Mental Health & Emotional Wellbeing

This topic covers mental health needs across all ages including children, young people, adults and older adults.

Good mental health and wellbeing are fundamental for a happy and healthy life. Mental health problems can significantly affect any individual, their family, the community and wider society. Mental ill health is not distributed equally across society and individuals with mental ill health can experience inequalities in care, including identification and access to services, which may impact health outcomes. Inequalities may include geographic isolation, cultural factors, and digital exclusion, alongside wider social determinants such as housing, employment, education, and health literacy. Mental ill health is an umbrella term for many different conditions and people living with diagnosable mental ill health disorders, for example depression, bipolar disorder or schizophrenia, can still be living in good mental wellbeing despite their mental ill health diagnosis. The phrase severe mental illness (SMI) refers to psychological conditions that people find so debilitating, their ability to engage in functional and occupational activities may be severely impaired, especially in the absence of good quality treatment and support. Schizophrenia and bipolar disorder are often categorised as SMI. 

In the UK, half of life-long mental health problems start before the age of 14 and three quarters of cases start before the age of 25. Today’s children are exhibiting worse mental health outcomes compared to previous generations (Source: RCPCH), and one in five children and young people aged 8 to 16 had a probable mental disorder in 2023 (Source: NHS England Digital). There has also been an increase in the prevalence of eating disorders among those aged 17 to 19 (Source: NHS England Digital). The proportion of 16 to 64 year olds with a common mental health disorder is increasing and in 2023/24 reached 22.6% (Source: NHS England Digital). Together with substance misuse, mental illness accounts for 21.3% of the total morbidity burden in England (Source: Public Health England).  

There is a well-established evidence base on the risk and protective factors for mental health. These include individual-level factors, social and environmental factors, life events and transitions, and global and structural factors (Source: World Health Organization (WHO)).

Specific factors where there is an emerging evidence base include excessive social media use, in some cases leading to social anxiety, depression, low self-esteem, reduced sleep quality, and higher perceived stress (Source: Ventriglio, A. et al., 2024). Exposure to distressing content, social comparison, loss of control and cyber bullying are all potential harms which may arise from social media use.

Additionally, for some individuals, mental health conditions may be exacerbated because of their working environment. Between 2022/23 and 2024/25, the Labour Force Survey found that the estimated annual rate of self-reported stress, depression, or anxiety that was caused or made worse by work among people working in Great Britain in the past 12 months was 2,580 per 100,000. This compares to the East Midlands rate of 2,330 per 100,000 (Source: Health and Safety Executive). This can result in reduced productivity, higher absence, strained relationships, and decreased retention of staff. If mental health in the workplace is not addressed, this may lead to poorer outcomes for the individual.

Loneliness and social isolation are key risk factors for mental health conditions in later life, with an estimated 14% of adults aged 70 and over living with a mental disorder (Source: World Health Organization). At older ages, mental health is shaped not only by physical and social environments but also by the cumulative impacts of earlier life experiences and specific stressors related to ageing, such as bereavement, a drop in income or reduced sense of purpose with retirement. Mental health promotion and prevention strategies for older adults focus on supporting healthy ageing, creating physical and social environments that support well-being and enable people to do what is important to them.

Poor mental health can increase a person’s risk of suicide. Suicide is the second biggest killer of males aged 35 to 49 years (after accidental poisoning) and is the leading cause of death for males and females aged 20 to 34 years in the UK (Source: Office for National Statistics (ONS)). The causes of suicide are complicated and can affect anybody at any time, although certain circumstances or characteristics may increase personal risk. Every suicide has a devastating impact upon family, friends, and the wider community.

Understanding how inequalities shape risks and protective factors for mental health conditions can help target prevention activity to support those affected. The risks and protective factors are well documented (Source: Public Health England (PHE)) with interrelationships between many of these, for example adults with problem debt and those not in employment were found to be more likely to have a common mental health condition (Source: NHS England Digital).   

