MH Cohort One : Individuals with smaller packages of care that are not changing in cost
Figure 26: Mental health cohort broken down by volume
The following section breaks down individuals with mental health conditions into three specific cohorts who share similar characteristics, namely: • MH Cohort One: Individuals with low levels of need whose package of care is not changing in cost • MH Cohort Two: Individuals with high levels of need whose packages of care are increasing slightly in cost • MH Cohort Three: Individuals with average levels of need whose packages of care are increasing significantly in cost To inform improvement activity and the prioritisation of effort, evidence is provided about the reasons why these different groups require social care support, the volumes of individuals receiving different types of social care support, and the costs associated, in addition to other factors such as age, gender, and levels of deprivation in the local area which may contribute to need and outcomes. Insight into the extent to which any of these factors are staying constant or changing is also provided. Figure 26 shows the way in which the overall group of individuals with mental health conditions is broken down into various specific cohorts, with individuals with smaller packages of care that are not changing in cost (cohort one) being the largest sub-group by far (64%). Figure 27 shows that this cohort accounts for 50% of expenditure.
Additional MH 3%
background shared support. She has built good relationships with the staff and other residents who she mentions are “helping [her] move on and
Kirsten is 42 years old, and has a history of anorexia, self-harm, OCD, and depression. She has been unwell since she was 11 and through her teenage years had several acute admissions. Despite her complex needs, Kirsten has a clear plan and is determined to build a positive future for herself. Kirsten has lived in supported living for the last three years with a low level of
MH Cohort Three 13%
MH Cohort One 64%
manage [her] anxieties”. She would like to work towards independent living through a recovery plan with her social worker.
MH Cohort Two 20%
What is known about this cohort:
Volumes
Based on the data analysed for this programme from the participating authorities, this cohort makes up the majority of individuals with a mental health condition, accounting for 64% of individuals and 50% of total mental health expenditure. Individuals aged 40–55 represent 24% of this group (the largest age group in this cohort) with a range across the remaining age groups. Although 18–25-year-olds are the smallest age group in this cohort, accounting for only 6%, they represent nearly twice as much of the total spend – 12% of expenditure on support for individuals with a mental health condition.
Figure 27: Mental health cohort broken down by spend
Demographics
Additional MH 1%
MH Cohort Three 12%
Expenditure The average weekly package cost of £434 per person has not changed over the past four years from 2020/21 to 2023/24 inclusive. 57% of individuals in this cohort have a weekly package cost under £300 . Support types The two most common support types for individuals in this cohort are homecare (26%) and supported living (25%).
MH Cohort One 50%
MH Cohort Two 36%
The proportion of working age and lifelong disabled individuals in this cohort ranged from 4.3% in one participating authority to 25.6% in another. Significant variation in cost is evident for individuals in this cohort. The average cost of packages of care for individuals in this cohort ranged from £317 per week in one participating authority to £1,382 in another.
Variation between authorities
How can improved outcomes be delivered for this cohort? Individuals in this cohort have a more stable package of care in comparison to a more variable care journey for other cohorts with a mental health condition. Evidence from within the sector suggests that this tends to be because individuals in this cohort – although they have poor mental health – do not experience a significantly increasing level of needs and therefore do not require an increase in support.
This does not necessarily mean however, that their level of need has decreased to a level below the adult social care support they receive. It has been found on average that 25-40% of individuals in this cohort would have more independent and sustainable outcomes if their needs were met through other services not unique to mental health provision, for example living in private or local authority housing instead of in supported living, or having support through a network of friends and family, local community groups, and/or charities rather than by a paid care staff worker.
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