The West Midlands Combined Authority has made mental health one of its strategic priorities. Ian Halstead discovers more from the two driving forces behind its ambitious proposals; Supt Sean Russell and former LibDem Health Minister, Norman Lamb.
Mental health remains the final taboo for Western civilisation; despite an array of programmes and initiatives aimed at tackling both the stigma, and the impact, of mental disorder over the decades. Well-intentioned all, of course, but it’s hard to say that they’ve resulted in more than minimal progress to the health and well-being of the millions of individuals affected.
However, the West Midlands Combined Authority (WMCA) is determined that actions rather than words will be the outcome of its Thrive West Midlands action plan, launched in January 2017, after months of diligent research by its Mental Health Commission (MHC).
An impressive line-up of researchers, academics, analysts, people with mental health issues, and members of the wider public contributed to the plan. Now, the individuals tasked with ensuring the MHC delivers on its targets are Supt Russell, seconded from West Midlands Police for two years as implementation director, and Lamb.
Both are high-profile campaigners for those impacted by mental health issues, and it’s easy to see why they’ve formed such an effective partnership, as their passion for improving the lives, the health and the wealth of those who suffer the blight of mental illness shines through their every word.
Russell - like Lamb - is very much one of the new breed of evidence-based observers, and has an array of statistics at hand to underline the case for putting mental health a-top the WMCA’s agenda.
The most eye-opening figure is that the failure to tackle mental health in all its forms costs the West Midlands £12.5bn each year. “Roughly 70,000 people across the region are economically inactive, because of mental health challenges, which costs £2.2bn a year, and in terms of crime, mental health adds £1bn a year to the costs of the criminal justice system,” says Russell. “Almost a quarter of adults will have a mental health problem at some point in their lives, and we lose 4.1 million working days a year because of such problems. If you look at the statistics for suicide, each one is a terrible tragedy for the individual, and their family and friends, but there’s also a significant financial cost.
“For the last full year in which data is available, 474 people took their own lives in the West Midlands, and the average cost for all the services involved in the aftermath of each death is £1.6m. If we could prevent just 60 of those deaths happening, we’d stop 60 personal tragedies - and save almost £100m.”
In an era of public sector austerity, where funding pressures grow ever-greater upon the NHS and the wider economy, Russell believes the MHC strategy also makes sound sense at the financial level.
“There is a fiscal gap of £3.9bn in the West Midlands, because of cuts in central government funding, and addressing issues relating to mental health can make a very significant contribution towards narrowing that gap, by reducing the benefits bill, getting people back to work and increasing productivity,” he says.
“We want to raise issues of mental health well-being across the community, and to make people aware of how widespread mental health issues are. We can all suffer from ‘initiative overload’ on occasions, but this is a precise and targeted strategy, and we also have a mechanism in place to make sure things happen.
”Firstly, we must give people more support and guidance to get back into work, then help them during their transition back into employment, and that aspect is very important.
“Secondly, we must do more to reduce the number of rough sleepers, and the numbers in hostels, or who are ‘sofa-surfing’, because they often have mental health issues, and we must get them into decent housing, so they have safe and stable places to live.
“Thirdly, we need to find ways of keeping people with mental ill-health out of the criminal justice system, to screen people right from the start so that they receive the treatment and understanding they need, and also to prevent such individuals from re-offending.
“There’s been an innovative project in Milton Keynes about ways to reduce the rate of re-offending, and we’re learning from their experiences to see what more can be done here.
”Fourthly, we have to develop and deliver new models of care, and to understand what modern mental health care looks like, for primary and secondary healthcare providers, and finally, we have to get the wider community involved.
“There’s been such a stigma about mental health for so long, that people still don’t like to talk about it, but we have to raise awareness about what mental well-being means, not solely for the individuals who suffer, but for everyone in the community, so it is regarded in the same way as any other illness or condition.”
Lamb makes an equally passionate advocate for tackling the scourge of mental health, and thinks the imminent election of the first WMCA Mayor will be a critical moment, if the MHC’s action plan is to be delivered swiftly and effectively. “I’m hoping the arrival of the Mayor will invigorate, and then turbo-charge this process, although it must of course depend on their personal motivation,” he says. “However, I am pleased that the Conservative candidate (Andy Street) has picked up on the idea of the ‘well-being premium’, which is a fiscal initiative for public and private sector employers, so they receive a discount on their business rates if they demonstrate commitment to the mental well-being of their employees.
“We’re talking to the government, and hoping to get support for a two-year trial, involving 100 companies of all sizes, across the West Midlands, so we can collect evidence to see if incentivising employers works.
“We have initial funding for a pilot, and I’d hope that if the Mayor puts their authority behind it, that we could get started during 2017. We are partnering with the Health Foundation on this project, and if it works, it could be rolled out nationally.”
Lamb is equally enthused by the concept of Individual Placement and Support (IPS) provision, which allows individuals with significant mental health issues to gain - and to stay in - employment.
“We’ve got almost £10m to carry out a full-scale trial of IPS. The idea is to help people ready themselves for work, help them identify suitable work, support them during the interview process, and then assist them when they’re in work.
“I visited Vancouver last year, and they have a well-established and proven IPS system. It gets people off benefits, gives them a better life, and everyone wins. Despite the evidence, we don’t yet do it here, because government operates from silos, and the DWP doesn’t work with the Department of Health as it should.
“However, if our trial delivers the data we are confident it will, I would hope government finally recognises that it needs to adopt a more joined-up approach to mental health issues, and again, there is no reason why IPS could then not be rolled out nationally.
“Sean and myself are absolutely committed to the Thrive West Midlands action plan, as is the WMCA, and I’m very optimistic that a year from now, significant progress will have been achieved.”