• The NHS 10 year health plan outlines how £120 million will be invested to develop mental health emergency departments to ensure patients get fast same day access to specialist support. Expansion of mental health support teams in schools and colleges is also proposed in the plan. 
• The Care Act 2014 sets out the duty for local authorities and their partners to promote wellbeing including mental health and emotional wellbeing;
• Core20PLUS5 (Adults) is the NHS approach to reducing health inequalities. This includes a focus on ensuring annual physical health checks for 60% of those living with severe mental illness. Core20PLUS5 (Children and Young People) outlines an approach to reducing health inequalities among children and young people, focusing on five key clinical priority areas including mental health.
• The Suicide prevention in England: 5-year cross-sector strategy – GOV.UK (2023 to 2028) is enhanced at a local level by the Lincolnshire suicide prevention strategy 24-28.
• The NHS Confederation’s No wrong door report, outlines the vision for mental health, autism and learning disability services for people of all ages in England, identifying 10 interconnecting themes and 3 key requirements to turn the vision into reality by 2032.
• The Gambling White Paper sets out a plan for reform of gambling regulation following the review of the gambling act in 2005. It includes recommended measures to reduce gambling related harm by tackling practices and products which evidence shows exacerbate risks and help ensure opportunities to prevent harm are taken.
• The Prevention Concordat for Better Mental Health promotes evidence-based planning and commissioning to improve mental health and wellbeing and reduce inequalities.
• National Institute for Health and Care Excellence (NICE) has produced guidance and quality standards for Mental Health and Wellbeing, including specific settings (e.g. workplaces), population subgroups (e.g. adults in contact with the criminal justice system) and disorders (such as gambling and SMI). 

In Lincolnshire there are 161,017 registered patients aged 8-25, of these 4.7% have had a mental health flag (anxiety, depression and/or SMI) within the last 2 years, and 12.7% across all time. This is likely to be an underestimation but represents approximately 20,410 children and young people (CYP) in Lincolnshire with a mental health need (Source: Lincolnshire Integrated Care System (ICS) Joined Intelligence Dataset, NHS Lincolnshire ICB, 2026). Within this population, 64% are female, however males may be under-represented as they are less likely to access psychological therapies (Source: Mental Health Foundation). Despite the majority of CYP in this group being aged 20-24 (54%), 129 are aged under 10 (Source: Lincolnshire ICS Joined Intelligence Dataset, NHS Lincolnshire ICB, 2026). The percentage of school age pupils in Lincolnshire who have social, emotional and mental health (SEMH) needs is increasing and is now 4.0% (2024/25). This has almost doubled in the last ten years, a trend which is mirrored at a regional and national level (Source: Department of Health and Social Care). There is also a clear difference between genders as 5.4% of male school age pupils have SEMH needs, compared to 2.6% of females (Source: Department of Health and Social Care) 

The NHS Mental Health of children and young people report in England 2023 report found that 20% of 8 to 16 year olds nationally had a probable mental health disorder (Source: NHS England Digital). Latest census data shows 76,143 children and young people aged 8 to 16 in Lincolnshire (Source: ONS), thus if we apply national proportions to local data, we may expect around 15,230 children in Lincolnshire to have a probable mental health disorder. Currently the Mental Health Services Data Set (MHSDS) reports there were 8,835 patients aged 0 to 18 in contact with mental health services within Lincolnshire ICB (Source: NHS England Digital).  

There are many different mental health needs that children in Lincolnshire face, one being eating disorders. In the reporting period 01/04/2025 – 30/06/2025, MHSDS reported 90 new referrals with eating disorders to Lincolnshire Partnership NHS Foundation Trust (LPFT) for patients aged 0 to 18. This was an increase from 50 referrals with eating disorders between 01/04/2024 and 30/06/2024 (Source: NHS England Digital).   

Hospital admissions as a result of self-harm for those aged 10-24 years in Lincolnshire showed a decreasing trend, with a rate of 252 per 100,000 in 2023/24 (down from 362 per 100,000 in 2011/12). However, admissions due to self-harm vary significantly between genders, with a rate of 400 per 100,000 in females compared to 107 per 100,000 in males. The rate also varies across districts, with the highest rate in East Lindsey at 357 per 100,000, followed by South Kesteven. The lowest rate was seen in North Kesteven at 186 per 100,000 (Source: Department of Health and Social Care).  

A range of social and environmental factors can adversely affect mental health, and certain settings show disproportionately high levels of mental health need — one of the most significant being the justice system. Children and young people in contact with the youth justice system are more likely to have mental health problems than those who are not, with 72% of children in the youth justice system having concerns about mental health (Source: HM Inspectorate of Probation). Although the rate of first-time entrants into the youth justice system has declined in recent years, it remains at 78 per 100,000. This indicates a vulnerable cohort, despite the figure being statistically significantly better than the England average (Source: Department of Health and Social Care). 

Young people who are not in education, employment or training (NEET) are also at greater risk of a range of negative outcomes, including poor health and depression. In Lincolnshire 8.8% of 16- to 17-year-olds are NEET, significantly higher than the England average at 5.4% and this is increasing. The proportion of 16-17 year olds who are NEET is higher in males at 9.1% compared to 8% in females (Source: Department of Health and Social Care). Additionally, 27.9% of secondary school students in Lincolnshire are persistent absentees, defined as missing 10% or more of possible sessions (a session is the equivalent of half a day), which is significantly worse than national data. This has risen sharply since COVID-19 with an increase from 15.2% in 2020/21, a pattern that is replicated at a regional and national level. (Source: Department of Health and Social Care).  

