The Health Report

This report provides insights on mental health issues, determinants, inequalities, and barriers to health in Greenwich London Borough Council. It discusses the role of nurses in promoting mental health and provides data and statistics on mental health issues in the locality. It also explores local and national policies, services, and charities available for public health concerns.

THE HEALTH REPORT

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
a) Locality....................................................................................................................................1
b) Statistics and Information........................................................................................................2
DETERMINANTS, INEQUALITIES AND THE BARRIERS TO HEALTH..............................5
Inequalities...................................................................................................................................6
Determinants................................................................................................................................6
HEALTH-CARE AND SERVICES FOR MENTAL ILLNESS....................................................7
a) Local and national policies, services, charities that are available for public health concerns.7
b) Role of nurse in health promotion and the screening of area..................................................8
CONCLUSION................................................................................................................................9
RECOMMENDATIONS...............................................................................................................10
REFERENCES..............................................................................................................................11

INTRODUCTION
Greenwich London Borough Council is a local authority for Royal Borough of the
Greenwich in the Greater London. It is recognized under top councils in London, UK. It is
categorised in 12 wards and have three councillors. It is envisaged that in accordance with
London Government Act, 1963, Greenwich as local authority will share the power with Greater
London Council. Kenyangi, Keith and Adegboye (2019) stated that local authority gets the
powers and functions from LGA, 1963 and the subsequent legislations. Greenwich has functions
and powers of London Borough council. It collects business rates and council tax as billing
authority and processes the applications for local planning and also responsible for the waste
collection, housing and the environmental health.
The London is facing increased issues of mental health and depression is one of the
common. In secondary study, it has been found that 1 of 4 individual faces mental health issues.
So, mental health is single largest sources for the disease burden, higher than cardiovascular or
cancer disease and costs extend beyond the social care and mental health. Around 7.5 billion are
spend every year for addressing the issue of mental health in London (London mental health,
2020). It includes the spending over social and health care for treating the illness, benefits for
supporting the people having ill mental health. The costs of around 26 billion within London is
spend every year to overcome the problem like decreased productivity and the quality of life.
Nurses play an important role in promoting the health of people of this locality. They
have the responsibility of taking care of the people and guiding them how to overcome these
issues (Brent, 2017). Nurses can motivate and provide them methods about how to handle the
situations of anxiety and depression.
The present report will be based upon mental health issue i.e. depression and role of nurse in
order to overcome the same. Also, data and statistics will be given on chosen mental health issue
in Greenwich London Borough Council. Along with this, report also explained the policy
implemented for public health benefits.
a) Locality
Greenwich London Borough Council is council in Greater London. It is one of 32 in UK.
The council was created by London government act 1963. It replaced two council that is
Greenwich metropolitan and Woolwich. The main reason of choosing this area is such that there
are number of mental health issues identified within Greenwich. Moreover, the people also did
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not get high quality health care services. Besides that, there are inadequate primary health care
facilities available in it. As per Brent (2017) population was 283,500, in which the life
expectancy of women is 82.4 years and men is 79.3 years. Further, 1 out 5 people found
depressed or else suffer from any mental health issue and people live is London faces the worst
condition of mental health among other states (The London boroughs you're most likely to suffer
from mental health problems, 2020). That is why, the rationale for choosing this locality is due to
higher rate of depressed person.
b) Statistics and Information
Health and social care data
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Statistics
From table it is stated that mental disorder rate among boys whose age is in between 5-
16 years was 11.4% in 2017 whereas, in 2020 it was 16.7% which lead to depression. Also, in
girls the mental health disorder in 2017 was 10.3% and in 2020 was 15.2%. Thus, overall rate of
mental health disorder in Greenwich London Borough Council 2017 in boys was 10.8% and in
girls was 16%. .
Discussion of Statistics
It is clearly analysed that there are increased rate of depression among individuals and
this is increases in young age group because that have enough stress which lead to depression.
Developed areas suffer more mental health problem because of higher indifferences.
As per the survey conducted by the Greenwich around 22000 people were diagnosed with
the mental disorders in which around 6517 adults were found having depression. One among
three had long term issue (Macdonald, 2020). Multi morbidity is a common problem and around
15% of the people having heart disease have more than the long term mental conditions and in
them 20% either had anxiety or depression. Well-being and health is better for mental ill health
in borough of Greenwich than England.
