Mental Health

The World Health Organization (2005) defines mental health as “a state of wellbeing in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”.

As in the WHO’s definition of health (“a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity”), mental health is not just the absence of illness, but requires an additional positive ‘something’ to be present in the individual. Thus, the concept of an individual’s mental health state is increasingly being uncoupled from mental illness. 

Mental health and wellbeing consists of emotional wellbeing or happiness, psychological wellbeing and social wellbeing. 

Psychological wellbeing is sometimes defined as consisting of six dimensions: positive evaluation of oneself and one’s past life (self-acceptance); a sense of continued growth and development as a person; the belief that one’s life is purposeful and meaningful; the possession of quality relations with others; the capacity to manage effectively one’s life and surrounding world (environmental mastery); and a sense of self-determination (autonomy). 

Social wellbeing has been defined as “individuals’ perceptions of the quality of their relationships with other people, their neighbourhoods, and their communities” with social wellbeing being made up of various dimensions including social integration, social acceptance, social contribution, social actualization and social coherence.

Life affects us all differently. We all go through difficult times, and negative emotions can be a healthy reaction to the challenges we face. But for many of us, things can become more serious, and each year as many as 1 in 4 of us experiences a mental health problem.

Being aware of what can affect our mental health can make it easier to understand when we, or someone we care about, are struggling, and helps us think about what we can do to improve things or where to get support.

Some things that affect our mental health include our:

• upbringing and environment, which shapes our brain development when young and opportunities throughout life
• experiences, like our relationships, how we are treated, our financial situation, work, where we live, physical health, life events and the changes we go through
• genes and temperament, which may make some of us more likely to develop certain kinds of mental health problems when combined with our life experiences

All of these influence how we think about, make sense of and respond to challenges and opportunities in life.

How we think about ourselves, the people and the world around us and the future, is a result of the things that happen to us. But it also has profound implications for our mental health.

There are many situations or life events that can affect us and make us feel distressed or less able to cope. We all respond to life's challenges differently – there's no single "right way" to react.

It may be everyday events, one-off experiences or several things building up. Even experiences that are positive can be difficult to cope with sometimes.

How we feel is often a completely natural reaction to challenges. But for some of us, these feelings can become more difficult to manage, especially if they do not go away – after a while, what we're experiencing affects our daily life.

Some things that affect our mental wellbeing include:

• personal life and relationships
• money, work or housing
• life changes
• health issues
• traumatic life events
• smoking, alcohol, gambling and drug misuse

This visual also considers the impact of Covid-19 on our mental health.

There is now accepted understanding and recognition that mental health is more than the absence of mental illness and that good mental health underpins everything we do, how we think, feel, act and behave. It is an essential and precious individual, family, community and business resource that needs to be protected and enhanced.

People with higher levels of good mental health and wellbeing have better general health use health services less, live longer, have better educational outcomes, are more likely to undertake healthier lifestyles including reduced smoking and harmful levels of drinking, are more productive at work, take less time off sick, have higher income, have stronger social relationships and are more social.

Higher levels of mental wellbeing are also associated with reduced levels of mental ill-health in adulthood. 

Wirral Report

Note: This report is based on key indicators that are at the time the data was published suggests we are in either a positive and a negative position.

• Adults in contact with secondary mental health services who live in stable and appropriate accommodation (Persons, 18-69 years): Wirral performs consistently higher than England, with the exception of 2016/17 (however there are data quality issues noted for this year).

• Gap in the employment rate for those in contact with secondary mental health services and the overall employment rate (Persons, 18-69 years): The gap between Wirral and England has fluctuated since 2014/15, but has generally widened compared to national rate, as 70.9 per 100,000 residents for Wirral vs 67.2 per 100,000 for England, in 2019/20.

• Hospital admissions for mental health conditions (Persons, <18 years): This has significantly increased over the last 8 reported years; the gap between Wirral and England is at it’s widest in 2019/20 (214.8 per 100,000 residents for Wirral vs 89.5 per 100,000 for England).

