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