To receive a presentation and discuss an update on the Croydon Mental Health Transformation programme.
The Deputy Head of Mental Health Commissioning SW London CCG Croydon Place, Wayland Lousley, introduced the Croydon Mental Health Transformation update. The Woodley Review, which was review of mental health services was launched in late 2016 to assess progress against Croydon’s mental health strategy (2014-19) and identify trends in inequalities, took place where there was clear evidence that there was a disproportionate model of care delivered in acute settings for mental health rather than across the voluntary sector.
A need was identified to develop a vision to look at an alternative which was more preventative and early intervention focused. A blue print was built to deliver this vision over a number of years ensuring the funding was correct. It was noted that some start dates were delayed because of the pandemic. Despite this, the Recovery Space was actioned in October 2020, which was an alternative café style setting for people presenting with mental health crisis, but who had been assessed as not needing clinical intervention and would enable them access to ongoing support across the voluntary sector. This was actioned in October 2020 and had been extremely successful.
The key focus was to develop the first pilot mental health and wellbeing Hub, which would be delivered in the Central area in September/October 2021 and the second hub going live in 2022/23. Leading on from the successes of the Local Voluntary Partnership across Croydon over the past two years, a bespoke focus was placed on mental health. The focus on key communities such as The Turkish Youth, Asian Resource and Croydon BME Forum, the Body and Soul Initiative (for people experiencing HIV) and to extend the counselling provision which was in response to the impact of Covid and preparing for the surge to meet the expected demand going forward.
Underpinning all the work was a focus on ethnic minority interventions where there was a need. Another initiative was the Ethnicity in Mental Health Improvement Programme, which was a development of an expert panel of local leaders to start addressing what was happening within communities to engage with them in a more productive way and at a deeper level. Hubs would be able to support those communities more effectively and look at the pathways through the crisis and the community pathway to improve the experience and inpatient services with better outcomes as a result.
Croydon Integrated Community Network Plus outlined all of the activity across the out of hospital work, the engagement with the GP communities and the connection between the council and out of hospital work, which brought together social and physical health care.Mental health had been a key partner within this process and this was about dealing with people with physical health as a primary issue, but also mental health as a presenting need.
The model of care for mental health wellbeing hubs was being developed in partnership with the BME Forum, in collaboration with SLaM. These hubs would be hosted by the voluntary sector with clinical input from SLaM on site.Another element was that peer support workers would be available within the hub, as well as an online presence being available with a self-assessment tool to identify needs. It would also enable people to understand groups and activities available within the area to support wellbeing as well as mental health.
Mental Health Personal Independence Coordinators had begun their work, taking referrals, and were engaged with GPs across Croydon. The first week operating they received seven referrals and the second week a further nine, which demonstrated the need for this outreach functionality and support for primary care.
The Primary Care Network Mental Health Practitioners were being recruited and would provide Band 6 and 7 clinical nurses to support GPs and primary care to meet the issues that were presented together with the increased demand going through GP practices.
The MIND Recovery Space in Croydon had seen 222 people in the first six months, of which about 32% were aged 18-25. A further 27% were aged 25-35 and 58% were not known previously to services, which reflected unknown needs coming through as a result of the pandemic and being picked up by this alternative provision.
The Core 24 is a standardisation and quality mark within the Mental Health Liaison team and a mental health assessment unit was moving forward at pace to create an onsite facility for people at CUH awaiting care, a bed or more intensive support. There was ongoing support to improve mental health connectivity between 111 and 999 into the mental health crisis line provided by SLaM.
The transformation work was aimed at improving the service users’ experience, access and outcomes and giving the care at the right place and time. The work was also aimed to improve the physical health for those experiencing severe mental illness and reducing presentations at A&E, reducing non-elective admissions, activity through police and around social care.
The Chair thanked the Deputy Head of Mental Health Commissioning, SW London CCG, Croydon Place for his presentation and invited questions and comments from the Board.
