Mental Health Joint Strategic Needs Assessment (JSNA) Topic Report

There is a wide range of mental health and wellbeing support offered across the life course in Buckinghamshire, from early intervention and prevention work to specialist and inpatient services. This is delivered by the commissioned mental health trust (Oxford Health NHS Foundation Trust) as well as provision (commissioned and not commissioned) by the voluntary sector.

People that are either residents of Buckinghamshire, or registered to a GP practice within the Buckinghamshire boundaries of the Buckinghamshire, Oxfordshire and Berkshire (BOB) Integrated Care System (ICS), can access the mental health services summarised below.

Getting Advice:

• Single Point of Access (SPA)
• Digital Platform (Kooth)
• Mental Health Support Teams

Getting Help/Risk Support:

• Eating Disorders
• Intellectual disability
• Looked After Children
• Crisis and Outreach

Thrive

• Dynamic Support Facilitation Team
• Neurodevelopmental

• Specialist Community Perinatal Mental Health
• ReConnect

• NHS Buckinghamshire Talking Therapies (previously Healthy Minds (Improving Access to Psychological Therapies, IAPT)
• Early Intervention Psychosis Service
• Working Age and Older Age Adults Service
• Complex Needs Service
• Urgent Care Pathway
• Neurodevelopmental
• Adult Inpatient Service (The Whiteleaf Centre)

Between March 2019 and March 2022, the demand for services for both female and males in Buckinghamshire increased. In March 2019 there were 1,943 referrals into mental health services (all ages) in Buckinghamshire. Between February and June 2020, the number of referrals to mental health services (all ages) steeply declined coinciding with the first COVID-19 lockdown period. Referrals had returned to pre COVID-19 levels by Autumn 2020. In later periods of COVID-19 restrictions (from November 2020 to February 2021) a smaller decrease in referrals was observed. Service referrals then steeply increased during Spring 2021 and have plateaued around 2,500 referrals since. At the end of the reporting period, March 2022, there were 2,782 referrals made.

The greatest number of referrals received into all mental health services are from residents in the most deprived fifth (or quintile) of the Buckinghamshire population (DQ5).

Overall, services receive more referrals for females than for males. Within the CAMHS services, SPA referrals prior to February 2020 were higher for males than females, reflecting the high number of referrals for males compared to females into the neurodevelopmental pathway. There were also higher numbers of referrals for males than females into the intellectual disability pathway, which is reflective of need. However, referrals for females then increased over male referrals from July 2020 onwards. The remainder of pathways within CAMHS saw higher referrals and an increasing number of referrals for females than males. In adult Mental Health Services, again there were increased numbers of referrals for females compared to males and a significantly higher number of referrals for females within adult eating disorders. Within the community mental health services and older adults', referrals for females increased post the June 2020 COVID-19 lockdown whereas for men, referral rates were similar across the period.

NHS Buckinghamshire Talking Therapies is an NHS programme in England that offers interventions to treat people with depression or anxiety and is the core Adult Mental Health Service. The majority of referrals into IAPT were those aged under 65 years with a significantly higher rate in those aged 18 to 25 years (65.1 per 1,000 population) compared to the other age groups. Of those with an ethnicity recorded, 83.4% of referrals were recorded as White (compared to 79.9% of the Buckinghamshire population). Asian ethnic groups were under-represented in referrals to BTT, 8.6% of referrals received were for people in this ethnic group (compared to 12.4% of the Buckinghamshire population). However, just under 1 in 10 referrals (8.6%) have an unknown ethnicity. This pattern is seen in other NHS service data where a proportion of service users have no ethnic group recorded as part of the referral.

Services and commissioners undertake regular engagement, feedback and coproduction activities both with service users and their families and/or carers, organisations and professionals who interact with services, as well as the wider public within Buckinghamshire. Engaging with a wide range of stakeholders enables services and commissioners to ensure that all aspects of health care are improved. These are summarised in the table below: