Agenda item

Annual Report of the Director of Public Health on the Health of the People of Lincolnshire 2016

(To receive a report by Tony McGinty (Interim Director of Public Health) which provides an independent statutory report raising the issues of importance to the health of the population of Lincolnshire.  Tony McGinty (Interim Director of Public Health will be in attendance for this item)

Minutes:

Consideration was given to a report from Tony McGinty (Interim Director of Public Health) which provided an independent statutory report to raise the issues of important to the health of the population of Lincolnshire.

 

Tony McGinty (Interim Director of Public Health) was in attendance for this item.

 

NOTE:       The Chairman declared a pecuniary interest in this item as she provided financial support to the Lincolnshire Rural Support Network (LRSN) and had also lobbied Lincolnshire Partnership NHS Foundation Trust and the Clinical Commissioning Groups to continue financial support to the LRSN for mental health services.

 

It was a statutory duty of the Director of Public Health to produce an annual report on the health of the people of the area in which they serve and was the statutory duty of the local authority to publish that report. 

 

The report was not an annual account of the work of the Public Health Team but an independent, professional, view of the state of health of the people of Lincolnshire including recommendations on the action required by a range of organisations and partnerships.

 

The focus of the report for 2016 was mental health and the mental illness profile of local people.  This decision had been taken based on the principle "no health without mental health" which led to a definition of mental health as a resource rather than a state involving the absence of illness or distress.

 

Good mental health was a valid goal for individuals and communities to pursue and was also a prerequisite for people to achieve their goals and potential in life; support their ability to make good choices and protect themselves from harm.  A number of different factors could support or challenge the mental health of individuals and communities and, due to this, the report presented a series of points along the average life-course and highlighted risk and opportunities to mental health at each stage of life.

 

The Interim Director of Public Health gave a presentation to the Committee which covered the following areas:-

·       Director of Public Health (DPH) Annual Report 2016

o   Reported on progress against the 2015 DPH Annual report recommendations;

o   Explored social and environmental risk factors associated with mental health;

o   Described the impact of mental health on children and young people, adults, families and wider society;

o   Provided recommendations to improve the mental health of the people of Lincolnshire;

·       Mental Health across the life-course – a framework for the Annual DPH Report 2016/17 chart;

·       Scale of the Problem

o   It had been estimated that over 3000 Lincolnshire women, each year, had mental health problems during pregnancy and after childbirth;

o   Over 9% of Lincolnshire children aged 5 to 16 were estimated to have a diagnosed condition which was similar to national rates;

o   Over 100k adults in Lincolnshire were estimated to have a diagnosed common mental disorder, such as depression or anxiety;

o   Every year since 1999, there had been at least 60 deaths from suicide in Lincolnshire;

·       Risk Factors

o   Clear evidence linking negative experiences throughout childhood and adolescence with a higher risk of mental health ill-health;

o   In adulthood, the built environment and the circumstances of life could influence mental and physical health;

o   Risk factors were not always evenly distributed throughout the population;

o   It was known that many of risk factors could affect those in the most deprived groups;

·       Perinatal and maternal mental health

o   10% - 20% of women were estimated to be affected by mental health problems at some point during pregnancy or the first year after birth;

o   Women lacking social support had been found to be at increased risk of antenatal and postnatal depression.  Poor relationships with partners was also a risk factor for postnatal depression;

o   Pregnancy in under-18 year olds was linked to poorer health and social outcomes for both the mother and child.  Rates in Lincolnshire, however, were falling and comparable to the national average;

·       Childhood and adolescent mental health

o   One in ten children and young people (10%) aged 5-16 had a clinical diagnosed mental disorder;

o   Emergency department presentations due to self-harm by those aged 17 and under had risen by 30% since 2003-04;

o   Societal influences and risks to mental health resilience were changing for children and young people;

o   Certain groups had a higher risk of mental ill health, such as looked after children;

·       Adult and older adult mental health

o   At any one time approximately 104k adults in Lincolnshire were living with a common mental disorder (CMD) which was roughly 17% of the population aged over 16;

o   CMD's included depression, anxiety, phobias, panic disorders and obsessive-compulsive disorders;

o   CMD was higher in younger age groups but was at its highest in people aged between 45 and 54, at 19.9%;

o   Lincolnshire had a wide range of mental health services including primary care, therapeutic and preventative interventions and acute and specialist care for those with more severe conditions.

 

Members were invited to ask questions, during which the following points were noted:-

·       An example was given regarding a man who had been admitted into the system at the age of 12 and transferred to assisted living at the age of 20.  At age 32, the man felt well enough to leave assisted living but there was no support in place to help him to do so.  Officers concurred that the same conclusion had been reached when reviewing the service and this was an area which would be looked at in further detail when reviewing wellbeing services.  For this particular man, the Interim Director of Public Health agreed to look into this case further;

 

At 4.00pm, Councillor Mrs R Kaberry-Brown left the meeting and did not return but indicated her agreement with the submission of the Committee to NHS England in response to the Consultation on Congenital Heart Disease Services, to be considered at item 11 of the agenda.

 

·       It was reported that GPs currently spend a considerable amount of time dealing with mental health issues of patients and were generally very skilled in that area.  The main issue for GPs was that the appointment times were not long enough to be able to talk at length with these patients;

·       A lot of investment had been made in Child and Adolescent Mental Health Services (CAMHS) in recent years which had resulted in considerable improvement within service provision;

·       The Chairman noted that an update on the outcomes of previous recommendations had not been reported to the Committee and suggested that an update be provided at a future meeting in relation to the implementation of these recommendations.  The Interim Director of Public Health had already made a commitment to take a proactive interest and develop an action plan approach to the recommendations, which could be considered by the Committee.

 

RESOLVED

1.    That the report and comments be noted; and

2.    That an update on the progress on outcomes from the Annual Report of the Director of Public Health on the Health of People in Lincolnshire 2016 be considered for addition to the Work Programme.

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