The joint report of the Director of Public Health and the NHS Director of Keeping Well (Document “K”) informs Members of a recent review undertaken to understand the impact of COVID-19 on the local population. 

Members are requested to note the report, to highlight areas for consideration and attention and continue to support the work undertaken.

(Sasha Batt – 01274 237537).

The joint report of the Director of Public Health and the NHS Director of Keeping Well (Document “K”) informed Members of a recent review undertaken to understand the impact of COVID-19 on the local population.

Members received a detailed presentation on the Mental Health Needs Assessment – COVID-19 (May – July 2020).  The Head of Mental Wellbeing, City of Bradford Metropolitan District Council, NHS Bradford District and Craven Clinical Commissioning; a Bradford Council Consultant in Public Health; the Chief Executive Officer from MIND in Bradford and Assistant General Manager, Bradford District Care Foundation Trust were in attendance at the meeting.

Following a very detailed presentation the Chair expressed concern about the rising number of people whose mental health had deteriorated during the pandemic but were not known to mental health services or aware of how to access their support. She requested that details of the number of people accessing services as a result of the pandemic be provided.

The Public Health Consultant reported that, in October 2020, the Centre for Mental Health had devised a forecasting tool and, whilst accurate figures were not yet available for Bradford, it was believed that the figure in the district was approximately 4,000.  It was explained that nationally approximately one in four people presented with some form of mental health issue each year.  Financial issues and social isolation experienced during the pandemic would exacerbate those issues and it was agreed that the forecasting tool should be used, as a matter of priority, to accurately predict demand.  Members would be provided with those figures when they were produced.

Instances of people being unable to visit relatives and the resulting rapid deterioration in patients’ mental health were raised by Members.  It was believed that those incidents were replicated across the District.  It was suggested that there was much more which could be done address those worries and it was questioned what measures were being taken to ensure that meaningful family visits were permitted.

In response assurances were provided that risk management measures were in place to ensure visits to care homes were facilitated whilst mitigating risk.  The importance of human contact was acknowledged and examples of garden visits which had been arranged were reported.

The significant impact on people who were unable to visit friends and relatives in in-patient settings was also raised and a Member questioned what action was being taken to allow in patient visits; provide support to friends and families of patients to deal with the emotional trauma and to facilitate a better understanding of mental health issues in nursing and hospital settings.

The Chief Executive Officer, MIND in Bradford, explained that national advice and local guidelines had dictated that visits to in patients must cease during the lockdown.  That situation had now been reviewed and risk assessments were conducted to allow visits to take place in safe environments.  Training and support was also provided by the Grief and Loss team to the Care Trust and Voluntary Sector to provide an understanding of the mental health impact of the virus.  In addition, the Education Psychology Team had received Government funding to work with teaching staff to facilitate conversations with students about mental health.

The interventions proposed to assist older people whose mental health had deteriorated due to lack of family contact was also questioned. It was explained that whilst one size would not fit all there was much which could be done.    People already working within mental health services who had the skills to deal with depression in people with dementia had been identified.  It was intended that training would be provided to transfer those skills into care homes so that staff had more knowledge of mental health. Psychological therapies were also available and could be utilised to assist elderly people who may be dealing with mental health issues for the first time in their lives.

A Member, whilst thanking officers for a comprehensive, wide ranging and well thought out presentation pointed out his belief that, contrary to the reference that COVID-19 had been a natural disaster, in terms of mental health he believed that the detrimental impact of the pandemic on mental health had been man-made He considered that a number of things which had impacted on people had been as a result of choices made by the Government and others.  It was agreed that stress on staff, careers and the bereaved was inevitable, however, the impact of the isolation of older people or on perinatal health was related to choices made about contact.  He referred to people, through no fault of their own, being unable to distinguish between population and personal risk.  He reported an experience of a fit and healthy person being terrified of the virus and the detrimental impact on her mental health. It was felt that the actions which had been required in order to drive social change in terms of social distancing had impacted on mental health.  It was also believed that people were less likely to be resilient when they felt things had been done to them rather than had happened out of the blue. 

The Consultant in Public Health agreed with much of that statement and referred to models, outlined in the presentation, about how communities rather than individuals responded to feelings of helpfulness.  The conclusions of those studies had acknowledged that, as a district, people should be moved from risk to safety; fear to calming; loss to connectiveness; helplessness to self-sufficiency and despair to hope. It was felt that national spirit, experienced during the summer with the clap for carers etc. had diminished and whilst indirect effects of the pandemic were many it was believed that mental health was an important factor.

The inability, from the information contained in the report, to perceive the volume of people affected mentally and the resources required to address mental health during, and following, the pandemic was raised.  The increases in problems arising from alcohol abuse was also queried and it was confirmed that those figure were recorded by the NHS and hospitals. 

A Member whilst welcoming that the mental health telephone contact line was free believed that this had not been widely communicated.  It was explained that the new telephone number had only recently been commissioned and contact information would be updated.

The report revealed that social workers were working with the police to ensure that anyone who was detained had mental health support and a place of safety.  It was suggested that former service users could be utilised to help in those instances.

Frustration at the disparity between physical and mental health was expressed. A Member reported physical health issues which had been addressed throughout the pandemic but he believed that mental health issues were not being addressed as urgently.  In response the Consultant in Public Health explained that all health issues in the District were taken seriously and he referred to additional funding to address mental health received following the Mental Health Needs Assessment.

A co-opted Member expressed her opinion that mental health services in the District were exemplary and congratulated people coming together to ensure services were maintained. It was questioned, however, what measures had been put in place for people with sensory or learning disabilities.  It was believed that there was currently no counsellor for deaf people and it was feared that people were withdrawing from social intercourse and should not be left behind.

The Head of Mental Health Wellbeing explained that virtual working had been undertaken with other authorities to allow access to services not available in Bradford.  Kirklees Council had a counsellor for the deaf and Leeds Council had other services not available in the Bradford District.  Work with West Yorkshire partners allowed provision to be shared across the region and help to access those services was provided.

Resolved –

(1)  That officers be commended and thanked for the depth and breath of the report

(2)  That a further report be presented in 9 months time

ACTION: Director and Public Health and Director of Living Well