Children and young people in care are among the most socially excluded in England, experiencing marked inequalities in both health and social outcomes compared with their peers. In Lincolnshire there are 754 children in care, 51 per 10,000, with the recent trends showing this to be increasing and getting worse, up from 42 per 10,000 in 2018/19 (Source: Department of Health and Social Care). Emotional wellbeing is a concern for 48% of looked after children (Source: Department of Health and Social Care). This is significantly higher than national data and highlights a large vulnerable population in Lincolnshire.  

Adults  

The prevalence of mental health conditions (2024/2025) is a growing concern nationally and this is reflected in Lincolnshire, where 0.9% of the population (7,725 patients) have a diagnosis of schizophrenia, bipolar affective disorder and other psychoses as recorded on practice disease registers. Across Lincolnshire Quality and Outcomes Framework (QOF) data shows the number of people with mental health conditions varies, and is highest in Trent Care (Gainsborough and surrounding areas) Primary Care Network (PCN) (1.2%) where prevalence is significantly higher than the national average (Source: Department of Health and Social Care). Some variation across PCNs and practices may be due to differences in capturing and recording this data, thus there may be under-reporting in some areas. Of those patients in Lincolnshire with schizophrenia, bipolar affective disorder and other psychoses and those on lithium therapy, 66% in 2024/25 received all six elements of the physical health check for people with SMI (Source: NHS England Digital). It is important to measure and improve this as it helps to address a major health inequality experienced by people with SMI, reflected in a reduced life expectancy of around 15-20 years (Source: NHS England).  

Results from the Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England, 2023/4 shows that one in five adults surveyed had a common mental health condition (CMHC) in the last week. 3.8% (CI 3.3, 4.5) of those surveyed found to have a CMHC had a depressive episode, within the last week (Source: NHS England Digital). 

In Lincolnshire 22% of registered patients aged 18+ have a diagnosis of depression. Almost 1 in 4 older adults in Lincolnshire (aged 60-74) have depression. The proportion of people with depression varies across the county, with about a quarter of the population of South Kesteven having a diagnosis compared to just below 20% of the population in Boston. For patients with depression, service utilisation is much higher, with those aged 18-59 having 35 GP contacts on average per year, compared to 17 per year for those in the same age band without depression (Source: Lincolnshire ICS Joined Intelligence Dataset, NHS Lincolnshire ICB, 2026). It is important to note that with differences in capturing and recording this data, along with appointment availability to the patient, GP workforce difficulties, and willingness to seek help, these figures are likely to be an underestimation. NB. GP contacts data includes any contact with primary care, including but not limited to GP appointments, nurse contacts, telephone appointments, blood results and discharge letters. 

In Lincolnshire there has been an increase in the number of people reporting a long-term mental health problem in recent years. Around 14% of people reported a mental health problem in the 2024 GP patient survey, compared to just over 12% in 2023. This increase has been seen nationally, however the proportion of people reporting a mental health problem remains higher in Lincolnshire compared to nationally (Source: Department of Health and Social Care). Despite potential limitations in this indicator due to survey bias and possible underrepresentation, this data clearly shows that increasing numbers of patients understand that they have a mental health condition. In Lincolnshire NHS Integrated Care Board (ICB), as of 30/06/2025 there were 19,065 people in contact with secondary adult mental health services (Source: NHS England Digital).  

The link between mental health conditions and suicide, and suicide attempts is well established. Over the last 3 years, 443 people (aged 18+) in Lincolnshire have attempted to die by suicide. This however may be an underestimation as this data shows only patients who have told a medical professional, there may be patients who attempt suicide that do not tell anyone. The average age in this group is 40, and just over half are aged 18-40 (Source: Lincolnshire ICS Joined Intelligence Dataset, NHS Lincolnshire ICB, 2026). Notably, 40% of suicides concluded in 2021-23 reflected in Lincolnshire coroners data were individuals who have had a previous suicide attempt (Source: Lincolnshire Suicide Audit 2024), demonstrating the importance of intervention for individuals following an attempt to help prevent a further attempt.  

