Public mental health in Havering takes a population-based approach focused on prevention and the promotion of mental wellbeing at every stage of life. This approach is structured around three key levels of prevention (1):
- Primary prevention aims to stop mental health disorders before they develop by promoting good mental health for everyone.
- Secondary prevention targets individuals and groups at higher risk, offering early support to reduce the likelihood of mental health problems emerging.
- Tertiary prevention supports people already living with mental health conditions, helping them to manage their symptoms, stay well and lead fulfilling lives.
Why is prevention important in mental health?
Mental health conditions are estimated to account for at least 21% of the total disease burden in the UK and cost the economy £117.9 billion annually (2). These costs are driven by the widespread prevalence, early onset and wide-ranging impacts of mental ill-health.
Evidence shows that prevention and early intervention are not only effective but also highly cost-efficient. Investing in interventions prevent mental illness and promote mental wellbeing, with long-term benefits for individuals, communities and society as a whole (3).
Figure 1: Examples of interventions with a strong evidence base for preventing mental health conditions across the life course. Image source: Mental Health Foundation
Examples of Prevention in Havering
In Havering, various organisations are working together to support prevention. For example:
- Community institutions, such as Havering Adult College and pastoral care teams in schools and colleges, which promote mental well-being through education and supportive environments.
- Voluntary and community organisations, including Mind, AgeUK and Andy’s Man Club, which offer targeted support.
- Social prescribers, care navigators and local area coordinators, who work across sectors to address individuals’ holistic needs and support early intervention.
Evidence Review: Preventing mental health crises in adults
Mental health crises rarely occur in isolation; they often result in the combination of risk factors that build over time. The Adult Mental Health Needs Assessment (AMHNA) Working Group identified early intervention to prevent mental health crises as a top priority. This chapter explores the evidence review conducted, in partnership with NELFT Library Services, to explore the effectiveness of community-based interventions in reducing emergency service presentations related to mental health crises.
Key chapter findings and implications for practice
- Evidence supports interventions to address the underlying building blocks for good mental health—such as housing support and social welfare advice—although the links to reducing mental health crisis are less well established.
- Voluntary and community sector organisations are well-positioned to deliver preventative interventions.
- Self-management approaches, recommended by NICE, are supported by this literature review in being effective for individuals with diagnosed severe mental illness.
- Recovery Colleges can support prevention at all levels—not just for those with diagnosed conditions—by reducing isolation, building skills and improving engagement.
- There are opportunities to explore local learning from other boroughs and neighbouring trusts—such as Recovery Colleges in Waltham Forest and Tower Hamlets and the money advice pilot in East London Foundation Trust (ELFT).
- Evidence supports housing interventions, including Housing First, for reducing emergency mental health service use. Havering’s use of this model should continue and other opportunities to address housing concerns before people reach mental health crisis should be explored.
- Focused and additional support for high-risk groups is shown to help prevent escalation to crisis. In Havering, this targeted support should be strengthened using existing models, such as social prescribing and Local Area Coordinators.
- Limited evidence exists for primary prevention of mental health crisis, particularly in the UK context.
- Emerging models, such as crisis cafés, must undergo evaluations to understand their full impact on service users and outcomes, including unintended consequences.
- Primary prevention could help reduce the onset of mental health problems and have broader intergenerational benefits. Supporting good adult mental health has additional benefits for children and young people’s mental health.
- Children of people with severe mental illness are a vulnerable group who could benefit from targeted, early intervention efforts.
Download the full chapter to explore the evidence found and implication for adult mental health crisis prevention in Havering
References
(1) Prevention and mental health | Mental Health Foundation
(2) Paying the price of our mental health in the cost-of-living crisis