Around 1 in the 6 adults suffered from depression in this area, such that research
identified that people around 2,100,050 experiences mental health issues (Mental health of older
adults, 2020). Also, there are many factors contributed to increase the depression among the
people such that gender, age and the lifestyle which contributes to likelihood of person to
develop mental issues and many of the people experience severe mental disorder during course
of lives.
Office of the National Statistics provides the insights about the level of general stress and
the well-being. In comparison with other localities, London has largest proportion of population
having high anxiety and depression levels. Around 41.3% of adults in London report higher
anxiety and depression compared with average UK of 38.5% (London Mental Health. 2020). The
satisfaction level and feeling of the worthiness is particularly low in the London. The mental
health problems begin by age of 14 and mainly by mid 20s. Mental disorders are distinguishable
beyond early years because communication improves and the child becomes more interactive.
There are different disorders diagnosed in the adulthood that have onset in the adolescence and
childhood. Around 15.8% of the adult age group have common mental problem.
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The areas that are having higher accommodation and health care services are seen having high
cases of mental disorders and problems. The health care services are to be improved in the
locality for enabling them to handle this disorder (Bonning and Cleaver, 2020). The mental
health issues in the working age group are increasing further due to increased distress and
competition. Similar to the severe mental disorders, problems with diagnosis and assessment has
made estimating prevalence of the personality disorders problematic. If such depression is not
deal rapidly then the mental disorders also lead to suicides. As per the study it could be analysed
that the depression and anxiety is seen high in Londoners.
DETERMINANTS, INEQUALITIES AND THE BARRIERS TO HEALTH
Good mental state and health is integral part of the human well-being and health. Mental
illness refers to wide range of the mental health condition or disorders that affects thinking mood
and behaviour. It includes anxiety disorders, depression, eating disorders and addictive
behaviours. People have different health concerns but mental health becomes illness when the
ongoing symptoms and signs that causes frequent stress and affects ability to function. It has
direct effect over daily life and working of the people. Mental health of a person and the
common ill mental health issues are shaped by the different economic, social and the physical
environment operating at various stages of the life. The risks factors of common mental health
problems are associated heavily with the inequalities, and higher the inequalities greater the
inequalities in risks (Social determinants of mental health, 2020). It is considerable important
that the actions are taken for improving conditions of the everyday life beginning from
childhood, adolescence, family building, working age to the older age. Actions throughout the
life stages provides opportunities for improving the mental health of population and reducing
risks of mental disorders associated with the social inequalities. Other social causes include
family, interpersonal, housing quality, community dynamic, employment opportunities social
support and work.
Depression is among most common mental disorder experienced by the people in
London. It could affect people in number of ways and could have different symptoms.
Determinants of the mental ill health vary across the life stages. Adverse experiences in
childhood are considered to account for 30% of ill mental health (Depression in Adults, 2020).
The other factors associated with increased risk to the ill mental health includes deprivation,
debt, unemployment, violence, inequality, stressful events and poverty.
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Among them deprivation and inequality are the key elements for range of factor leading
to ill mental health that further increases the inequalities. People that are living in the deprived
areas have increased mental health risk and the poor well being in comparison with others. The
areas that are not getting proper health services are prone to suffer higher mental health issues.
The health services of the regions required to be improved for deriving maximum benefits out of
it (Cadogan and Hughes, 2021). It could be observed that the people living in the property which
is considered to have significant impact over the developing mental issues.
Greater proportion of the adults having lower socio economic position or relative low
household income, as a result, they are identified with more symptoms of the depression and
anxiety as compared to those having higher income and position. Study shows that the financial
issues and the problems in accessing good food and medicines have larger impact over mental
health of the people. Lower income puts pressure on the individuals to do things for higher
earnings. The inability to reduce the inequalities and differences between the gap lead to
increased anxiety and depression among the people. Social inequality is a significant determinant
that is causing depression and mental illness among the individuals.
Employment is another determinant behind the chosen problem i.e. depression. Large
number of people in London are not satisfied with their existing job and working conditions. Due
to non-working condition, most of the adults were reported with mental illness with high anxiety
and depression. Loss of income and unemployment leads to severe health issues in people of
different age group (Duignan, Pappalepore and Everett, 2019). Unemployment is impacting the
people and leading them towards mental disorders and disruptions in employment are seen
causing psychological distress among the people. There are also studies showing dissatisfaction
with the jobs and quality of life of people.