The rate of suicide deaths in Lincolnshire is significantly higher than the national average, at 14.9 per 100,000 people. In 2024 there were 98 registered deaths due to suicide in Lincolnshire, a small decrease on the number of suicides in 2023 (105). Lincoln continues to be the highest district by rate in Lincolnshire in the period 2022 to 2024, with 20.6 deaths per 100,000 (Source: ONS). As reflected in national data, the rate of suicides is higher in males than females (Source: Department of Health and Social Care). The rate of suicide in Lincolnshire is higher in the most deprived areas compared to the least deprived and this is consistent when breaking these down into rural and urban areas. (Source: Lincolnshire Suicide Audit 2024). Each suicide is estimated to affect 135 people. The impact on friends, family and communities is significant and persists over time, which means there is a growing number of people affected by suicide in Lincolnshire (Source: Cerel et al, 2018).  

The rate of emergency admissions for intentional self-harm has decreased steadily since 2017/18 and was significantly lower in Lincolnshire compared to England in 2023/24 (102 per 100,000 in Lincolnshire compared to 117 per 100,000 across England). The number of emergency admissions was considerably higher for females compared to males (Source: Department of Health and Social Care).  

Social determinants of mental health include economic stability, education, social relationships and physical environment (Source: WHO), and exposure to unfavourable factors can increase a person’s risk of poor mental health or exacerbate existing mental health conditions. For patients who are in contact with secondary mental health services, just 7% (2021/22) were in paid employment. There is large inequality across genders, as 8% of females were in paid employment compared to just 5% of males (Source: Department of Health and Social Care). Unemployment has been shown to have a negative effect on people’s mental health (Source: The Health Foundation), as this may increase economic instability and may result in isolation. 

The number of households in Lincolnshire in temporary accommodation is increasing, in 2024/25 there were 212 such households (Source: Department of Health and Social Care). Instability of temporary accommodation can increase stress and negatively affect mental health, creating an ‘at risk’ group. Statutory homelessness data shows in England just over a quarter of households owed a prevention or relief duty had a support need of ‘History of mental health problems’. This compares to South Kesteven, where 36% of households had a history of mental health problems (Source: Ministry of Housing, Communities and Local Government) highlighting a vulnerable cohort facing both homelessness and mental ill health.  

Life satisfaction and the degree to which an individual feels like their life is worthwhile, can have a significant impact on mental health. The ONS annual population survey shows that in 2022/23, the mean life satisfaction score was 7.53/10. This is higher than the national average at 7.45/10, however this has fallen from 7.80/10 in 2018/19. When asked to rate how worthwhile their life was out of 10 (10 being high, 0 low), the mean score was 7.91/10. In Lincolnshire, the mean happiness score out of 10 was 7.53 compared to 7.38 in England. However, this varies by district and is lower in Lincoln at 6.57/10. Since 2020/21 mean anxiety scores in Lincolnshire have fallen from 3.06/10 to 2.67/10 in 2022/23 (Source: ONS).  

Outcomes for people with SMI in Lincolnshire are poorer than the national average, with notably higher rates of premature mortality. The rate of premature mortality among adults with SMI in Lincolnshire continues to rise, reaching 125.9 per 100,000 in the most recent reporting period. This is statistically significantly higher than England with a rate of 110.8 per 100,000 (2021-23). The rate of premature mortality of males with SMI is considerably higher than the rate in females, at 152.3 per 100,000 and 100.7 per 100,000, respectively. This demonstrates a gender inequality in Lincolnshire (Source: Department of Health and Social Care).  

Projecting adult needs and service information (PANSI) predicts that people aged 18-64 with a common mental disorder will increase from 83,042 people in 2023, to 83,557 in 2040 (Source: PANSI). 

Older Adults 

Understanding the mental health of older adults at a local level is essential for identifying community needs and shaping targeted support. Isolation can affect older people by increasing loneliness, reducing cognitive stimulation, and limiting access to social and practical support. In Lincolnshire 48% of adult social care users report having as much social contact as they would like, meaning over half of this population do not feel that they have adequate social contact (Source: Department of Health and Social Care).  

In Lincolnshire, the Projecting Older People Population Information system (POPPI) predicts the size of the population over 65 years with depression is expected to increase by 27% from 16,423 people in 2023 to 31,596 people in 2040, resulting in a significant increase in demand. These projections, however, do not take into account any policy changes, interventions, economic or global health factors, the assumptions used are based on past trends (Source: POPPI). 

Mental Health in Lincolnshire is a priority of the Joint Health and Wellbeing Strategy (JHWS) and is recognised as a key driver and theme within Lincolnshire’s Integrated Care Partnership Strategy.  

