 27.39
Mean score: 27.57
Mean score: 27.52
Key: Low Moderate High
Deprivation & WEMWBS
Key: Low Moderate High
Least deprived
Fourth most
deprived
Third most
deprived
Second most
deprived
Most deprived
20.2%
15.7%
19.1%
14.0%
11.4%
62.2%
64.3%
59.1%
63.4%
66.1%
17.6%
20.0%
21.9%
22.7%
22.5% Mean score: 28.39
Mean score: 28.18
Mean score: 27.59
Mean score: 27.71
Mean score: 27.17
Ethnicity & WEMWBS
White
Non-White
13.0%
17.1%
60.4%
62.9%
26.5%
20.0% Mean score: 27.63
Mean score: 28.72
Key: Low Moderate High
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 wellbeingby feelings towards income
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Living comfortably onpresent income
Coping on presentincome
Finding it difficult onpresent income
Finding it very difficulton present income
Per
cen
tag
e w
ith
a lo
w le
vel o
f w
ellb
ein
g
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 55-64
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, 3rd 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