Inequalities
Inequalities in the society leads people towards distress as the competition is increasing
everyday and people have to continuously work for performing above average to get the desired
goals. Increasing competition and work culture is increasing pressure over people. People not
able to meet the required standards are not getting the adequate jobs. They have to do work not
of their interests leading to mental health.
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Determinants
World health organization (WHO) defines social determinants as circumstances or situations
in which individuals are born, growth, live, work and their age (Social determinants of health-
WHO, 2020). The conditions are influenced through distribution of power, money and the
resources operating at local, national and global level. The present conditions of locality shows
that they required high medical facilities in order to improve their current situation. It is essential
that individuals must be in good mental state so that they are productive and live good life as
well. The area has to be improved by providing better health services to people and establishing
equality in the environment. Government has to establish the medical facilities to enable the
people to deal with such situations of mental health issues and how those can be improved.
However the social determinants are the key factors behind the mental illness of people in area
which is hard to be controlled however actions could be taken to deal with own mind.
HEALTH-CARE AND SERVICES FOR MENTAL ILLNESS
a) Local and national policies, services, charities that are available for public health concerns
Public policies are rules, codes and the legislations pertaining to the employment,
education, food, wages and other facets. Public policies have downstream effects on the mental
and physical health which includes higher tuition fees for education, minimum wage system and
such other. The policies do not appears to be health policies at first but drive social determinants
of the mental health. For promoting the mental health at population level and for reducing risks
of mental illness.
NHS provides mental health support and services to people diagnosed with mental health
issues and provide support in crisis within Greenwich London borough. It provides 24 hour
support and advice for children, parents and others and also provides consultation with mental
health professionals. It provides great support in the area to patients of mental health to improve
their situation and conditions. NHS has also provided national mental health policy to focus over
people facing mental disorders like anxiety and depression (Rutkow and et.al., 2019).
Parity of esteem in mental health strategy government focused to give equal importance
to physical and mental health issues within chosen locality. Strategy contains Coalition plan for
improving mental health of people and to improve the services for people having mental issues.
Health & Social Care Act, 2012 has introduced duty towards recognising mental health as well.
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It led to constitution of system in NHS to treat, diagnose and to improve the mental health. NHS
5 Year Forward Review was aimed to achieve parity of esteem.
5 year forward view of the Mental Health provided recommendations for improving the
outcomes in mental health. It aimed at achieving parity between physical and mental health of
children, adults, young and old people. It provided government needs strict actions in areas of
employment, social inclusion and housing. Inequalities have to be tackled to reduce instances of
mental health issues.
There are different charitable and government care services that provides psychotherapy
to treat mental illness by trained professionals. People with severe mental disorders are provided
with cognitive behavioural therapy, dialectic behaviour therapy and other talking therapies at
lower prices. Health services are generally provided to people for improving their own situation
and study analysed that the chosen locality have more people suffer from depression (Masters
and et.al., 2017). However, medications are less helpful in such situations but are of significant
important for the people. Different charitable organisations are helping providing the medication
for free. Government is also taking actions to improve the social determinants and reduce social
inequalities among the people.
b) Role of nurse in health promotion and the screening of area
Nurses are important medical practitioners that deal directly with patients facing the
mental disorders. They are required to diagnose mental health of people coming to clinics and
other places for treatment. To diagnose the mental state different tools are there but at first stage
they have to assess and communicate with patients regarding the problems and discussing best
method to deliver care to them.
Nurses to diagnose people, interact with them to identify the issues faced by them and
their concerns. Communication is the main tool for identifying depression and anxiety among the
people. Nurses conduct interviews, tests, observations and standardised tests to diagnose mental
health. Those having severe issues are further screened using behavioural and talking therapy.
The screening is done at different levels and interaction is done with them to identify the cause
of depressions and anxiety. Moreover, they also instruct, prepare and assist the clients for
screening examination which identify the diseases, infections as well as other earliest stages. In
order to serve the people who faces depression, nurses identify the changing behaviour of
individuals and tries to provide best cure as well.
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Nurses based on the diagnosis of patients with mental health disorders plan and deliver
care to improve their state (developing nurses for mental health. 2020). They empower the
patients to make healthy choices through use of behavioural therapies and talking therapies
(Cadogan and Hughes, 2021). Communication with them is kept first to help them overcome the
anxiety and depression. Along with this, they also have high standards of professionalism which
in turn assist to provide best care to the people. Based on the diagnosis nurses apply change
model to improve their mental health and to bring them out of anxiety and depression. There are
different stages of change model that are:
Precontemplation: At this stage people do not think to change and defend to AOD use pattern.
