SPECIAL FEATURE: More still to be done to improve mental health services in Calderdale

That is the message after figures revealed that more than 16,000 people were referred to the Trust that manages mental health provision in Calderdale over the last three years.

There were 16,279 referrals from Calderdale to the South West Yorkshire Partnership NHS Foundation Trust between 2016 and 2018.

In February this year, there were 822 people on the waiting list for their first appointment with a mental health service, two of whom had been referred in 2013. Eighty-one people had been waiting over a year for their first appointment.

The highest age range of referrals was for people aged over 65, of which there were 4,043, while 1,958 of the referrals were children.

Figures released under the Freedom of Information Act also show that bed occupancy rates increased from 88 per cent in 2016 to 91 per cent in 2018.

The number of mental health nurses has risen from 902 to 990, while the number of mental health therapists has increased from 228 to 545.

When asked if there needs to be more funding into mental health services in the borough, Jonny Richardson Glenn, Chief Officer of Healthy Minds, a mental health charity based in Calderdale, said: “Yes. There is increasing demand for mental health services nationally and limited options mean that GPs channel everybody into a few routes, leading to blockages in the system.

“This is what is illustrated in the figures. Increased awareness and more open discussion about how mental health affects everybody is welcome – it reduces stigma and encourages people to seek help earlier – but the downside is that the government’s headline-grabbing rhetoric around mental health has not translated into increased resources that have reached the front line yet.

“The point must be made that this is not unique to Calderdale: it is a national problem.

“It isn’t just about having more resource but also having resources in the right places: it seems an obvious equation that more resources at the preventative and early intervention end can reduce demand for very expensive, intensive services further down the line.

“We need all these parts of the system to one degree or another but it is currently very ‘top-heavy’: the greatest proportion of funding goes to the high-end services that work with very few people.

“Calderdale’s Joint Strategic Needs Assessment identifies that 76 per cent of people who have mental health problems do not access any treatment.

“This is, again, broadly the same nationally. At Healthy Minds, we hear that people do not approach NHS mental health services for various reasons, such as past experiences, the “stigma” or they choose to self-manage.

“Calderdale Council and CCG are working with service providers like Healthy Minds to improve what’s on offer locally.

“From a voluntary sector perspective, and hearing from others around the country, I can tell you that Calderdale is relatively ahead on this and there is a genuine will among providers and commissioners to find solutions.

“Among these is more focus on preventing people developing mental health problems – through awareness and education, a ‘public health’ approach; and more early intervention so that people don’t escalate to the point of needing expensive, longer-term treatment.

“Getting this right is crucial: it reduces demand further down the line and means that there are more choices for people rather than everybody being crammed into narrow channels for few services.

“Calderdale is especially progressive on children and young people’s mental health: after many years of inadequate services, recent developments have seen the tide turn by bringing statutory and voluntary providers together to create the Open Minds programme, which is leagues ahead of most other areas in the country, even though there is much more that could be done.

“This has been achieved despite huge pressures and austerity and shows how it can be done with the right energy and imagination.”

Jonny says the mental health provision in Calderdale is not coping with the demand, but feels the situation is improving.

“Calderdale’s commissioners today are demonstrating more insight and better engagement with all service providers, including those of us in the voluntary sector, to encourage everyone working together to offer a more accessible and comprehensive service so that people can get more appropriate support when they need it.

“There is a long way to go yet but Calderdale is making progress that is way ahead of some other areas.

“As someone who has spent many years in both the NHS and the voluntary sector, I have seen both sides and there is definitely a different slant to the debate these days:

“I used to find it frustrating trying to lobby indifferent commissioners for organisations like Healthy Minds to be taken more seriously as part of the

solution to the many, complex problems in the health system; nowadays, there is much more willingness to listen to us and include what we offer as part of the system.

“A recent example is our Safespace project, which offers emotional support in evenings and weekends when it can be even harder to get help.