• Depression: Recorded prevalence (Persons, aged 18+ years): Gap between Wirral and England continues to increase intimating higher incidence locally; the gap is currently at its widest for 2019/20 at 18.1% for Wirral vs 11.6% for England.

• *Mental Health Quality Outcomes Framework (QOF) Prevalence (all ages):  Gap between Wirral and England continues to increase intimating higher incidence locally; the gap is currently at its widest in 2019/20 (1.10% for Wirral vs 0.94% for England respectively).

• Admission episodes for mental and behavioural disorders due to use of alcohol (Narrow measure, Persons, All ages): Substantially higher rates in Wirral than England since 2008/09, current rate (2018/19) is highest since 2009/10, and with England showing one of its lowest rates, the gap is at its widest between Wirral and England (223.0 per 100,000 vs 75.6 per 100,000 respectively).

• Number of adults who entered treatment at a specialist alcohol misuse service who were engaged in mental health treatment and Number of adults who entered treatment at a specialist drug misuse service who were engaged in mental health treatment. Both of the above indicators are lower in Wirral compared to England until the most recent period recorded. This could possibly be interpreted as positive if people do not require these services, but equally negative if services are needed and that need is not being met (Wirral’s poor performance on alcohol- and drug-related admissions would indicate the latter). The most recent data available is for 2016/17 and is therefore possibly not indicative of the current number of dual diagnosis service users.

• Emergency Hospital Admission for Intentional Self-Harm: Has been higher in Wirral compared to England since 2010/11 and has increased steadily since 2016/17 and 2019/20 data is now 301.0 per 100,000 residents in Wirral compared to 192.6 per 100,000 in England.

• Long term mental health problems (GP Patient Survey): Percentage (%) of respondents: The 2018/19 GP Patients Survey (latest available date) showed that Wirral had a higher proportion of patients with mental health problems than England (13.4% for Wirral compared to 9.9% for England).

*The Mental Health register includes all patients with a diagnosis of schizophrenia, bipolar affective disorder and other psychoses to avoid a generic phrase that is open to variations in interpretation. 

Perinatal Mental Health

Mental health in pregnancy and infants

Wirral: Emotional health and wellbeing of children and young people

PHE Profile: Children and Young People's Mental Health and Wellbeing

Teenage pregnancy and young parents

Mental Health and Wellbeing JSNA

Common Mental Health Disorders

Severe Mental Illness

Severe mental illness (SMI): inequalities in cancer screening uptake report

Co-occurring substance misuse and mental health issues

Suicide Prevention Profile

Dementia JSNA: key findings and detailed report (Published July 2019)

PHE Dementia Profile

Productive Healthy Ageing Profile

The coronavirus (COVID-19) pandemic continues to have an impact on everyone’s daily lives, as the government and the NHS take necessary steps to manage the outbreak, reduce transmission, treat those who need medical attention and plan a way forward with vaccines.

So any data, information and insight that the following Public Health Profiles and other sources present will not yet be able to reflect the true gravity and depth of impact of this virus, and the changes we are subsequently encountering.

These web pages, the content and information across the site will continue to change over the coming months to reflect this new reality and the resulting impact on our mental health. If you are aware of content that could enhance this resource - then please do get in touch.

THIS TOOL IS NO LONGER AVAILABLE AS COVID-19 DATA SOURCES ARE WITHDRAWN.

COVID-19: mental health and wellbeing surveillance report

• This Public Health England report is about population mental health and wellbeing in England during the Covid-19 pandemic.

• It includes up-to-date information to inform policy, planning and commissioning in health and social care.

• It is designed to assist stakeholders at national and local level, in both government and non-government sectors.

COVID-19 mental health and wellbeing surveillance: Spotlights (November 2020)

• Spotlight reports are part of the COVID-19: mental health and wellbeing surveillance report.

• They describe variation among the population.

