West Midlands Mental Health Commission

The impact on children & young people in the education system, particularly those with special educational needs and disabilities (SEND)
Disruption associated with the pandemic has been a significant driver of mental health difficulties, potentially unsettling children’s emotional, cognitive and social development.

Whilst most children and young people’s mental health improved after restrictions were reduced, some have experienced longer-term difficulties with a greater demand for mental health services for that demographic reflected in the region. Greater impacts were noted overall among girls and children from the most disadvantaged backgrounds, including those from racialised communities.

• School exclusions have increased significantly in the region. These are much more common among children with a mental health difficulty (6.8%) than those without (0.5%)

The opportunities presented by physical activities & sports (including the Commonwealth Games) to support mental health and wellbeing
Physical activity can help prevent and manage mental health problems and promote mental wellbeing. The West Midlands Combined Authority region has the highest levels of physical inactivity in England and some of the greatest inequalities in those who take part.

• People from a low socioeconomic classification are twice as likely to be inactive compared to a person from a high socioeconomic classification.

• People from the Bangladeshi, Pakistani and African / African-Caribbean communities are twice as likely to be inactive compared to a person from a high socioeconomic background.

• Unemployed adults are 59% more likely to be inactive compared to a person who is working full or part-time.

The mental health implications of the cost of living crisis (in conjunction with the Health of the Region Core Group)

There is compelling evidence that financial wellbeing plays a major factor in mental health and the single factor in explaining mental health inequalities.

Deprivation is a particular challenge in the West Midlands, with the 3 local ICS areas ranking 1st, 2nd and 21st (of 42).

Poverty increases the risk of experiencing multiple adverse childhood events (ACEs) which leads to an increased risk of mental ill health. Research has indicated that:

• ACEs are 5x more likely for the most deprived 20% of children. When one has experienced multiple ACEs

• There is an increase of negative outcomes, such as: Depression: +460%; Suicide attempts: +1220%; Intravenous drug use: +4600%;

The core ingredients that support mentally thriving communities

Communities with good mental health wellbeing have strong social networks, trust and mutual exchanges.

The pandemic put more people at risk of mental ill health, exacerbated pre-existing health inequalities and led to some longer-term higher incidences of distress; The initial stages of the pandemic saw numerous positive examples of local communities acting to support each other through, amongst other things, volunteering.

The Better Mental Health Fund stimulated some short-term good work from eligible / participating local systems. For instance, Sandwell worked with 30 local organisations from October 2021 on a range of projects, including a community hub for new parents in the borough’s libraries, a football-based programme through the local club, and a project offering befriending within racialised communities through gardening.

Racial inequalities and mental health – what works, for whom and why? (in liaison with the Race Equalities Taskforce)

There are stark inequalities in mental health and mental health care between ethnic groups in the UK (and other Western nations), which are impacted by structural racism and discrimination. There is increasing evidence of:

• The significance of ‘community trauma’ on the mental health of respective racialised communities in modern Britain

• Associated inequalities and links to historical issues

• Recognition that traditional models of mental health support are not working for everyone.

Higher rates of mental ill health (particularly severe mental illness) are mirrored in the greater use of coercion in mental health services. Experiences of racism in society are too often reflected in the ways people are treated within mental health services.

The contribution of the voluntary, community and faith sector to meeting mental health needs, including early help and prevention, particularly for women and girls

There are deep inequalities among women and girls in mental health in comparison men and boys with violence and abuse are major risk factors to women and girls’ mental health.

During the pandemic the Voluntary and Community Sector played a critical role supporting mental health within communities and lessening the strain on the NHS by providing skills and expertise that was complimentary and distinct from existing services.

The VCS has strengths that are different from and complementary to those of statutory services. Identified strengths include:

• An ability to work across traditional disciplinary and clinical boundaries

• Service user support which reflects a deep understanding of and responsiveness to the diverse needs of communities they support and a focus on advancing equality, diversity and inclusion,

• Experience addressing the social determinants of mental health (e.g. job insecurity, poverty and isolation).