Many of them do not mental health as problem and are not ready to take actions for it. Nurses
communicate and plans small actions for them that helps in improving.
Contemplation: People are aware of problem at this stage and also think to overcome the issue
but no commitment is made to take actions. Nurses help them to take the action planning with
them strategies and implementing them through constant support.
Preparation: This stage combines behavioural and intention criteria. People have made attempt
for change using actions last year and becomes less ambivalent to take next steps. Nurses in this
stage initiate them to take small steps to change behaviour. It is believed that change is essential
and time is imminent. Equal proportion of people also decide of not doing for changing
behaviour.
Action: People in this stage takes actions to modify the behaviours, experiences or the
environment to deal with anxiety or depression. The actions involve behavioural changes and
require considerable commitment to energy and time (Chen and et.al., 2020). Nurses take
effective care in this stage.
Maintenance: The stage where individuals work for preventing relapse and to consolidate gains
from actions. Nurses determine the time period to which the actions tends to extent to prevent the
relapse.
Nurses execute the change model in treatment of patients of health issues. It provides
effective results that show improvement in behaviour and mental health of patients.
Nurse provides services based on the outcomes of diagnosis of patients. They provide
primary care to patients with severe mental disorders, direct interactions is made with them and
health relationship is established with them to overcome the mental problem. They also provide
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clinical supervision to patients, they plan meetings and interviews with patients to plan the care
delivery (van Os Gand et.al., 2019). Timely contact and communication is made with them to
identify the progress and to plan further strategies for health improvements. They also arrange
for the materials that will be used during care of patients.
CONCLUSION
It has been observed that majority of people nowadays are facing mental health issues
and problems that is affecting their daily life. These issues include anxiety, stress, depression and
other issues. The statistics shows that 1 from 4 is experiencing depression as a mental health
issues which is very high and common within such people. Due to mental issues people them to
become less productive and efficient that is affecting the growth of area and region. The position
is increasing still continuously. The social determinants of mental health include increasing cost
of living, stable wages, increasing cost of education and lower growth.
It has been seen that among the majority of patients the root cause is social inequality.
They are not able to achieve as per their expectations from life and there is increased pressure on
them to live up to the expectations. It is becoming serious concern for society and government.
As nurses deal directly with patients they have significant role to provide the patients with care
and enabling them to look positively towards things in life.
RECOMMENDATIONS
 The nursing profession has increased responsibilities in the society and play significant
role in treating people with mental health. They are the direct players that deal with
patents and establish methods through which patients could overcome their anxiety,
depression and other mental issues.
 It is to be suggested to the health care service to provide more advanced medical
equipment to nurse in order to diagnose people with mental issues as existing
communication and therapies are at times not able to identify the problem (Brehaut and
et.al., 2019). Providing advanced tools will enable them to identify issue faster and also
to make care plan that will improve the situation and state faster. Nurse through change
model can implement the care plan more effectively for people. Government can provide
support in providing such services.
 Further, it is also suggested to provide effective training systems to the nurses in order to
deal with any complex situation. Such that during depression, each and every individual
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has different behaviour which needs to be observed by nurses. Therefore, to handle such
situation, there is a need to focus upon training session which in turn improve the overall
situation.
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REFERENCES
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Chen, H. and et.al., 2020. Comparative study on the strands of research on the governance model
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Duignan, M. B., Pappalepore, I. and Everett, S., 2019. The ‘summer of discontent’: Exclusion
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Kenyangi, B. D., Keith, R. S. and Adegboye, A. R. A., 2019. Exploring Infant and Young Child
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Macdonald, L. T., 2020. Proposals to Move the Royal Observatory, Greenwich, 1836–
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Rutkow, L. and et.al., 2019. Local public health policymakers’ views on state preemption: results
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van Os, J. and et.al., 2019. The evidence‐based group‐level symptom‐reduction model as the
organizing principle for mental health care: time for change?. World Psychiatry. 18(1).
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<https://www.who.int/mental_health/policy/mnh_nursing/en/ >.
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<https://www.london.gov.uk/sites/default/files/gla_migrate_files_destination/Mental
%20health%20report.pdf>.
Mental health of older adults. 2020 [Online]. Available through: <https://www.who.int/news-
room/fact-sheets/detail/mental-health-of-older-adults >.
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