The Mental Health, Dementia, Learning Disability and Autism (MHDLDA) Alliance in Lincolnshire lead a multi-agency collaboration to improve mental health and wellbeing across Lincolnshire. The broad membership of the MHDLDA includes Lincolnshire Partnership Foundation Trust (LPFT), Lincolnshire County Council (LCC), Lincolnshire Integrated Care Board (ICB), the Voluntary and Community Sector (VCS), District Councils, and the Office of the Police and Crime Commissioner (OPCC). Adopting an overarching, all-age, prevention and early intervention approach, the outcomes for this work are to: 

1. Reduce the number of children and adults with mental ill health 
2. Reduce the number of people in mental health crisis 
3. Maximise people’s independence 
4. Increase the number of people who have meaningful occupation 
5. Improve quality of life  
6. Increase the number of people who live longer in good health

Children and Young People  

An ongoing transformation programme is working to further improve support for children and young people’s mental health in Lincolnshire. Currently, Lincolnshire Partnership NHS Foundation Trust (LPFT) is the main provider for children’s mental health and emotional wellbeing services in Lincolnshire. Its specialist community mental health services for children and young people are rated as Outstanding by CQC and the trust supports children in a number of ways: 

Healthy Minds Lincolnshire (HML) provides emotional wellbeing support to children and their families who are experiencing emotional distress with early interventions; by promoting resilience and by preventing deterioration of emotional wellbeing leading to mental health issues.   

Mental Health Support Team (MHST) provision is expanding and the NHS 10 Year Health Plan for England has committed to reach full national coverage by 2030 These teams are crucial to: 

• Delivering evidence-based interventions for school-aged children experiencing mild to moderate mental health issues.
• Supporting the Senior Mental Health Leads in each education setting working in partnership with individual MHSTs to introduce or develop their whole-setting approach to positive mental health and emotional wellbeing.
• Giving timely advice to education setting staff, liaising with specialist services to help children get support at the right time and stay in education.  

Child and Adolescent Mental Health Service (CAMHS) provides community-based specialist support when children develop moderate to severe mental health concerns, or present in a mental health crisis; deliver evidence-based treatments and interventions that are appropriate to the child’s age, development and presentation/diagnosis and that are culturally competent and delivered within a family context. This also includes a specialist team to support children with moderate to severe LD, as well as a specialist CYP eating disorder service.

Additionally, the ICB provide the provision of the Twilight café for CYP and their families. 

The Complex Needs Service (CNS) works with partners to support mental health, wellbeing and wider outcomes for children with complex needs and trauma, including those within the youth justice system, children in care/care experienced, and CYP involved in sexually harmful behaviours.

CYP Keyworker Service is available to support young people who are under 25 who have a Learning Disability (LD) and/or are Autistic and are at high-risk of being admitted to specialist inpatient services, or already inpatient in a specialist LD or mental health setting. This work is further supported by a non-clinical Virtual Autism Hub which works directly with autistic adults and parents/carers of autistic people of all ages to help with advice, signposting to support groups and services, information about autism and diagnostic pathways and practical support with tasks such as filling out forms or accompanying individuals going to their first meetings. 

Online counselling and mental health support is currently available via Kooth, for young people aged 11 to 18 years (up to 25 if they have SEND or are a care leaver) living in or attending education settings in Lincolnshire. This is an anonymous service where young people can self-register and access online counselling support, text messaging support, message boards, forums and advice on a wide range of emotional wellbeing and mental health concerns.

Digital therapy for childhood anxiety – Lumi Nova – has been commissioned as a pilot in Lincolnshire until December 2026. It is a NICE recommended digital therapy, provided via a mobile game (smartphone/tablet) for 7-12-year-olds to support mild to moderate fears, worries and anxiety. It is classed as a low-risk medical device – safe, effective and easy to use – and provides Exposure Therapy (Gold standard treatment) based on Cognitive Behavioural Therapy (CBT) techniques.

Adults (including working age and older adults) 

Individuals, communities and organisations across Lincolnshire can all play a part in prevention of poor mental health and wellbeing and the promotion of good mental health. From awareness raising campaigns supporting people to look after their own mental health and wellbeing and knowing where to find help; through to community and societal measures such as developing whole-setting approaches to mental health and wellbeing. Shine Lincolnshire supports a range of community and voluntary sector organisations supporting mental health and wellbeing, increasing the range and reach of local organisations. Across the county there are many organisations connecting people to opportunities to improve their mental wellbeing and build resilience, for example, through HAY Lincolnshire.

The Community Mental Health Transformation Programme aspires to improve mental health and reduce demand for specialist services like mental health crisis, adult social care and mental health inpatient care. This is done by utilising integrated place-based teams, aligning to primary care network areas, and striving to deliver locally-focussed, connected-communities; developing strong partnerships; fluid pathways for access to mental health services; an integrated digital offer to support face to face engagement; continuous and active mental health dialogue; training and upskilling communities; reducing mental health prescribing; and delivery of comprehensive psychological therapies. Practically, this provision includes night light cafes and twilight cafes for CYP and their families and community connectors to help improve community mental health.