“After several years of Healthy Minds lobbying for such a service in Calderdale, when the opportunity arose Calderdale CCG asked us to develop a proposal and it has become part of Calderdale’s offer to people in emotional distress.

“Safespace acts as a buffer so that people don’t have to call the emergency services, or the Crisis Team, or go to A&E.

“We need to see more of this sort of bold and creative commissioning to help find ways to close some of the gaps in the current mental health offer for the people of Calderdale.”

Emma Woods-Bolger, Assistant Director of the Community Foundation for Calderdale, said: “Clearly there is a need for mental health services in Calderdale, unfortunately some people are having to wait for that support.

“That’s why we commission mental health projects provided by multiple charities in Calderdale every year. The funding enables them to work with those in crisis.

“For example we have commissioned Health Minds to provide services and support in Todmorden, this project started in response to the Boxing Day Floods in 2015, and only a few weeks ago we agreed to extend the funding and roll out the mental health provision across the Upper Valley.”

Halifax MP Holly Lynch said: “It’s clear that there are unacceptably long waits for mental health assessments in Calderdale and that our services are unable to cope with the level of demand.

“Nobody should be forced to wait years for an appointment, especially if they are experiencing a debilitating mental health condition.

“We need an increase in mental health spending and ring-fenced budgets so that the funding reaches the frontline.”

Paul Butcher, Calderdale Council’s Director of Public Health, said: “We take mental health very seriously, as it’s an important part of people’s wellbeing. One of our priorities is prevention work, to help improve local people’s mental health. Through Calderdale Cares, we are working with a range of organisations, including the voluntary sector, to continually improve services for residents and help build more resilient communities across the borough.”

In a statement, NHS Calderdale Clinical Commissioning Group said: “There are many reasons why the pressure upon mental health services provided by the NHS and voluntary sector are increasing.

“Evidence is mounting that political decisions to reduce public sector spending in response to financial pressures have had a significant and negative effect on the mental and physical health of many people across the country, as well as damaging the services in place to support these people.

“Need is growing faster than services can cope with, and we need to find new and better ways of helping people. Alongside this, and entirely appropriately, in recent years we have worked hard to raise awareness of the importance of emotional wellbeing, and have worked hard to create an environment in which it is OK to be honest about how we are feeling and to seek support.

“In response to this we have opened up access to diagnosis and support, through the investments that we have made into improving access to psychological therapies - usually first point of contact mental health services.

“One of the key difficulties we face is that there are workforce shortages of some of the specialist skills that are required to help people who have more complicated problems.

“It takes time to address workforce shortages in health services, but we are working with partners regionally and nationally to improve workforce planning.

“Despite these issues, Calderdale’s mental health support services are doing a brilliant job. Accessibility to talking therapies for those with anxiety and depression, and work to reduce waiting times for psychosis treatments were two of the areas singled out by NHS England as Calderdale’s mental health services received a ‘Good’ rating for 2017/18.

“A dedicated perinatal mental health service to support parents during pregnancy or in the first year following the birth of a child has launched in recent years, and those in mental health crisis can get free, timely support through SafeSpace: a community based initiative that provides a service for adults in mental health distress.

“Calderdale CCG is investing an additional £2m in mental health in 2019/20. However, we know that this cannot meet all the needs of people in our area. There are wider issues which need to be addressed, such as inequality, employment and access to benefits, if we are really going to get to the root of the problem we face.”

Carol Harris, Director of Operations at the South West Yorkshire Partnership NHS Foundation Trust, said: “While demand for our services in Calderdale is both high and increasing we are committed to making sure that people receive the care that they need at the right time and in the right place.

“We are investing in services in Calderdale and working with commissioners and other partners to make sure that service users and their families are fully supported while they are on waiting lists, and when they are receiving care.

“Putting people first and in the centre is one of our values and we will continue to prioritise safety, so that people’s experiences while they are with us are as positive as they can be.”