SUBJECT:                  FINAL REPORT FROM THE TASK AND FINISH GROUP ON tackling potential mental health issues post pandemic








1.1       This report seeks to inform Cabinet Members of the findings of the task and finish group that was established to review how Caerphilly County Borough Council works with partners to tackle any potential mental health issues post-pandemic. Cabinet Members are asked to consider the recommendations of this review group of the Social Services Scrutiny Committee.

2.         SUMMARY


2.1       This report outlines the findings and recommendations of the Task and Finish group established to review how the Council works with partners to tackle any potential mental health issues post-pandemic. It charts the process that led to the group concluding that the impact of the Covid-19 pandemic on the mental health and wellbeing of the population was immense and that action is now needed locally in mitigation.





3.1       That Cabinet Members consider the content of this report and appendices, and support the following recommendations:


3.1.1    Caerphilly County Borough Council prioritises the provision of bereavement counselling across the County Borough during future meetings with Health and Wellbeing partners.


3.1.2    Caerphilly County Borough Council uses its influence within the WLGA to recognise the importance of the role played by Psychological Wellbeing Practitioners and recommends a collective appeal from all Welsh Councils for additional funding from the Welsh Government for this vital service within GP surgeries.


3.1.3    Council communications platforms are actively used to promote community health and wellbeing activities such as Bereavement Cafes organised via the Integrated Wellbeing Network.


3.1.4    Caerphilly County Borough Council liaises closely with partners in order to explore ways of allowing increased community self-determination for post-COVID wellbeing recovery through processes such as Participatory Budgeting.


3.1.5    Caerphilly County Borough Council actively encourages CCBC staff and Members to undertake Gwent Connect 5 training in order to help improve population mental wellbeing.


3.1.6    Caerphilly County Borough Council works with Health and Wellbeing partners to develop a “Tool Kit” outlining some of the key symptoms of Mental Health issues and signposting users to the range of help available such as the Melo website.






4.1       These recommendations have been suggested as it is believed that implementation would significantly mitigate against some of the key mental health issues identified during the course of the Task and Finish review.



5.         THE REPORT


5.1       At the Social Services Scrutiny Committee pre-meeting on 2nd February 2021 Members raised news reports of a “Mental Health Timebomb” during their discussions on the Committee’s Forward Work Programme. Media coverage was  suggesting that there was potential for a considerable increase in mental health cases and therefore an increased demand for services as a result of Covid-19 restrictions. During the Social Services Scrutiny Committee meeting afterwards Cllr Carmen Bezzina suggested a Task and Finish inquiry into preparations for a potential increase in demand for mental health services post-pandemic. This proposal moved by Cllr Bezzina was unanimously endorsed by Committee Members when the Forward Work Programme was discussed. 


5.2       The terms of reference for this Task and Finish Group are: To determine the likelihood of a rise in demand for mental health services due to the restrictions placed on society because of the Covid-19 pandemic. To then establish if Caerphilly County Borough Council is as best placed as possible to work with partners in order to tackle potential mental health issues as restrictions are relaxed.


5.3       The Task and Finish Group on Tackling Potential Mental Health Issues Post Pandemic met for the first time on 26th July 2021 and agreed the terms of reference and Inquiry Plan  set out in the review’s Scoping Document. The Task and Finish Group was made up of the following Members:


            Councillor C Bezzina – Chair (until the Council elections in May 2022)

            Councillor C Bishop

            Councillor D Cushing

            Councillor K Etheridge

            Councillor M Evans

            Ms M Jones – Vice Chair (until her retirement from the Parent Network in December 2021).    


5.4       Prior to the second meeting of the Task and Finish Group a selection of online articles on Mental Health and the Pandemic was circulated to Members. These included information on the Welsh Government’s Mental Health Delivery Plan 2019 – 2022, Public Health Wales’ Covid-19 Wellbeing Campaign, tips from the charity MIND on coping with Mental Health Issues during the Pandemic and also several articles from leading UK news agencies.     


5.5       The second Task Group meeting was held on 3rd November 2021 and focussed on an overview of the current situation. The key witness at this meeting was Karen Morris, Service Manager in Adult Services with responsibility for both mental health services and drug and alcohol services at Caerphilly County Borough Council.


5.6       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.


5.7       The Chair asked if there had been a significant increase in CMHT 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. The Service Manager advised that should this situation change in the future she is well placed to request additional resources and continues to review the volume of referrals.


5.8       The Service Manager outlined groups that she was a Member of alongside colleagues from Public Health Wales and Aneurin Bevan University Health Board. The first one highlighted was the Foundation Tier Steering Group which focussed on prevention. Members heard how the MELO website and “Gwent Connect 5” workforce training programme were developed as a result of meetings by this group. The Service Manager also represented CCBC at Suicide Prevention and Self-Harm workshops and at meetings of the Integrated Wellbeing Network.


5.9       Group Members heard how good relationships had been developed with Primary Care Mental Health Specialist Services (PCMHSS). The Service Manager advised that GPs were the first point of contact and then it would be decided if an individual required Primary Care (which operated within GP surgeries) or if the case would be better treated at CMHT level i.e., secondary care. Primary Care Services would deal initially with low-level conditions such as anxiety and depression. The Group also heard about the development of Psychological Wellbeing Practitioner (PWP) roles in some surgeries. PWPs are non-registered practitioners who are trained to assess common mental health disorders.  


5.10     Task Group Members were given a synopsis of the collaborative working which was taking place across all agencies including other Gwent Local Authorities. Mental Health Crisis Concordat meetings were held on a regular basis. Attendees at these meetings included Service Managers from each Local Authority, Gwent Police, Welsh Ambulance Service and Senior Managers from the Health Board. These meetings discussed the future development of mental health services in the Gwent region.  


5.11     At the second Task Group meeting Members were also told about Mental Health Implementation Group meetings which focussed on issues pertaining to the adherence of the Mental Health Act.  


5.12     At this meeting it was stressed that currently Caerphilly County Borough Council was equipped to deal with the demand for mental health services, but this situation was constantly being monitored by managers. 


5.13     The third Task Group meeting was held on 15th December 2021 and focussed on testimony from leading mental health charities. The key witnesses were Jenny Burns, Associate Director (Wales) of the Mental Health Foundation and Jill Lawton, Director of Caerphilly Borough MIND.


5.14     Jenny Burns 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.  


5.15     A report on the impact of the pandemic on the elderly was also highlighted. 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.


5.16     Another study by the Mental Health Foundation focussed on resilience across the UK during the pandemic. This showed that the majority (64%) coped well with the stress of the pandemic but of those that did experience stress 9 in 10 used at least one coping strategy. Some of these strategies were positive such as the use of green spaces and staying connected with others, but negative strategies such as increased alcohol consumption, substance misuse and overeating were also identified. The report recommended that whilst every nation had made mental health literacy resources available, greater policy and investment could be targeted at those that lacked resilience.  


5.17     Jenny Burns also highlighted an article in medical journal 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.


5.18     On the issue of participation Jenny Burns 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.  


5.19     The Service Manager highlighted the importance of joined up working within organisations. Members heard how 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. Similar processes were also developing within the Health Board in order to better signpost the services available  


5.20     Jill Lawton outlined some of the key projects such as Supporting People and Active Monitoring, and Members heard how MIND in the Caerphilly region was providing a counselling service for the primary mental health teams.  


5.21     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.


5.22     At the third meeting Jill Lawton also 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.


5.23     The fourth Task Group meeting was held on 16th February 2022 and focussed on evidence from healthcare professionals. The key witnesses were Dr Chris O’Connor, Divisional Director for Mental Health and Learning Disabilities at Aneurin Bevan University Health Board and Dr David Llewellyn, Service Development Lead for the Integrated Wellbeing Networks of the Gwent Public Health Team.     


5.24     Dr Chris O’Connor highlighted to Group Members that the impact of the pandemic on the mental health of the population had been immense.  Dr O’Connor outlined to Group Members how research and studies over the last two years showed that that the pandemic has had a significant impact on the mental health and wellbeing of the population. Group Members then heard how this was also the conclusion of research Dr O’Connor carried out along with Cardiff University and Swansea University (The Influence of the Covid-19 Pandemic on Mental Wellbeing and Psychological Distress: A Comparison Across Time – 15th July 2021).  


5.25     This research found 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, and people working in the health and social care arena.


5.26     Dr O’Connor also 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.  


5.27     At the fourth meeting the issue of referrals to mental health services in the Caerphilly County Borough was discussed. The inquiry heard how despite a reduction in referrals during the first lockdown for older people with functional mental health difficulties such as depression and anxiety, there was now significantly more referrals than was the case pre-pandemic.


5.28     The number of people going to see their GP about mental health difficulties was then raised by Dr O’Connor. The Task Group Members heard that demand within the Primary Care arena had gone up massively during the pandemic.


5.29     One Member asked about GP timeframes for referring a patient to a consultant. Dr O’Connor highlighted to the Task Group that waiting times for counselling and interventions were now increasing.


