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Priority: Mental Health and Wellbeing

The specific focus is on:

  • improving care pathways
  • promoting wellbeing
  • ensuring residents know where and how to access support and information

Key strategic aims under this priority are:

  • Prevent mental ill health and promote wellbeing - with a focus on supporting early to prevent mental health problems developing.
  • Promote good mental health and wellbeing across all age groups in Bexley.
  • Undertake local research - to better understand whether there is an over representation in accessing acute mental health services (specific communities or groups for example young black men) and whether specific communities experience barriers to mental health and support.
  • Support those working with individuals and communities to ensure they have the skills to support people early with a focus on suicide prevention and mental health first aid.
  • Increase community-based care and support communities – delivering more community-based care in Bexley and supporting a sustainable and resourceful voluntary and community sector. This will include supporting local communities and publicising the range of community assets available in the borough.
  • Improve clinical and care services - delivering a sustainable mental health system by focussing on evidence-based models of care that generate better outcomes on where care is delivered and how it is delivered.
  • Improve crisis care pathways - continuing to invest in improved crisis support services in the community and working to reduce the need for unnecessary attendances to A&E. This will involve increasing alternatives to admission, ensuring that where admissions do occur, it is always in the best interests of the patient. It will also extend to improving discharge processes and enhancing community capacity and care planning to prevent crises re-occurring.
  • Supporting recovery - placing the principles of recovery at the heart of the approach to commissioning. This includes ensuring that local people are aware of the wide range of local organisations and community assets available in Bexley. It also means creating opportunities for people to engage in meaningful activities that promote social and community connection, as well as ensuring that more people have access to personal budgets to enable them to plan and tailor support that meets their own identified care and support needs.
  • Improving quality and outcomes - delivering improved system-wide outcomes for Bexley residents who live with a mental illness and other issues such as physical health problems. The focus will be on improving data and systems to evaluate progress to better understand patient experience, quality and the efficiency of the services and support we provide.
  • Undertake a local suicide audit - every three years to better understand local risk factors and required actions.

Good mental health and a sense of wellbeing are central to living a purposeful, healthy and enjoyable life.1 However, for too many people, the reality is that they are living with poor mental health, with wide-ranging and long-lasting consequences for themselves, their family, friends and community. Many people who live in Bexley will be impacted, directly and indirectly, by poor mental health and wellbeing. Mental health problems also disproportionately affect people living in poverty, those who are unemployed and people who already face discrimination.

People can be affected by mental health problems at any point in their lives, including new mothers, children, teenagers, adults, and older people. Good mental health and wellbeing, and not simply the absence of mental illness, has been shown to result in health, social and economic benefits for individuals, communities, and populations. Benefits include better physical health, improved productivity, higher incomes, reduced absenteeism, less crime and reduced mortality.

Those from Black, Asian and minority ethnic communities can experience higher levels of mental health issues. Black people are four times more likely to be detained under the Mental Health Act than white people. Refugees and asylum seeker are more likely to experience mental health problems than the general population, including high rates of depression, anxiety and post-traumatic stress disorder.2

There are additional risk factors associated with suicide including mental health conditions such as depression, traumatic experiences in childhood or adulthood, relationship problems, serious illness or chronic pain and barriers to support or care and stigma. A cross-government strategy sets out the aims and ambitions to reduce suicide. There is a requirement for each local authority area to develop its own plans designed to reduce suicide at place level.3

The Covid pandemic has had a significant impact on the mental health and emotional wellbeing of adults and children.4 There has been a significant increase in demand of children and young people’s mental health services, including through schools, community Children and Adolescent Mental Health Services (CAMHS) and specialist services including children and young people’s eating disorders. Research has shown that those who struggled with their mental health before the pandemic were more at risk of further deterioration.5

In Bexley, partners aim to better support residents through a range of strategies and plans including a mental health transformation plan which articulates a new model of primary and secondary mental health care already in planning when the pandemic started. This model aligns with the pledge of the NHS Long Term Plan6 and the Mental Health Implementation Plan7 which provides a framework to deliver the mental health commitments. The local vision is a new service that incorporates existing Community Mental Health Teams (CHMTs) with primary care mental health services and clear links to other services such as supported housing, substance misuse, debt advice and employment support. There is also a system transformation plan for children and young people’s mental health and emotional wellbeing services. Locally the aim is to achieve a sustainable mental health system, where high quality, responsive and accessible services result in improved outcomes for those with mental health issues. Mental health services in the borough need to reflect and respond to the needs and wishes of the local population and be delivered without stigma or discrimination.

To achieve this, new ways of working will be adopted; recognising parity of esteem (valuing mental health equally with physical health), and changing the way services are commissioned, placing a greater focus on prevention, and leveraging local assets to develop stronger, more resilient communities. Improving mental health and wellbeing requires a whole borough, whole system approach. It is essential that commissioners work together with service providers, the voluntary and community sector, employers, people using services, carers, families, and communities.

Each of these priorities will require a number of actions in order to transform services and achieve improved outcomes for Bexley residents. Some of these actions will require investment, and others will require new ways of working, new approaches to commissioning and better ways of co-producing services with residents.

  1. Better Mental Health For All: A public health approach to mental health improvement, Mental Health Foundation (2016)
  2. Mental Health Foundation
  3. Suicide Prevention in England Fifth Progress Report, HM Government and Suicide Prevention Strategy for England, HM Government 
  4. Proto, E. and Quintana-Domeque, C., 2021. COVID-19 and mental health deterioration by ethnicity and gender in the UK. PloS one, 16(1), p.e0244419.
  5. The Consequences of Coronavirus for Mental Health, Mind (PDF)
  6. NHS Long Term Plan
  7. NHS Mental Health Implementation Plan