It’s All About People is a place for the Lincolnshire health, care and wellbeing workforce to reflect, learn and share how together we support people to live their best life. At its core, Our Shared Agreement describes the foundations for making decisions together, moving beyond problems and processes, and instead focusing on strengths, hopes, and what truly matters most to people. It helps guide professionals and the people they support to have better conversations, build stronger relationships, and achieve more meaningful care and support.

To support the physical health of those with Severe Mental Illness (SMI), anyone aged 18 or over who has schizophrenia, bipolar disorder or psychosis can have a free health check once a year. Work is ongoing to further improve physical health care for patients with an SMI, including the timeliness and way in which health checks are delivered, addressing health inequalities regarding the checks and associated physical health of people with an SMI and supporting a more comprehensive health check which considers a wider range of health needs for people affected. Ensuring this work is undertaken in line with recommended practice will help to improve health outcomes for people with SMI.

LPFT is the lead provider for mental health treatment services in Lincolnshire. Their community and specialist services include inpatient care for Lincoln and for Boston. In addition to NHS commissioned services, LPFT deliver functions on behalf of Adult Social Care via a Section 75 agreement. This includes the assessment and care management for adults aged 18 to 64 with mental illness, enabling LPFT to better integrate mental health related support.

LPFT Adult services are structured around four key divisions: 

• The adult community mental health division provides mental health services and care for people in the community, providing the right support in the right way in the right place and ultimately avoiding hospital admissions. Teams work with many different groups of people, including the homeless, those involved in the criminal justice system and those accessing maternity services.  
• The adult inpatient and urgent care division provides hospital care and support across the county. Care ranges from acute support through to reablement.  
• The specialist service division works alongside mental health teams helping support people in the community. This includes support for veterans, autistic people and those accessing the sexual advice referral centre, amongst others.  
• LPFT also offers mental health support for older people from assessment through to diagnosis and beyond. This incorporates support for dementia, as well as ME and neuropsychology. 

The Adult Eating Disorders team covers all areas of Lincolnshire, working to provide assessment, treatment and support for people over the age of 16 who are experiencing difficulties with their relationship with food or eating and/or any body weight, shape and size concerns which are impacting their daily lives.

The Personality and Complex Trauma Team, also known as PACT for short, offers psychologically informed interventions and talking therapy for people who are currently living with complex personality difficulties. These often include distress and unhelpful emotions; difficulties in relationships; difficulties knowing who we are and where life is heading and low self-esteem.

LPFT also supports with other areas of people’s lives which can negatively impact on their mental health, for example supporting people into meaningful occupation and employment through their Individual Placement and Support (IPS) Employment Service and assisting people who are homeless to access health care support through their Holistic Health for the Homeless service.

A full list of LPFT services can be found here.

Elsewhere the Suicide Prevention Strategic Group (SPSG) is responsible for delivering the Lincolnshire Suicide Prevention Strategy. This strategy has been developed alongside people with lived experience and sets out the aspirations for reducing deaths by suicide in Lincolnshire through delivery of several shared commitments. Work on suicide prevention is guided by an annual Suicide Audit that helps inform the targeting of evidence-based action to prevent suicides.

Alongside support for people who have suicidal thoughts or attempted suicide, Amparo provides support to anyone affected or bereaved by suicide through emotional and practical support that can be delivered one to one, in family groups, and for colleagues or peers of people who die by suicide. This confidential service helps with a range of practical matters such as dealing with police and coroners; helping with media enquiries; preparing for and attending inquests and helping you to access other, appropriate, local support services. LPFT Wellbeing and Recovery college has also recently co-produced courses that support people following a suicide attempt. This course begins to acknowledge the reality of what has happened, exploring different strategies and skills to choose more helpful responses when feeling overwhelmed by challenges and working towards recognising what’s important in our lives and taking practical steps towards a brighter future. 

This factsheet was developed in collaboration with stakeholders of the Mental Health, Dementia, Learning Disabilities and Autism Alliance.

A workshop was held in June 2025 with members of the Mental Health and Dementia Joint Delivery Group and people with lived experience, from the countywide co-production network for community mental health transformation. At the workshop the latest data was discussed, the feedback from this has been incorporated into earlier sections of this commentary.

The group also considered what this data tells us about the mental health needs of our population, shared understanding of the impact of health inequalities on mental health, examined how services are currently delivered, proportionate and tailored to people’s needs and discussed how mental health needs might be better supported by the three national shifts in the NHS. Feedback relating to equitable access to support and inequalities are covered under the section ‘Gaps and Unmet Needs’ below.

