Hertfordshire and West Essex Integrated Care Strategy

Strategic priority 6: improve our residents’ mental health and outcomes for those with learning disabilities and autism

We will provide early help to our residents to prevent mental illness and support the health and wellbeing of those with a severe mental illness (SMI), learning disabilities or autism.

Where we are now
  • Mental disorders represent the second largest single cause of disability in the UK across all ages, with 1 in 4 adults experiencing at least one diagnosable mental health problem each year.
  • The cost of mental-ill health to the UK economy is estimated at £105 billion a year, almost the cost of the entire NHS.
  • Mental health is known to be mutually and intrinsically linked with physical health and has been implicated as a risk factor for the development and progression of diseases, such as cardiovascular disease and diabetes.
  • Mental health problems are associated with higher rates of smoking and alcohol and drug abuse, lower educational outcomes, poorer employment prospects, social disadvantage, that in turn increase the risk for physical health problems. Poor physical health is common in people with a SMI. It is estimated that for people with SMI, two in three deaths are from physical illnesses that can be prevented.
  • In England and Wales, suicide was the leading cause of death in people aged five to 34 years in 2018. In males aged 20 to 34 years, almost 26% of deaths were by suicide. Research indicates that the impact of someone dying by suicide can impact 135 people with an estimated fiscal impact to the economy and those impacted of £1.7m (Knapp et al 2011) HWE has a similar suicide rate when compared to the national average. The suicide rate in Harlow is statistically higher than the national average.
  • Social disadvantage and poverty are well documented as both consequences and causes of common and severe mental illness. The prevalence of severe mental illness is higher in more deprived areas. Housing issues and food insecurity have frequently been cited as having a negative impact on mental health.
  • People with a learning disability experience increased exposure to social determinants of poor health such as inadequate housing, unemployment, living in areas of deprivation, financial hardship, violence, discrimination, and social isolation. Rates of paid employment are substantially lower than the general population for those with a learning disability known to local authorities. Exposure to these factors leads to adverse impacts on health and wellbeing, whereas paid employment is associated with better physical and mental health in people with a learning disability. Employed adults are around half as likely to have a common mental disorder than those who were economically inactive or unemployed.
  • In Hertfordshire, the excess mortality rate for adults with a severe mental illness is above the regional average and in Essex, the rate of premature mortality for those with a SMI is similar for cancer, cardiovascular disease, and respiratory illnesses. (HWE ICS Health Needs Analysis Overview, 2022).
  • Mental health is a contributor to the gap in life expectancy between the most and least deprived areas in Hertfordshire and west Essex, 6.9% for males in Hertfordshire and 2.9% in west Essex and 10.3% for females 7.6% in West essex, (Hertfordshire Public Health Evidence and Intelligence, 2022 and Essex Joint Strategic Needs Assessment 2021-22).
  • In HWE there has been an increase each year over the last three years in percentage of adults reporting a long-term mental health condition.
  • People with a learning disability on average die 23 years younger for men and 27 years younger for women than the wider population.
Outcomes we want to achieve

We want people to be able to say:

  • I am supported to have good mental health and I know how to access activities that promote my wellbeing.
  • My care and support are driven by my needs and what is important to me, rather than the needs of systems and processes.
  • I do not see multiple professionals to manage my health and I can access support through digital and online options should I want them.
  • I am supported to think about what will happen in the short, medium, and long-term. There will not be any surprises about the support and care I receive
  • I have access to employment and volunteering opportunities.
  • My school or education setting, or workplace understands my neurodiversity and makes reasonable adjustments to ensure my participation.
  • My family and I are supported to get a diagnosis of my condition and support is provided whilst I await diagnosis.
What will change

We will:

  • Reduce the gap in life expectancy between people with a learning disability and severe mental illness compared to the general population.
  • Ensure there are clear pathways and timely access to psychological therapies for children, young people and adults who require this support.
  • Develop and implement an integrated whole life approach for children, young people and adults with autism that includes a focus on home and school life, diagnosis and transition into adulthood, housing support, adult learning, and work opportunities. 
  • Improve integrated pathways to access housing, education, employment, and skills, particularly for people with learning disabilities and autism, physical disabilities and severe mental illness, embedding support within models of care.
  • Work more effectively as a system to improve outcomes for our population with a mental health diagnosis or learning disabilities or autism by ensuring that reasonable adjustments are integrated in all pathways through implementing the NHS Accessible Standards.
  • Develop and deliver an integrated neurodiversity service for children and young people.
  • Improve the physical, mental, emotional health and social wellbeing of people with learning disabilities and autistic people of all ages and their carers.
  • Reduce suicide through a focus on system support of suicide prevention and having addressed the seven national priorities as set out in Suicide Prevention: policy and practice
  • Work with local employers and partners to ensure they develop suitable opportunities and roles for people with a learning disability and severe mental illness to access and maintain employment and to develop new skills and help employers feel able and confident to be making the reasonable adjustment required to help them to prosper in work.