Where next for mental health nursing: a glimpse of the future Populations, Probabilities and Predictions

1. Where next for mental health nursing: a glimpse of the future?Populations, Probabilities and Predictions Hugh Masters Nursing OfficerMental Health & Learning Disabilities Ayrshire And Arran NHS Board, 10th March 2010

2. �It�s tough to make predictions, particularly about the future�

3. The recent past and the near future: Rights, Relationships and Recovery: the National Review of Mental Health Nursing in Scotland

4. What has been achieved � wider impact Major factor in: (re) energising the profession (re) affirming core purpose and values of MH nursing (re) stating the importance of the MHN role (re) positioning MHNs as an influential group (reality?)

6. The �refreshed� RRRs action plan�available now

7. Before we �move on��shall we complete the RRRs?�are you?� �still to do ESCs and RR training? �using the SRI in your area? �doing/giving Clinical Supervision? �engaging with therapies - Psych Therapies and NMP? �using the new resources and policies? �contributing to new ways of designing and delivering services? �thinking about your role in preventing mental health problems and promoting health for all? �tackling stigma and discrimination? �linking with local community resources? �showing that you and your service are making an impact? �mapping out your career as a professional � including education and development activity? �looking after yourself?

8. �The future ain�t what it used to be��

9. Two new Government Strategies � April 2010

10. Why are these strategies important to the future of Mental Health Nursing? Rapidly changing demographics Opportunities and challenges

11. Headline Projections:

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14. The near future� Financial Pressures The NHS Quality Strategy The influence of mental health nurses

15. Older people are an asset not a burden: demographic change creates a challenge but these shifts also offer a potential solution in that older people provide far more care and support than they receive. AGE DISCRIMINATION? We are adding healthy years to life � we need to push back our concept of older age, with less of a focus on �over 65� years and more on �over 75�. [Only 3% of people aged 65-74 years are in receipt of continuing, formal health or social care services.] We need a shift in philosophy, attitudes and approaches that moves us away from measuring success by how much we do to how many, and towards measuring success by how many older people can be enabled to stay independent and well at home and remain out of the formal care system. Services should be outcome focussed - which requires personalised/patient focused support designed to optimise independence and well-being through an enabling approach. FUNCTIONAL AND ORGANIC � not seen as best practice. We need to accelerate the pace of sharing good practice � there is lots of good practice across Scotland and beyond, but examples tend to be fragmented and narrowly focussed. We need to rapidly build, grow and spread these examples and reduce variance in practice. Equitable services. The importance of aligning partnership resources to achieving policy goals � all of the �4.5�billion currently spent annually on services for over 65 year olds is being used to optimal effect. The costs and funding of care �Essentially there are two mechanisms available to us for increasing expenditure on services; public spending and personal spending. Older people are an asset not a burden: demographic change creates a challenge but these shifts also offer a potential solution in that older people provide far more care and support than they receive. AGE DISCRIMINATION? We are adding healthy years to life � we need to push back our concept of older age, with less of a focus on �over 65� years and more on �over 75�. [Only 3% of people aged 65-74 years are in receipt of continuing, formal health or social care services.] We need a shift in philosophy, attitudes and approaches that moves us away from measuring success by how much we do to how many, and towards measuring success by how many older people can be enabled to stay independent and well at home and remain out of the formal care system. Services should be outcome focussed - which requires personalised/patient focused support designed to optimise independence and well-being through an enabling approach. FUNCTIONAL AND ORGANIC � not seen as best practice. We need to accelerate the pace of sharing good practice � there is lots of good practice across Scotland and beyond, but examples tend to be fragmented and narrowly focussed. We need to rapidly build, grow and spread these examples and reduce variance in practice. Equitable services. The importance of aligning partnership resources to achieving policy goals � all of the �4.5�billion currently spent annually on services for over 65 year olds is being used to optimal effect. The costs and funding of care �Essentially there are two mechanisms available to us for increasing expenditure on services; public spending and personal spending.

16. The Scottish Mental Health Nursing Workforce

17. Current Staff � Age Distribution

20. Looking a little further ahead�

21. The Quality Challenge The NHS Quality Strategy 6 Dimensions Person centeredness Safety Effectiveness Efficiency Timely Equitable

23. Prevention and Promotion� Social cohesion and health inequalities Employment Physical Health Improvement - smoking Equitable service response and uptake of services Children, parents and families Alcohol and drug misuse Older people and Dementia Includes mental health nurses own health

24. Why is this important? �Health problems are immensely varied and almost impossible to summarise. The very clear exception is mental health. Across most population groups, there is a repeated finding of diminished mental health because of the pervasive and insidious effects upon wellbeing of experiencing personal prejudice, collective discrimination and structural exclusion from full and fair participation in Scotland�s material prosperity, social life and power structures�. (Dimensions of diversity: population differences and health improvement opportunities. ScotPHO 2010: p.1)

25. More Evidence and Outcomes� Evidence-based services and nursing Information, monitoring and regulation and high quality outcome measures for services and MH nursing We need to accelerate the pace of sharing good practice The next �phase� of Rights, Relationships and Recovery?

26. �The only way to predict the future is to have power to shape the future� (Eric Hoffer 1954)

27. More information: http://www.scotland.gov.uk/Topics/Health/health/mental-health Hugh Masters Nursing Officer (Mental Health and Learning Disabilities) Mental Health Delivery and Services Unit Scottish Government Health Directorate Floor 3ER, St Andrew's House EDINBURGH EH1 3DG 0131 244 3498 Hugh.Masters@scotland.gsi.gov.uk