Information gathered at Task Review meetings since July 2021.

KEY ISSUES	EVIDENCE RECEIVED
The impact of the pandemic on the Mental Health and Wellbeing of the population.	Jenny Burns (Director, Mental Health Foundation) highlighted the Mental Health Foundation’s longitudinal study of mental health during the pandemic. It found that the mental health of people with inequalities, such as those from ethnically diverse backgrounds, single parents and people with long-term conditions, had worsened during the pandemic. Jenny also highlighted a report on the impact of the pandemic on the elderly. It found that the impact was largely minimal but that those with long-term conditions had been impacted due to factors such as increased isolation. (Meeting held on 15^th December 2021). Dr Chris O’Connor highlighted to Group Members that the impact of the pandemic on the mental health of the population had been immense. (Meeting held on 16^th February 2022). Research showed that key groups within our communities were particularly impacted by the pandemic and were therefore at greater risk of developing mental health difficulties. Examples given by Dr O’Connor were: people who have had a severe Covid illness, those experiencing financial difficulties, people who have experienced significant relationship difficulties, people experiencing domestic abuse, people feeling socially isolated, those with previous mental health difficulties, people working in health and social care and the general impact on the wellbeing of carers. (Meeting held on 16^th February 2022). Dr David Llewellyn highlighted a community study by the Integrated Wellbeing Networks at the end of 2020 which found that the pandemic had exacerbated existing difficulties. (Meeting held on 16^th February 2022). The number of people going to see their GP about mental health difficulties was then raised by Dr O’Connor. The Group heard that demand within the Primary Care arena had gone up massively during the pandemic. (Meeting held on 16^th February 2022). Isolation especially amongst older people in our communities remains an issue. The pandemic has highlighted and exacerbated existing wellbeing inequalities and challenges. (Sustaining and Strengthening Community Wellbeing Together in the Covid Era – August 2020 p.7). The present data indicate there has been a further reduction in the mental health and wellbeing of the Welsh population during the second national lockdown as compared to the first, with younger age groups continuing to be more adversely affected by the COVID-19 pandemic. (The Influence of the Covid-19 Pandemic on Mental Wellbeing and Psychological Distress: A Comparison Across Time – 15^th July 2021 p.40). Rates of clinically significant psychological distress were found in 40.4% of the 2021 sample representing a 9.8% increase in prevalence from the first survey. Overall, population wellbeing was lower, and rates of clinically significant psychological distress were higher in the 2021 sample compared to the 2020 sample. First Survey June-July 2020/ Second Survey January-March 2021. (The Influence of the Covid-19 Pandemic on Mental Wellbeing and Psychological Distress: A Comparison Across Time – 15^th July 2021 p.35).
How are Caerphilly County Borough Council currently working with partners to deliver services?	Members heard how there were two Community Mental Health Teams (CMHT) responding to GP referrals for the north and south of the County Borough. Both teams consisted of a range of professionals including Consultant Psychiatrists, Psychologists, Community Psychiatric Nurses, Occupational Therapists and Social Workers. The Teams are a blend of Health Board and Caerphilly County Borough Council (Social Workers) staff. The Service Manager outlined how she met regularly with her counterpart from the Health Board to manage the teams. (Meeting held on 3^rd November 2021). The Service Manager then moved on to external working relationships in relation to the provision of mental health services. The first group highlighted was the Foundation Tier Steering Group which focussed on prevention. Members heard how the MELO website was developed as a result of meetings by this group. (Meeting held on 3^rd November 2021). The Task Group also heard about the links established with the North Caerphilly Integrated Wellbeing Network. (Meeting held on 3^rd November 2021). Task Group Members were then given a synopsis of the collaborative working which was taking place across all agencies including other Gwent Local Authorities. Every couple of weeks Mental Health Crisis Concordat meetings were held. Attendees at these meetings are Service Managers from each Local Authority, Gwent Police, Welsh Ambulance Service and Senior Managers from the Health Board. These meetings discuss the future development of mental health services in Gwent. (Meeting held on 3^rd November 2021). Members were also told about Mental Health Implementation Group meetings which focussed on issues pertaining to the adherence of the Mental Health Act. (Meeting held on 3^rd November 2021). The Service Manager highlighted the importance of joined up working within organisations. An example of this practice at Caerphilly County Borough Council was the Caerphilly Cares initiative which linked service areas such as Social Services in order to aid community access to services. (Meeting held on 15^th December 2021).
