Promoting mental well-being in Greenwich - a strategic approach

ABSTRACT

This article outlines the mental health promotion strategy evolveed by Greenwich teaching Primary Care Trust (tPCT) The strategy focuses upon four themes: isolation, anxiety and depression, nap and stigma and discrimination. The aim is to address mental health promotion for all as well as targeted action for higher risk clumps in recognition of the great contrasts, diversity and significant economic inequalities that characterise the borough. A lock opener challenge has been to integrate mental health promotion with wider agendas and it is intended that the strategy will inform other important areas of work in the borough, of that kind as the neighbourhood renewal and health benefits regeneration programmes.

Greenwich in southerly east London is a highly diverse borough with significant social and economic contrasts and inequalities. In 2001 there were 214450 residents (Office for National Statistics, 2003) and by dint of 2014, with new housing unfoldings planned in Greenwich and along the Thames Gateway, this number is wait fored to increase by 25%. The population is varied in limits of age structure (nearly single in four are children and young nation aged 0-19 years and individual in seven are older adults aged above 64 years), ethnic structure (23% defined themselves as non-white in the last census) and social and economic urgencys (overall nine per cent were receiving income support, rising to 15% in a certain quantity of wards). Greenwich Primary Care Trust was formed in 2001 and in 2003 became a teaching PCT giving it a lead part in supporting the whole sector to disclose innovative ways of working and a learning tillage We were recently rated as a sum of two units star trust.

The development of a strategy to aid mental well-being in Greenwich began in 2001 in replication to standard one of the national service framework for mental health. From the beginning the strategy was based upon a clear use of local evidence to demonstrate ne a mapping of existing activity and linkage of the strategy with the wider public health agenda across agencies.

To capture views of the local population, the wants assessments and mapping exercise focused on:

* the general adult population, including vulnerable groups

* children, young tribe families and schools1

* workplaces

* specialist mental health and social services

* physical environment.

The findings of the straits assessments are discussed in six reports available from the public health department of Greenwich PCT (Guite, 2002a-f).

Each of the six reports followed a similar format to identify markers of ne for mental health promotion in Greenwich at the individual horizontal at the community level and at the policy level

At the individual horizontal we applied epidemiological findings from the national psychiatric morbidity review (ONS, 2001) to our local population and summarised the evidence base for protective and risk factors (drawing upon the source document Making It Happen (DH 2001a)). For the community horizontal we identified local data to attempt to describe baseline horizontals of trust and tolerance, social networks, participation, faculty of perception of control and participation in decision-making. For the structural horizontal we focused on social and economic deprivation and issues that require a policy approach.

Two masters pupils from King's University, London carried on the outside a detailed review of evidence relating to mental well-being, neighbourhoods and the environment. Their work has enabled us to gain a more thorough insight into the relationship between the physical environment and mental health (Chu et al, 2004)

Key themes for the mental health promotion strategy were pick outed based on the following criteria:

* available evidence base of effective interventions

* findings of the urgencys assessments

* mapping of services exercise

* consultation groups

* Greenwich, regeneration and renewal programmes, local priorities and strategies.

The lock opener themes selected are isolation, anxiety and depression, doze and stigma and discrimination. These themes affect large numbers of family across the majority of settings identified in the strategy and met the inclusion criteria mentioned above. Challenging stigma and discrimination has also been identified as a lock opener theme for action since it is a central uncompounded body of promoting mental well-being the one and the other for people with long-term mental health question s and for the general population. sum of two units themes identified for further exploration are violence and alcohol.

Isolation

Isolation that leads to loneliness is a lock opener factor in determining an individual's faculty of perception of well-being. People who are isolated and lone-some are likely to have fewer links with nation to help them in a crisis, reduc feelings of trust and a lower faculty of perception of their own worth (Steptoe, 2003; Jackson, 1991) In Greenwich there are a number of factors that increase the likelihood of isolation.

1 Population mobility. Residential turnover in Greenwich has increased between 1991 and 2001; at the last census individual in eight people reported having mov house in the previous year (Census, 2001) In addition, with the further planned expansion of housing, many areas will experience large numbers of newcomer The impact of this horizontal of mobility on community arrangements will mean a lower proportion of residents with knowledge of local services, fewer clan with time for involvement in the community, and potentially fewer race who want to invest in developing their local community.