Mental health for all?
The final report of the Commission for Equality in Mental Health (November 2020)

• Inequalities in health, including mental health, have been highlighted in national reports for at least 40 years.

• The Commission for Equality in Mental Health was set up to explore what causes mental health inequalities, what perpetuates them, and what might help to break the cycle.

• Mental health for all?, the final report of the Commission, says that inequalities which have for too long been accepted or ignored can and should be reduced, through concerted action nationally and locally.

Worst hit: dementia during coronavirus ‘Exhausted’ family and friends spent 92 million extra hours caring for loved ones with dementia
since lockdown

• Since the coronavirus (Covid-19) lockdown on 23 March, this investigation found family and friends have spent an extra 92 million hours caring for loved ones with dementia.

• This is due to the double impact of lockdown making dementia symptoms worse, and the chronically underfunded social care system leaving them nowhere else to turn.

• It states that the government must fix social care now, learning lessons to avoid further winter tragedy, as dementia carers struggle with depression, insomnia, and  exhaustion.

Coronavirus (COVID-19) Review: data and analysis, March to October 2020

• A thematic overview of the coronavirus (COVID-19) pandemic between March to October 2020 and

• how Office for National Statistics data and analysis has been able to provide insight and understanding of the impacts of the pandemic on health, society and the economy.

Mental Health of Children and Young People in England, 2020: wave 1 follow up to the 2017 survey

• This is the first in a series of follow-up reports by NHS Digital to the Mental Health and Young People Survey (MHCYP) 2017,

• exploring the mental health of children and young people in July 2020, during the coronavirus (Covid-19) pandemic, and changes since 2017.

• Experiences of family life, education, and services, and worries and anxieties during the Covid-19 pandemic are also examined.

The impact of Covid-19 to date on older people’s mental and physical health (October 2020)

• This Age UK research finds that some older people are coping with the pandemic, but a sizeable minority are finding life incredibly tough.

• Those who are not very well and have long-term health conditions were particularly likely to report that this is an extremely challenging time for them.

• The research was made up of a survey of older people, their friends, families, and loved ones (promoted across the Age UK social media channels for two weeks in August 2020 and completed by 569 people) and representative online polling of 1,364 people over the age of 60, conducted by Kantar Polling in September 2020.

Covid-19 and the nation's mental health (October 2020)

• A new study from the Centre for Mental Health estimates that 8.5 million adults and 1.5 million children in England will need support for depression, anxiety, post-traumatic stress disorders and other mental health difficulties in the coming months and years.

• This is the equivalent of 20% of all adults and 15% of all children.

• The report says two-thirds of the people who will need support have existing mental health difficulties and may already be receiving care and treatment.

• The pandemic may mean they need more support, while others will need help with their mental health for the first time.

Depression in British adults doubles during coronavirus crisis (August 2020)

• The Guardian are reporting that the ONS study shows almost 20% experienced depression, with female, younger and disabled adults most affected
  

The mental health emergency: how has the coronavirus pandemic impacted our mental health? 

• A survey of more than 16,000 people during lockdown by the charity Mind has revealed the scale of the impact of the pandemic on people with mental health problems.

• Two out of three (65 per cent) adults over 25 and three-quarters (75 per cent) of young people aged 13-24 with an existing mental health problem reported worse mental health.
  

The mental health effects of the first two months of lockdown and social distancing during the COVID-19 pandemic in the UK. IFS Working Paper IFS Working Paper W20/16 (Institute of Fiscal Studies (IFS) (June 2020) 

• This report finds that the COVID-19 episode has had substantial negative impacts on mental health across the population.

• The biggest impacts have been on the gender and age groups – broadly women and the young – that already had relatively low levels of mental health.

• Pre-existing inequalities in mental health have therefore been exacerbated by the crisis.

COVID-19: guidance on supporting children and young people’s mental health and wellbeing (Public Health England)

• Advice for parents and carers on looking after the mental health and wellbeing of children or young people during the coronavirus (COVID-19) outbreak. Updated with guidance on 'support bubbles'.