Issues / Challenges identified.	Jill Lawton (Director, Caerphilly Borough MIND) highlighted the lack of specific bereavement counselling across the borough as an issue. One Member agreed and asked why general counsellors were unable to provide bereavement counselling as part of the package of care they provided. Jill advised that Caerphilly Borough MIND offered mental health counsellors and that specific advice on dealing with bereavement was a specialism. (Meeting held on 15^th December 2021). Jenny Burns (Director, Mental Health Foundation) highlighted an article in The Lancet which showed that 75% of respondents to a secondary schools’ survey knew how to access help in their school, but that only 28% responded that they would do so. The conclusion was that counselling services should receive wider consultation prior to implementation. (Meeting held on 15^th December 2021). On the issue of participation Jenny outlined how it was key to involve stakeholders including youth groups in the design of services, but that there were challenges around resources at the beginning of the process. Proper engagement with public groups to determine what is needed. (Meeting held on 15^th December 2021). Jill Lawton highlighted the importance of ensuring that services signposted on websites such as Melo are still active. Members heard about the frustration experienced when people tried to access services that have been closed. (Meeting held on 15^th December 2021). Dr Chris O’Connor brought to the attention of Panel Members data and research carried out by the Centre for Mental Health on the future need for Mental Health Support. Modelling throughout the pandemic showed that within the next 3-5 years their prediction is that capacity within NHS Mental Health Services will need to grow between twofold and threefold in order to deal with the increased demand. (Meeting held on 16^th February 2022). The Group heard how despite a reduction in referrals initially during the first lockdown, there were now significantly more referrals for older people with functional mental health difficulties such as depression and anxiety than was the case pre-pandemic. (Meeting held on 16^th February 2022). It was highlighted to the Task Group that waiting times for counselling and interventions were now increasing. (Meeting held on 16^th February 2022). Dr David Llewellyn outlined the challenge of ensuring that Psychological Wellbeing Practitioners were aware of the full range of services and activities available within the community and gave the example of Bereavement Cafes which were being planned by the Integrated Wellbeing Networks. Greater connectivity between mental health service providers. (Meeting held on 16^th February 2022). Dr O’Connor welcomed any lobbying for additional resources as he advised that historically mental health had been underfunded when compared with physical health services. (Meeting held on 16^th February 2022). Caerphilly, Monmouthshire, and Torfaen were the Local Authorities to experience the sharpest decline in population wellbeing. (The Influence of the Covid-19 Pandemic on Mental Wellbeing and Psychological Distress: A Comparison Across Time – 15^th July 2021 p.26).
An understanding of services/ help available.	Members heard how the Service Manager represented Social Services at Suicide Prevention and Self-Harm Workshops, which were multi-agency and had helped to design an Action Plan for the Gwent region. (Meeting held on 3^rd November 2021). The Group heard about the development of Psychological Wellbeing Practitioner (PWP) roles in some surgeries, which are non-registered practitioners who are trained to assess common mental health disorders. (Meeting held on 3^rd November 2021). The presentation concluded with details of the support available to Caerphilly County Borough Council staff and included information on advice from Care First and Mindfulness courses run by Primary Care. (Meeting held on 3^rd November 2021). Members heard how MIND in the Caerphilly region was providing a counselling service for the primary mental health teams. Jill Lawton also highlighted the Supporting People, Active Monitoring and My Whole Life projects. (Meeting held on 15^th December 2021). Members also heard that Caerphilly Borough MIND were delivering Connect 5 training and was also taking the lead on the Public Health Wales funded suicide prevention training. (Meeting held on 15^th December 2021). Dr Chris O’Connor reiterated praise for the training provided by Public Health Wales via the Connect 5 programme. (Meeting held on 16^th February 2022).
How is Caerphilly County Borough Council currently coping with the demand for Mental Health Services?	The Chair asked if there had been a significant increase in Community Mental Health Team workload during the pandemic. The Service Manager advised that there had been an increase in general referrals but not to the extent that would necessitate the need for additional staff and that the volume was currently being managed well by the teams. (Meeting held on 3^rd November 2021). It was stressed that currently Caerphilly County Borough Council was equipped to deal with demand, but this situation is constantly being monitored. (Meeting held on 3^rd November 2021).
The future plans for Community Services.	Dr David Llewellyn advised Task Group Members that talks were taking place about the implementation of Participatory Budgeting within Caerphilly County Borough. He outlined how the ambition was to empower communities to implement the services they required themselves and highlighted how Third Sector organisations could bid for funding under this process. Dr Llewellyn also raised plans for an online Wellbeing Index which would accumulate anonymised data at a community level on the key issues and suggested solutions in terms of community mental health and wellbeing. It was suggested that this would then feed into the Participatory Budgeting process and allow the monitoring of impact. (Meeting held on 16^th February 2022). Recovery is best achieved when the affected community is able to exercise a high degree of self-determination. (Sustaining and Strengthening Community Wellbeing Together in the Covid Era – August 2020 p.2).