Recommendations & Conclusions
8 items
10
Conclusion
Fourth Report - Rural Mental Health
Rejected
Although DEFRA is clearly responsible for working with the Department for Health and Social Care (DHSC) to ensure mental health policy and services are rural proofed, it is unclear what priority, resources and energy DEFRA has assigned to achieving impact in this area. The NHS Long Term Plan and Mental …
Read more
Although DEFRA is clearly responsible for working with the Department for Health and Social Care (DHSC) to ensure mental health policy and services are rural proofed, it is unclear what priority, resources and energy DEFRA has assigned to achieving impact in this area. The NHS Long Term Plan and Mental Health Implementation Plan, together, provide the national framework for ambitions on mental health but, again, it is unclear how far rural communities’ mental health needs are being taken into account not least when, as DEFRA confirmed, it does not have adequate data in this area.
Show less
Government response AI summary
The government acknowledges the importance of rural proofing health policy and inter-departmental collaboration but rejects the idea of a joint Defra/DHSC rural mental health policy and delivery team, stating existing channels are more effective. It confirms the Rural Wellbeing Framework is not intended for measuring …
Read full response →
Department for Environment Food and Rural Affairs
11
Recommendation
Fourth Report - Rural Mental Health
Rejected
DEFRA has produced a welcome framework and associated guidance for rural proofing policy but, for instance, claimed close working with DHSC and NHSE 78 Rural Mental Health over the new 10-year cross-government Mental health and wellbeing plan has not so far resulted in a single reference to rural priorities (rather …
Read more
DEFRA has produced a welcome framework and associated guidance for rural proofing policy but, for instance, claimed close working with DHSC and NHSE 78 Rural Mental Health over the new 10-year cross-government Mental health and wellbeing plan has not so far resulted in a single reference to rural priorities (rather the reverse). Furthermore, there is no indication yet that any consideration has been given to the effect of subsuming national mental health and well-being into the new holistic Major Conditions Strategy on the struggle of rural mental health for attention and appropriate prioritisation. The profile of rural mental health needs to rise much further for real progress to be made, with DEFRA taking a more active role alongside DHSC. We recommend: a) DEFRA and DHSC should establish a new joint rural mental health policy and delivery team to lead and improve on current “rural proofing” of health policy; and work with NHS England to set targets to measure and improve outcomes for rural mental health services and support rural health providers. b) The new joint DEFRA/DHSC rural mental health team should also set up a national working group, drawing together a range of experts, to identify practical changes to support more effective rural prioritisation within mental health services provision. c) The new joint DEFRA/DHSC rural mental health team should work with NHS Digital, to evaluate the availability of data and information on rural mental health services to start to address the gaps we have identified. d) DEFRA should consult on how the Rural Wellbeing Framework will be used to measure rural communities’ mental health.
Show less
Government response AI summary
The government rejects the recommendation for a new joint DEFRA/DHSC rural mental health team and a national working group, preferring existing collaborative channels and a new Mental Health Impact Assessment Tool. It also rejects consulting on using the Rural Wellbeing Framework for measuring rural communities' …
Read full response →
Department for Environment Food and Rural Affairs
15
Recommendation
Fourth Report - Rural Mental Health
Rejected
The NHS also needs to open-up access to the rural veterinary community to reflect restrictions on their ability to attend appointments, and support people who need to Rural Mental Health 79 continue practising. Better digital provision could improve service access but must not be the default offer to rural communities, …
Read more
The NHS also needs to open-up access to the rural veterinary community to reflect restrictions on their ability to attend appointments, and support people who need to Rural Mental Health 79 continue practising. Better digital provision could improve service access but must not be the default offer to rural communities, as it is not always appropriate or suitable.
Show less
Government response AI summary
The government highlights existing support initiatives for the veterinary profession but states there are no plans to commission a specific training programme for rural NHS staff. It promotes existing digital and remote access options for mental health services as beneficial for rural communities.
Read full response →
Department for Environment Food and Rural Affairs
17
Recommendation
Fourth Report - Rural Mental Health
Rejected
We recommend the joint rural mental health policy and delivery team issue a call for evidence on the effectiveness of the ICS-model for providing rural communities with access to mental health services and publish its findings with proposals to address any shortcomings, by the end of March 2024. The team …
Read more
We recommend the joint rural mental health policy and delivery team issue a call for evidence on the effectiveness of the ICS-model for providing rural communities with access to mental health services and publish its findings with proposals to address any shortcomings, by the end of March 2024. The team should work with rural ICSs, health providers, and charities, to identify cost-effective care pathways to increase provision and remove barriers to NHS treatment for agricultural and veterinary workers, by increasing flexibility in appointments times, options for care, and location of services including outreach at auction marts.