5.30     At the fourth meeting the inquiry heard how Psychological Wellbeing Practitioners had been introduced within GP practices in order to provide a more effective service. Dr David Llewellyn advised that there were 12 Psychological Wellbeing Practitioners currently in place across the County Borough and that feedback from patients was very positive.           


5.31     Dr 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. Dr Llewellyn also agreed with a point made about the need for greater connectivity between mental health service providers and he stressed that this would ensure activities complimented each other and that users were signposted in the right direction.


5.32     Dr Llewellyn highlighted a community study by the Integrated Wellbeing Networks at the end of 2020 which found that the Pandemic had exacerbated existing difficulties (Sustaining and Strengthening Community Wellbeing Together in the Covid Era – August 2020). Dr Llewellyn also drew the Task Group’s attention to the support available via the Melo website and the Gwent Connect 5 training programme. Dr O’Connor reiterated praise for the training provided by Public Health Wales via the Connect 5 programme.


5.33     At the fourth Task Group meeting one Member asked what more Caerphilly County Borough Council could do and specifically enquired if lobbying the Welsh Government for additional resources for more Psychological Wellbeing Practitioners would be beneficial. Dr O’Connor welcomed any lobbying for additional resources as he advised that historically mental health had been underfunded when compared with funding for physical health services.


5.34     Dr 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 effective monitoring of impact.


5.35     At a meeting of the Social Services Scrutiny Committee held on Tuesday 6th September 2022, Members considered this report and supported the recommendations outlined earlier (3.1.1 – 3.1.6).



5.36     Conclusion

The Task and Finish Group have been meeting regularly since July 2021 and have received evidence from key witnesses ranging from the Consultant Clinical Psychologist responsible for the delivery of mental health services across the Gwent region, to the Director of the Mental Health Foundation in Wales. Group Members have also considered a range of written material and gained a good understanding of the current situation in terms of how mental health services are delivered within the County Borough. The conclusion reached is that the impact of the Covid-19 Pandemic on the mental health and wellbeing of the population is immense and that action is now needed locally in mitigation against the resulting issues. After due deliberation the Task and Finish Group have made several recommendations for Cabinet consideration on the action required. These recommendations are outlined in Section 3 of this report.       


6.         ASSUMPTIONS

6.1       No assumptions are necessary.




7.1       As this report is for information only an Integrated Impact Assessment is not necessary.





8.1       There are no specific financial implications arising as a result of this report.





9.1       There are no personnel implications with respect to this report.  





10.1     All responses from the consultations have been incorporated in the report.


10.2     At their meeting held on Tuesday 6th September 2022, Members of the Social Services Scrutiny Committee considered the final report from the Task and Finish Group which was introduced by the Scrutiny Officer in the absence of the Task Group Chair. Discussion then ensued. One Member observed that that the report did not mention how stress from physical pain and delayed operations could affect mental health.  The Scrutiny Officer acknowledged that the stress and pain from procedures that had been delayed because of the pandemic would be very concerning, however this aspect was not considered when the remit of the inquiry was discussed by the Group Members. The Member stated that they would have liked it to have been acknowledged in the report. Following consideration of the report, it was moved and seconded that the recommendations be approved for recommendation to Cabinet.  By way of Microsoft Forms (and noting there were 8 for, 0 against and 1 Abstention) this was carried.


It was therefore RECOMMENDED to Cabinet that recommendations 3.1.1 – 3.1.6 be considered and supported.






11.1     The Local Government Act 2000.



12.       URGENCY (Cabinet items only)


12.1     Non-urgent.



Author:                  Mark Jacques, Scrutiny Officer –     


Consultees:           Dave Street, Corporate Director for Social Services and Housing

                              Richard Edmunds, Corporate Director for Education and Corporate Services

                              Jo Williams, Assistant Director Adult Services

                              Karen Morris, Service Manager (Mental Health Services/ Drug and Alcohol Services)  

                              Robert Tranter, Head of Legal Services/ Monitoring Officer

                              Lisa Lane, Head of Democratic Services and Deputy Monitoring Officer, Legal Services

                              Councillor Elaine Forehead, Cabinet Member for Social Care

                              Councillor Donna Cushing, Chair of Social Services Scrutiny Committee

Councillor Marina Chacon-Dawson, Vice Chair of Social Services Scrutiny Committee




Appendix 1 – The Influence of the Covid-19 Pandemic on Mental Wellbeing and

Psychological Distress: A Comparison Across Time – 15th July 2021.


Appendix 2 – Sustaining and Strengthening Community Wellbeing Together in the Covid Era

– August 2020.


Appendix 3 - Information gathered at Task Review meetings since July 2021.