The workshop also reviewed the Next Steps from the previous JSNA Commentary (published in 2022), updating and marking as complete as appropriate. This is highlighted in the Next Steps section below.

The draft commentary that resulted from this engagement was shared with other partnership groups including the following, the feedback from which has also been incorporated into the final published commentary: 

• Strategic Development, Innovation, and Integration (SDII) Programme Managers Group, which reports to the MHDLDA Alliance. 
• Prevention Concordat for Better Mental Health Steering Group. 
• Suicide Prevention Strategic Group. 
• Community Mental Health Transformation Partnership Group. 
• Community Mental Health Transformation Programme Oversight Group.

Key Data Insights & Feedback 

• Data Quality & Gaps: Issues with underreporting (e.g., QOF data), survey bias, and lack of granularity (e.g., unique suicide attempts). 
• Research: Increased research is needed, including mixed methods approach to include both qualitative and quantitative research. Areas for research include causes of mental health issues in CYP and inequalities in service utilisation, treatment times between different cohorts, including males and females.  
• Children & Young People (CYP): Rising social, emotional and mental health needs, school attendance issues and CYP experiencing more emotional based school avoidance. Increasing numbers of CYP electing for home education and increasing numbers of CYP with SEND.  There are also concerns about data accuracy.  
• Adults: Need for clearer commentary on long-term mental health data, housing indicators, and GP-based service disparities. 
• Inequalities amongst priority groups: Further work is needed to identify inequalities among priority groups, the barriers to care and how these would be best addressed. Priority groups include but are not limited to: those who live within the most deprived 20%, Ethnic minorities, people with a learning disability, autistic people, people experiencing homelessness and drug and alcohol dependence. These groups should be informed by local data and include population groups experiencing poorer than average health access and/or outcomes.  
• General: Emphasis on using pre/post-COVID data comparisons, exploring additional data sources, and including self-harm and inpatient data.

Health Inequalities in Lincolnshire 

• Access Barriers: Geographic, cultural, and digital exclusion. 
• Social Determinants: Housing, age employment, education, and health literacy. 
• Underserved Groups: Traveller and agricultural communities, people with autism, and those with multiple conditions. 
• Approach: Shift from ‘tackling inequality’ to ‘increasing equality’ using asset-based and community-driven strategies.

Proportionate Service Delivery 

• Challenges: Inconsistency in what reasonable adjustments are offered to people to support engagement in support, workforce shortages, and lack of specialist skills. 
• Opportunities: Use of local expertise, valuing qualitative data, and learning from Mental Health Transformation innovations. 
• Risks: Larger ICB footprints may overlook local needs; pilot fatigue and short-termism risk longer term sustainable improvements to mental health.
  

National NHS Shifts & Local Implications 

Hospital to Community: 

• Community Mental Health Transformation model praised for innovation. 
• Need to reframe ‘acute’ focus for mental health in the Ten Year Plan to focusing more on the right support for the right person at the right time. 

Analogue to Digital: 

• Digital tools (e.g., portals, AI scheduling) show promise. 
• Can support improvements to patient engagement portal and patient initiated follow up technology. 
• Risks of digital exclusion and need for digital literacy support. 
• Need to manage risks that digital is used to make things easier for professionals and not patients. 

Treatment to Prevention: 

• Emphasis on long-term investment and outcomes. 
• Prevention must address current needs to reduce future demand. 
• Strong role for Voluntary, Community Faith and Social Enterprise Sector (VCFSE) in sustainable delivery, through Lincolnshire’s VCFSE Strategy. 
• Provision of community based psychological therapy and interventions through community older adult mental health teams is inequitable across Lincolnshire along with a lack of access to occupational therapy. This leads to an over-medicalised model and parity of provision with adult CMHTs is required to narrow this gap. Data by age range for access to all age services is required to better understand the equitable access for older adults to those services. 

Summary update on 2022 JSNA Next Steps 

• CYP: Progress made in prevention, early intervention, and eating disorder services. Some areas remain ongoing (e.g., trauma-informed practice, access expansion). 
• Transition: Ongoing collaboration between CYP and adult services; NICE guidance being followed. Some next steps were statements and not actions so have been removed. 
• Adults: Some progress made. Some initiatives complete (e.g., Suicide Prevention Strategy, SMI data baselines), others ongoing or impacted by national policy changes.