Coronavirus: Impact on young people with mental health needs Survey 2: Summer 2020.

• The findings in this report are the results of a second survey YoungMinds carried out into the impact of coronavirus on young people with a history of mental health needs. (First Report).

Out of the woods? Young people's mental health and labour market status as the economy reopens

• Much has been said about the plight of young people during the Covid-19 crisis, both in terms of their labour market and mental health circumstances.

• This Resolution Foundation briefing provides an update on how young people were faring at the end of May 2021, shortly after the major relaxation of Covid-19 restrictions in mid-May. 

Fit for purpose? Addressing inequities in mental health research exacerbated by Covid-19

• This Centre for Mental Health report was produced on behalf of the Mental Health Research Group, an independent group of leaders in mental health in England.

• It highlights the inequities in mental health research funding and production, what gets investigated and who gets to contribute, as well as who and what is left out of the conversation.

• It shares examples of work taking place to address mental health inequalities and to challenge inequities of power and influence within mental health research.

• The report calls for systemic change in the ways mental health research is planned, funded, and delivered in the wake of the Covid-19 pandemic 

Coronavirus: the consequences for mental health

• This research from Mind with almost 12,000 people found that those with mental health problems report an increase in the severity of challenges they're facing now and concerns about the future.

• The authors call for services to be ready for the increase in severity of people's mental health problems, and to take into account the trauma that people have experienced over the past year and how this might affect the support they need. 

Public mental health and wellbeing and COVID-19

• The LGA and the Association of Directors of Public Health (ADPH) have jointly produced this briefing for Directors of Public Health about the public mental health and wellbeing issues arising from the COVID-19 outbreak.

Unemployment and mental health (April 2021)

• This Health Foundation analysis estimates that an increase of 900,000 people in unemployment expected by the end of the year, compared with before the pandemic, will lead to 200,000 more people with poor mental health in the UK.

• It acknowledges that while government action to reduce a rise in unemployment by extending the furlough scheme to September will support mental health, it suggests that the benefits system and employment support programmes currently fail to properly account for the mental health needs of those who are unemployed.

• It concludes that there is now an opportunity to ensure that efforts to tackle unemployment in the pandemic recovery are designed to better support mental health.

Next steps for funding mental healthcare in England: prevention (September 2020)

• The RCPsych has identified four areas that must be fully and sustainably resourced if access to the quality of mental health services in England that has been promised by the government is to be realised.

• These are:

  • infrastructure;

  • prevention;

  • people; and

  • technology.

• This paper focuses on prevention and considers the next steps for funding mental health care in England, with a specific focus on public health and prevention, promoting resilience in social care, and budgeting for workforce growth, education and training.

NHS Reset: Mental health services and COVID-19: preparing for the rising tide

• Mental health services have faced unprecedented challenges due to COVID-19. They quickly and effectively moved to different ways of working to protect service users and staff.

• As we move to the next phase of the pandemic, NHS Confederation expect demand for mental health support to increase and to remain high for some time.

• This will have serious implications on resourcing and staff wellbeing. This NHS Confederation report from the NHS Reset campaign considers what mental health services need to prepare for the expected surge in demand.

• It also highlights how the health and care system can 'reset' the way care and support are planned and delivered in aftermath of COVID-19.

COVID-19 and the nation’s mental health Forecasting needs and risks in the UK: May 2020 

• This briefing seeks to use evidence from existing research about the likely impact of the COVID-19 pandemic on the mental health of the UK population.

• It draws on published evidence to make projections about the potential impacts and which groups within the population face the highest risks to their mental health as a result of the crisis.

Mental health care in the time of COVID-19 (July 2020)

• This Kings Fund opinion piece, reflects on the experiences of staff and people with mental health problems during the first months of COVID-19, and urges mental health services to learn from those experiences to plan for the future.

Advice and information on how to look after your mental health and wellbeing during the coronavirus (COVID-19) outbreak.