Councillor Fitzpatrick asked for reassurance that there would be appropriate data available to enable the understanding of ethnic minority needs. He secondly asked, as the Croydon’s Autism Champion, if there would be introducing any neuro-diversity champions to the work and stated that population was the most over-represented in ill-health and a large proportion of that was within ethic minority groups where there was insufficient data.
In response, reassurance was given that data, for ethnic minorities and neuro-diverse population, would be obtained from SLaM, Public Health and an expert panel to gain data directly from communities. Additionally, there was an Autism Strategy where work was taking place to understand and assess needs of users and to provide training, specifically if there were mental health issues.
The BME Forum representative, Andrew Brown, added that there was work currently being carried out with SLaM, with support from the Police, where a new project had been started around ADHD and Autism and how it affected men in their society.
The Director of Public Health stated that the journey had been a challenging one and it was reassuring they were now at this point. Regarding trauma informed care, it was known that many user coming into the service had adverse childhood experiences in the past. She stated that she had previously made recommendation for trauma based training for staff. She additionally raised that the LGBT+ community were often in the vulnerable category with a high rate of self-harm, suicide and long term disability within these communities.
Councillor Hopley said it was good to see an integrated system and expressed the difficulties in accessing mental health care in the past. She was particularly pleased to see the new hub and the recovery space for MIND. She asked where the other two hubs would be located and commented there was a need in the south of the borough, hoping one could be set up in Sanderstead.
Many residents had contacted Councillor Hopley in the past because they were feeling down and had been locked within their homes for over a year during the pandemic period. They were still scared to go out and she stated they residents would benefit from these hubs across the borough.
The Deputy Head of Mental Health Commissioning, SW London CCG Croydon Place, explained that hubs would be presented in the Central location in the Whitgift Centre, the Thornton Heath area and in the south there would be two smaller hubs, located in New Addington and east Coulsdon. In response to a question raised regarding trauma provision, he informed the Board that psychologist input would be available within the hubs.
The Asian Resource Centre CEO, Ima Miah, welcomed the plan and commented that the Asian Resource Centre had been operating in the borough for 20 years and this was the first time they had been involved in discussions around mental health which was greatly welcomed. She stated that the Centre was taking full advantage of being involved in the discussions relating to Asian mental health and this conversation was important, together with gaining data from different and varying communities. She added that talking about trauma and other things that influence mental health would provide high quality data. If these hubs were effective and genuine co-production was put in place, it would be evident how Croydon differs and stood out to other boroughs.
Councillor Flemming echoed the previous comments and welcomed the work taking place, acknowledging the difference it made and the impact it had on young people who were within the criminal justice system and the impact of mental health within the black community. Firstly, Councillor Flemming asked about educational psychologists being involved within this work and what teaching could be shared into how support was developed for older members of the community. Secondly, the CVA CEO asked how this work could connect with schools and head teachers, who would feel valued to be included in this.
In response, the Deputy Head of Mental Health Commissioning SW London CCG Croydon Place firstly stated that the focus would be on the clinical psychologist by engaging with SLaM and clinical support using a systemic therapy approach, engaging with families within the wider community. Secondly, he informed the Board that transitions were being reviewed and there would be connection built within hubs as the programme moved forward with an interface with schools and young people who would be supported if they presented within hubs.
A number of initiatives were under way to address younger people and the Croydon Drop-In was one of the successful applicants for the transitions initiative and as part of the process the funding panel asked for the age to be dropped from 18 to 16, to include apprenticeships, to address needs across the borough.
There was a need to improve support for older adults in the area. Age UK, the Alzheimer’s Society and the Memory Clinic through SLaM, were working with older adults and the Dementia Action Alliance would be reignited with additional resource provided.
The Deputy Head of Mental Health Commissioning SW London CCG Croydon Place stated that the work discussed was a journey and successes would be clear in the next two years.