Show less
Government response AI summary
The government rejects launching a call for evidence or setting national targets related to the ICS model for rural mental health, stating it does not align with NHS England's new operating model of local accountability. It reiterates that work is already underway through ICSs and …
Read full response →
Department for Environment Food and Rural Affairs
18
Recommendation
Fourth Report - Rural Mental Health
Rejected
Child and Adolescent Mental Health Services (CAMHS) have been under intense pressure for many years, but a lack of alternative rural social infrastructure and a fall in support for youth services means CAMHS is often the “only show in town”. However, focussing on providing ‘reactive’ mental health services will only …
Read more
Child and Adolescent Mental Health Services (CAMHS) have been under intense pressure for many years, but a lack of alternative rural social infrastructure and a fall in support for youth services means CAMHS is often the “only show in town”. However, focussing on providing ‘reactive’ mental health services will only go so far, especially given CAMHS waiting times, so the focus and resources need to shift to prevention. Early intervention via Mental Health Support Teams (MSHTs) is a positive development but needs to be rolled-out to all rural schools as soon as possible and adequately resourced with appropriately trained staff given the many responsibilities on schools. Youth service provision in rural areas also needs to be expanded but until that is delivered, whilst demand is high on CAMHS, and alongside MHSTs, much more investment is needed in other forms of prevention such as ‘Early Support Hubs’. Therefore, we recommend that DHSC, NHS England and DEFRA consult on proposals to reduce reliance on CAMHS by expanding preventative mental health support for children and young people by, (a) setting out a path to expand provision of MHSTs to 100% of schools and colleges in rural areas by 2026/27, and (b) committing to establish and fund ‘Early Support Hubs’ that can be accessed by children and young people in rural areas by 2024/25.
Show less
Government response AI summary
The government outlines its existing rollout for Mental Health Support Teams (MHSTs) but does not commit to expanding provision to 100% of rural schools by 2026/27. For Early Support Hubs, it has commissioned a longitudinal study but does not commit to establishing and funding them …
Read full response →
Department for Environment Food and Rural Affairs
19
Recommendation
Fourth Report - Rural Mental Health
Rejected
It is very important for the farming and veterinary communities to feel that their circumstances are understood by NHS staff when seeking to access, or receiving, support (otherwise this may work against help-seeking behaviours). Charities with specialist-knowledge can gain people’s trust from a position of credibility, so it makes sense …
Read more
It is very important for the farming and veterinary communities to feel that their circumstances are understood by NHS staff when seeking to access, or receiving, support (otherwise this may work against help-seeking behaviours). Charities with specialist-knowledge can gain people’s trust from a position of credibility, so it makes sense to engage them to boost NHS staff understanding and/or to develop occupationally specific mental health initiatives, to provide a model for the NHS to improve support for farming and veterinary mental health. We recommend that DHSC and DEFRA identify farming and veterinary mental health as high priorities for action and by September 2023, develop a work programme with NHS England, public health and agricultural and veterinary charities to identify measures and targets to improve mental health outcomes for these occupational groups; and that DHSC mandate Health Education England to work with agricultural and veterinary charities to develop a training programme for rural NHS providers and staff to be launched by Autumn 2023, about these occupational groups’ mental health needs to improve their care. (Paragraph 136) 80 Rural Mental Health
Show less
Government response AI summary
The government recognizes the importance of mental health for farming and veterinary communities but explicitly rejects developing a work programme with specific measures and targets, citing misalignment with NHS England's operating model. It also states there are no plans to commission a specific training programme …
Read full response →
Department for Environment Food and Rural Affairs
24
Recommendation
Fourth Report - Rural Mental Health
Rejected
We recommend that by the end of this year, 2023: a) DEFRA and DHSC, working with all relevant public health, environmental and first responder stakeholders, assess the readiness of local plans for crisis events, and commence consultations on upgrading local preparedness for rural populations’ mental health, and b) HM Treasury, …
Read more
We recommend that by the end of this year, 2023: a) DEFRA and DHSC, working with all relevant public health, environmental and first responder stakeholders, assess the readiness of local plans for crisis events, and commence consultations on upgrading local preparedness for rural populations’ mental health, and b) HM Treasury, DHSC, DEFRA and NHS England review current emergency funding mechanisms and how these can be improved by establishing a dedicated Rural Mental Health 81 funding stream, to enable local areas to quickly access more resources to respond to rural communities’ mental health needs during and, crucially, after crisis events. (Paragraph 156) Addressing mental health in government policy and regulation
Show less
Government response AI summary
The government rejected the recommendation to establish a dedicated rural mental health funding stream, stating there are no such plans. While acknowledging the need for close planning and provision of support, the response did not commit to assessing the readiness of local plans or commencing …
Read full response →
Department for Environment Food and Rural Affairs
26
Recommendation
Fourth Report - Rural Mental Health
Rejected
We hope that DEFRA’s attempt to reduce regulatory stress is a positive change in cultural practice. However, encouraging and investing in Mental Health First Aid (MHFA) training for people dealing with farmers is a pre-requisite to ensure they are skilled and able to signpost to mental health support. We recommend …
Read more
We hope that DEFRA’s attempt to reduce regulatory stress is a positive change in cultural practice. However, encouraging and investing in Mental Health First Aid (MHFA) training for people dealing with farmers is a pre-requisite to ensure they are skilled and able to signpost to mental health support. We recommend that: a) the next round of the Farm Resilience Fund prioritises providing mental health support to the farming community as a key deliverable alongside business resilience, to ensure it is more firmly established so that farmers engage with mental health support, and b) the Government develop an implementation plan by December 2023, to fund and roll-out the MHFA- training to front-line staff—across the public sector, auction marts, farming organisations and charities—who deal with farmers.
Show less
Government response AI summary
The government did not commit to prioritising mental health support as a key deliverable within the Farm Resilience Fund, instead noting its indirect positive impact and current signposting services. It rejected developing an implementation plan to fund and roll out Mental Health First Aid training, …
Read full response →
Department for Environment Food and Rural Affairs