The coronavirus (COVID-19) pandemic continues to have an impact on everyone’s daily lives, as the government and the NHS take necessary steps to manage the outbreak, reduce transmission, treat those who need medical attention and plan a way forward with vaccines.

It may be difficult, but by following government guidance to stay alert, you are helping to protect yourself, your family, the NHS and your community.

During this time, you may have been bored, frustrated or lonely. You may also feel low, worried, anxious, or be concerned about your health or that of those close to you. These are all common reactions to the difficult situation we face. Everyone reacts differently to events and changes in the way that we think, feel and behave vary between different people and over time. It’s important that you take care of your mind as well as your body.

Advice and information on how to look after your mental health and wellbeing during the coronavirus (COVID-19) outbreak.

Government plan to prevent, mitigate and respond to the mental health impacts of the pandemic during 2021 to 2022.

There are many determinants in our lives which influence our mental health: from positive parenting and a safe place to live, to experiencing abuse, oppression, discrimination, or growing up in poverty. Determinants of mental health interact with inequalities in society, putting some people at a far higher risk of poor mental health than others.

• Men and women from African-Caribbean communities in the UK have higher rates of post-traumatic stress disorder and suicide risk and are more likely to be diagnosed with schizophrenia (Khan et al, 2017)

• People who identify as LGBT+ have higher rates of common mental health problems and lower wellbeing than heterosexual people, and the gap is greater for older adults (over 55 years) and those under 35 than during middle age (Semlyen et al, 2016)

• Children from the poorest 20% of households are four times as likely to have serious mental health difficulties by the age of 11 as those from the wealthiest 20% (Morrison Gutman et al, 2015)

• Children and young people with a learning disability are three times more likely than average to have a mental health problem (Lavis et al, 2019)

• Women are ten times as likely as men to have experienced extensive physical and sexual abuse during their lives: of those who have, 36% have attempted suicide, 22% have self-harmed and 21% have been homeless (Scott and McManus, 2016)

• Deaf people are twice as likely to experience mental health difficulties (All Wales Deaf Mental Health and Well-Being evidence to the Commission)

• 70% of children with autism (Simonoff et al, 2008) and 80% of adults with autism (Lever and Geurts, 2016) have at least one mental health condition (Autistica evidence to the Commission)

View Centre for Mental Health Factsheet: INEQUALITIES IN MENTAL HEALTH: THE FACTS

Only one in three people who experience mental health problems are able to access the support they need (NHS Digital, 2016). As with the determinants of mental health, access to mental health support is not equally distributed across the population. Groups facing particularly high levels of poor mental health also, paradoxically, often experience the greatest difficulty in accessing services.

• Black adults are the least likely ethnic group to report being in receipt of medication for mental health, or counselling, or therapy (Cabinet Office, 2018).

• The National LGBT Survey (2018) found that 24% of respondents had accessed mental health services in the last year, but a further 8% had tried to get help and failed. The majority of those who sought help found it difficult, with long waiting lists and unsupportive responses from GPs cited as reasons for this.

• Only just over a quarter (27.9%) of children and young people who experience both a learning disability and a mental health problem have had any contact with mental health services.

View Centre for Mental Health Factsheet: INEQUALITIES IN MENTAL HEALTH: THE FACTS

People with the poorest mental health too often find the help they are offered is the least effective, the least relevant and, for some, the most coercive. This is most dramatically evident for people from Black communities in the UK, and is evident on a number of other dimensions that often intersect with each other – including income and wealth, gender, specific ethnicity (for instance, Gypsy, Roma and Traveller communities), age, sexual and gender identity.

• LGBT+ people who have experienced multiple disadvantage (for example abuse, homelessness and poverty) reported that mental health professionals often failed to understand their experiences and, as a result, were unsupportive or less likely to meet their needs. (LGBT Foundation, 2020)

Black people in the UK:

• Are less likely to have the involvement of GPs leading up to a first episode of psychosis than white patients (Singh et al., 2013).