Those next steps which are still ongoing from the last time the JSNA commentary was published are maintained here for future review:

Children and Young People  

• Empowering parents, carers, and professionals working with children, to identify and respond to their emotional wellbeing and mental health concerns.
• Increasing and improving access to community-based emotional wellbeing, and high-quality, evidence-based, timely, mental health assessment and support.
• Avoiding unnecessary specialist and acute mental health related hospital admissions, particularly for children with LD or autism.  
• Continue to work with NHS England (NHSE) and local partners to support the implementation of national initiatives, and meet access and waiting time targets, in line with the NHS Long Term Plan. 
• Continue to roll out and embed MHSTs that provide support in education settings. 
• Implement and embed trauma informed practice to support children with the most complex needs as part of the Framework for Integrated Care (Community) programme. 
• Continue actioning recommendations related to children’s suicide prevention, augmenting the work of the Lincolnshire Strategic Suicide Prevention Steering Group, their SP action plan and the developing Lincolnshire Suicide Prevention Strategy (due in 2023). 

Transitions

• NICE guideline, Transition from children’s to adults’ services for young people using health or social care services [NG43], covers CYP, up to age 25, who are going through planned transition, including those with mental health problems, are disabled, or who are ‘looked after’. The guidelines define transition as the ‘purposeful and planned process of supporting young people to move from children’s to adult services’. The transition can be difficult, anxiety provoking, particularly in the context of broader cultural and developmental changes that surround young people growing into adulthood.  
• Improved support for transition to adulthood and adult services requires the work of CAMHS and Adult Mental Health Services, as recommended in the guidance [NICE]. 

Adults 

• To co-produce community assets for mental health and wellbeing – building resilience within and across the community and voluntary sector.  
• Review Mental Health Crisis, and Home Treatment Services; consider alternatives.  
• Work with stakeholders to test approaches to measuring rates of attempted suicide, and to develop effective signposting to suicide prevention support.

A new set of next steps from 2025 has been collectively identified via our MHDLDA Alliance focusing on four key aspirations as follows: 

Achieve national priority success measures as set out in the NHS Planning Guidance for 2025/26  

• Reduce average length of stay in adult acute mental health beds. 
• Increase the number of CYP accessing services to achieve the national ambition for 345,000 additional CYP aged 0–25 compared to 2019. 
• Reduce reliance on mental health inpatient care for people with a learning disability and people with autism, delivering a minimum 10% reduction. 

Focus on local delivery of the NHS Ten Year Plan in areas specific to mental health, including: 

• Support local development of more dedicated mental health emergency departments, to ensure patients get fast, same day access to specialist support in an appropriate setting. 
• Expand mental health support teams in schools and colleges and provide additional support for children and young people’s mental health through Young Futures Hubs.
• Support the work of reformed National Quality Board in developing its new quality strategy, as well as the development of modern service frameworks.
• Transform mental health services into 24/7 neighbourhood care models, improving assertive outreach care and treatment, with a focus on narrowing mental health inequalities. 

Ensure that the MHDLDA Strategic Development, Innovation and Integration Hub delivers the following workstreams to achieve meaningful impact on MHDLDA identified priorities and outcomes: 

• Contribute to new and existing Transformation Programmes in line with MHDLDA priorities and programme need, including development of the Local Mental Health Team Framework (to bring integrated place-based teams and community mental health teams closer together in local areas) and working through transitions – of age cohorts and across geographies. 
• Address Health Inequalities – using a Population Health Approach as a tool to ensure that we are able to address health and social inequalities that are congruent within MHDLDA and enable intelligence driven conversations and decision making. 
• Deliver an MHDLDA Primary Care Strategy – the continuing alignment and delivery of person-centred care requires a strong framework to be created and agreed to continue to embed new ways of working.  
• Deliver an MHDLDA VCFSE Strategy – continued investment into the VCFSE sector to ensure resilience and sustainability as we build and develop the infrastructure around the sector and create increased accessible opportunities for people within their communities. 
• Develop an Inclusive Digital Offer – identifying opportunities to utilise a needs led digital approach and addressing digital poverty and exclusion. 
• Co-production and Social Impact – development of a citizen offer that supports working with people to address cultural change pertaining to MHDLDA, embed self- efficacy, ensure the voice of people is integrated in a consistent way to ensure that we embrace personalisation and wellbeing. 
• Evaluation and Research Opportunities – build in evidence-based rigour to aspects of transformational delivery to ensure that we make best use of resources and basing decision making on continuous improvement and quality, reflecting social return on investment. 
• Housing and Accommodation – Work across the health and care system to ensure people with mental health and housing needs/barriers can be identified and supported earlier. 

 Deliver the Mental Health Priority Plans as set out in the Joint Local Health and Wellbeing Strategy for the Lincolnshire Annual Assurance Report 2024/25.