Mental Health

One in four people in the UK will suffer a mental health problem in the course of a year (The Mental Health Foundation).  The cost of mental health problems to the economy in England have recently been estimated at £105 billion, and treatment costs are expected to double in the next 20 years (Department of Health).  Mental Health is high on the government’s agenda, with a new strategy, ‘No Health without Mental Health’, published by the Department of Health in 2011.  The strategy takes a cross government approach with a focus on outcomes for people with mental illness.  Locally, profiles and assessments of need are available to download below, which should be used to support commissioners of health and social care services in their decision making, leading to the improvement of mental health and mental health services.  Headlines for Derby City in 2013 include:

  • Conduct disorders (characterised by repeated episodes of severe aggressive and anti-social behaviour) are the most common CAMHS (Child and Adult Mental Health Services) diagnosis both overall and among young offenders
  • The estimated prevalence of common mental health disorders in the City is the highest in Derbyshire at 158.8 per 1,000 population, with the most common diagnosis being mixed anxiety and depression
  • The most common primary diagnosis on mental health admissions is mental and behavioural disorders due to psychoactive substance use
  • Hospital admissions for intentional self-harm (aged 18+) are significantly higher than average
  • The mortality rate from suicide and injury of undetermined intent is similar to the rate for England
  • Hospital admissions to acute and specialist care for both eating disorders overall and anorexia specifically, are significantly higher than the East Midlands average
  • The rate of section 136 police detentions (whereby individuals are judged to be in need of “immediate care or control” in a public place) by Derbyshire Constabulary is higher than the England average.

Mental Health Sub Pages


Dementia

Dementia is a debilitating neurodegenerative syndrome that predominately affects older people through brain structural and chemical changes due to physical diseases. There are several symptoms of dementia but characteristics comprise of deterioration in memory, reasoning and communication abilities, and this impacts on a person’s capability to conduct daily activities independently (Alzheimer’s Society, 2007).

It is calculated that one in every 79 people in the UK population has dementia, and this is represented as one in 14 people aged over 65 years old. As dementia advances, the symptoms will become more severe. There are many forms of dementia which adds to the complexity of understanding the disease however many factors, such as age, lifestyle, medical history and genetics, are believed to contribute together to the onset of dementia (Alzheimer’s Society, 2014).

The importance of further developments in the field, in terms of funding, research, care and services, have been highlighted by the growing aging population both in England and globally. The number of UK dementia cases is expected to increase by 40% to over one million by 2025 and by 156% to over two million by 2051. These increasing number of cases projected for the future may be altered by adult’s efforts to prevent and treat lifestyle conditions, such as obesity, hypertension, diabetes and high cholesterol, in order to preserve brain and body health and reduce dementia risk in later years of life. The aforementioned lifestyle related conditions are modifiable risk factors for dementia (Alzheimer’s Society, 2014).

Recent emphasis on dementia

The National Dementia Strategy for England was launched in 2009 by The Department of Health. The government outlined the five year Dementia Strategy spanning 2010 to 2015 and this Strategy focused on the quality of life for people with dementia and their carers. The Strategy key recommendations for improving dementia care services covered three broad themes: Raising awareness and understanding; Early diagnosis and support; Living well with dementia. The delivery of the Strategy was supported by an additional £150 million funding (Alzheimer’s Society, 2009).

In 2012, during the National Dementia Strategy delivery timeframe, the Prime Minister created the challenge of major dementia care and research developments by 2015. This was followed, and built upon, by the Prime Minister’s Challenge on Dementia 2020. This second challenge aimed to make England the world leading country of dementia care and support, and research (Department of Health, 2016). England has the Living Well With Dementia: a national dementia strategy which outlines improvements for dementia services and includes a focus on health inequalities.

In 2013, the world’s first G8 dementia summit was held in London and brought together ministers, researchers, pharmaceutical companies and charities. This event resulted in the ambition for a cure or a disease-modifying therapy for dementia by 2025 (Department of Health, 2014). The World Health Organization hosted the first Ministerial Conference on Global Action Against Dementia in 2015, which was partially supported by the UK, to bring together Ministers and dementia experts to discuss the worldwide problems of dementia (WHO, 2015). Dementia is a public health priority not only in England and localities but is a priority shared by many countries globally.

Dementia health indicators

Indicators associated with dementia that commissioners should be aware of, include an aging population, and lifestyle factors, including smoking, physical activity and healthy eating. Public Health England’s Dementia Profiles offer health intelligence with which to inform the provision of care of people who have dementia. Headlines for Derby include:

  • More than 2,100 residents have been diagnosed with dementia
  • 20.5% of eligible residents have received an NHS Health Check – promoting opportunities in mid-life to reduce the behavioural risk factors for dementia
  • 33.5% of adult carers have as much social contact as they would like
  • The directly age-standardised rate of admission to hospital in those aged 65 years and over with dementia, was 1,648 per 100,000 population in 2014/15
  • 8.1% of residents with dementia died in their own home in 2014.

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