• Are far more likely to experience police involvement in their first contact with mental health services (Bignall et al., 2019).

• Are eight times more likely than White British people to be given a community treatment order after being treated in hospital under the Mental Health Act (NHS Digital, 2019).

View Centre for Mental Health Factsheet: INEQUALITIES IN MENTAL HEALTH: THE FACTS

Wirral specific information from Public Health England Profiles 

• Wirral profile - Mental Health and Wellbeing JSNAs

• Wirral profile - Perinatal Mental Health

• Wirral profile - Suicide Prevention

• Wirral profile - Dementia

• Wirral Profile - Children and Young People's Mental Health and Wellbeing

• Wirral Profile - Co-occuring substance misuse and mental health issues

• Wirral Profile - Common Mental Health Disorders

• Wirral Profile - Neurology

• Wirral Profile - Severe Mental Illness

 Local Information 

• Download Mental Health Chapter - August 2012

• Download Summary for Mental Health Services (Last refreshed - August 2012)

• A new Mental Health section will soon be started (Summer 2020)

Other related content

• Black, Asian & Minority Ethnic Health section for Mental Health and Dementia
  

Further information

• Wirral Commissioning for Value - Mental health and dementia pack (NHS Right Care, January 2017)
  This pack contains data across a range of mental health and dementia services.and should be used to help support discussions about mental health care in the local health economy, to improve the value and utilisation of resources and reducing variation in outcomes.

• Mental Health Survey with Young People 
  National Citizen Service Programme and Birkenhead Sixth Form College (Summer 2016)
  Healthwatch set out to complete the survey with young people, over 140 making their feelings known, to allow then to share their understanding of mental health issues and to raise awareness of the services that are commissioned to support them. The survey was promoted through July, August and September via the National Citizens Scheme and with Birkenhead Sixth Form College. The results highlight the concerns and issues being faced by our young people today, services they want to access and ways they want to be communicated with.

• Wirral Mencap Consultation Report: How do we make Wirral a better place to live for people with a learning disability and their families? July 2016
  Wirral Mencap has gathered data from over 160 people with a learning disability and/ or family carers to establish the main concerns and aspirations of people living in Wirral. The data includes information gathered via surveys, focus groups, accessible consultation exercises and statistical information from existing service provision. 

• The Five Year Forward View for Mental Health
  This national strategy, which covers care and support for all ages, was published in February 2016 and signifies the first time there has been a strategic approach to improving mental health outcomes across the health and care system, in partnership with the health arm’s length bodies.

• Deliberate Self Harm across Merseyside and Cheshire April 2011 to March 2014 (September 2015)
  Self-inflicted violence, self-poisoning or deliberate self-harm (DSH), is an important public health problem in the UK and across the world. This local report by Centre for Public Health at Liverpool John Moores University looks to increase our understanding of self-harm as both a public health issue and an individual concern for those involved, and provide up to date information on how self-harm impacts on the people of Merseyside and Cheshire. 

• Wirral Mental Health Forum: JSNA Call for Information Report - August 2014
  This short report outlines the survey results provided by the Mental Health Forum (MHF) in April 2014 in response to the first Wirral Joint Strategic Needs Assessment (JSNA) Call for Information. There were 16 responses to the survey both through the Forum meeting and individual submissions during April 2014. 

• Wirral Mental Health Survey (Wirral results) 2013
  The first North West Mental Wellbeing Survey was carried out in 2009 and provided a baseline measure of the regions mental health and wellbeing. A repeat of the survey was carried out in 2013. This report is for Wirral results.

• Mental Health Promotion and Prevention: The Economic Case 
  Personal Social Services Research Unit, and London School of Economics and Political Science were asked by the Department of Health to identify and analyse the costs and economic pay-offs of a range of interventions in the area of mental health promotion, prevention and early intervention, and to present this information in a way that would most helpfully support NHS and other commissioners in assessing the case for investment.