The first year of the CSG: Much achieved but more to be done

Formed to pool resources, share expertise and best practice and bound by a desire to transform the mental health of our capital, we sought – and continue to seek – to become greater than the sum of our parts. To achieve more for the people of London, together as the Cavendish Square Group, than we could do alone. We are proud to employ some of the world’s most passionate and talented mental healthcare professionals who make a difference to the lives of people with mental health problems day in and day out.

On this, the one year anniversary of the foundation of the Cavendish Square Group, we take a retrospective look at what London’s mental health services have achieved together over the past 12 months and cast our eyes forward to the challenges and opportunities ahead.

IAPT

People living in the capital are a greater risk of mental ill-health due to unemployment or debt and are likely to report lower levels of life satisfaction than the UK average. However, through breaking down the barriers – the stigma – to seeking help, we’ve seen more people than ever come forward to take advantage of London’s IAPT services, over 180,000 people in 2014 alone.

Psychosis

Our city has significantly higher incidents of schizophrenia (at 99.8 per 100,000) compared to the rest of the UK and yet less than 38% of Londoners felt they understood what the condition was or how to recognise its symptoms. We’ve worked on pan-London initiatives to help Londoners become more ‘psychosis aware’ and to ensure our services are geared up to meet  psychosis referral-to-treatment time targets in readiness for their introduction in April 2016. A further 140 London clinicians are also being trained in behavioural family therapy – one of NICE’s concordat treatments for psychosis – to ensure people in the capital benefit from leading-edge interventions.

Dementia

We have made huge strides in meeting the needs of our older population by improving how we detect and diagnose dementia. The current London average is 71.3% against a national target of 67%. By comparison, in 2011 only 50% of Londoners living with dementia had received a confirmed diagnosis.

Children and young people

Millions has been in invested in transformation plans for children and adolescent mental health services in London. From eating disorders, support in school, waiting time initiatives and crisis we’re working harder than ever to give children in the capital the best possible start in life. By investing heavily in early intervention and evidence-based specialist services for children and in developing new models of care, we will help more young people obtain help.

Crisis care

We are also responding better to people in crisis. London has seen a drastic reduction in the use of police cells as places of safety for people experiencing a mental health crisis thanks to a collaboration with the Metropolitan Police and other partners under the Crisis Care Concordat initiative. In 2013, Metropolitan Police cells were used as places of safety 87 times. By November 2015, that number had dropped to 16. Our street triage pilot schemes – which partner police personnel with mental health professionals either in person or by phone – mean that people experiencing a crisis are now receiving appropriate care more quickly, seeing better outcomes and are less likely to be detained under S136 powers. Evidence has found that street triage schemes can reduce the use of Mental Health Act powers by as much as a third.

We’ve invested in round the clock care. One central London 24/7 call centre is receiving on average 200 calls a day and has the ability to get a team out to someone in a serious crisis within an hour. Other similar schemes are in operation across London: a patient and carer support line servicing West London is available 365 days a year and in December 2015, a Freephone crisis number staffed by a team of six nurses 24 hours a day, offering a single point of contact for people experiencing crisis or seeking advice on medication, accessing services or immediate support was established in a number of South London boroughs.

Looking ahead

Much has been achieved, but there is more still to be done. The latest patient survey conducted by HealthWatch England saw access to mental health services overtake GP appointments as the thing patients were most concerned about for the first time. It is crucial that greater interest in mental health is matched by increased funding to ensure all Londoners with mental health conditions receive the help they need and deserve. The promised parity isn’t yet the reality and there are undeniable gaps in care and areas of extreme pressure that require urgent attention. Fairly funded mental health services also offer an answer to wider pressures on NHS finances by helping us respond better to the needs of people in acute hospitals who have mental health as well as physical health needs.

Today, a year after making our first commitment to London by forming the Cavendish Square Group, we make another promise. We commit to building a solid, evidenced-base case for greater financial investment in mental health and will not rest until we have secured equality of funding.

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