The perinatal period is usually defined as the time between conceiving a baby and one to two years after giving birth. About one in every five women experience mental health problems during this time, making this a relatively common experience. Women may experience mental health problems prior to pregnancy and/or develop mental health problems during pregnancy or in the postnatal period.
At Healthy London Partnership we want to shift from focusing on treatment of mental health issues to prevention and helping Londoners stay emotionally, mentally and physically well at all ages. When care is required we want people to be able to easily access services and be treated promptly. We want mental and physical health needs to both be met and to ensure individuals experience high quality integrated and seamless care across all settings. Through this we aspire to eliminate the inequality in life expectancy of those with serious mental illness.
Fast-Track Cities is an international initiative to end new cases of HIV by 2030. Over 200 cities across the world are part of this movement to get to zero new cases of HIV, zero preventable deaths, zero stigma and discrimination and a better quality of life for people living with HIV.
London has already made great strides towards achieving the United Nations (UN) targets for the Fast-Track Cities initiative. In 2016, for the first time in London, all the UN’s 90:90:90 targets were met. London is only the third city to achieve this target so far – joining Amsterdam and Melbourne. We have now reached:
95% of people living with HIV infection diagnosed
98% of people diagnosed receiving treatment
97% of people receiving treatment being virally suppressed.
Why is this initiative important?
HIV remains an important problem in London, with the infection impacting on Londoners more than any other part of the UK.
In 2020, there were 955 new cases of HIV, with an estimated 35,966 people living with HIV in London – almost 40 per cent of all those in the UK. Of these new cases, 349 of new diagnoses were reported among gay and bisexual and other men who have sex with men, 324 cases were among men and women who reported heterosexual sex as their probable route of infection, 14 cases were among people who inject drugs, 257 cases were among people with an undetermined exposure group and the remaining 11 were through pregnancy.
Recently, London has seen a significant fall in people newly diagnosed HIV positive, particularly in men who have sex with men. However, this fall is neither uniform across all population groups nor in all areas of the city, and rates of late diagnosis, although showing improvement, remain stubbornly high at 35 per cent. Late diagnosis significantly impacts people who are who are disproportionately affected by HIV like African, Afro-Caribbean and migrant women, trans women, gay men living with HIV who are also migrant men, men of colour and men who don’t have English as a first language.
People diagnosed late are at increased risk of developing an AIDS-defining illness and continue to have a more than 7-fold increased risk of death in the year following their diagnosis. The rate of one year mortality was 31 per 1,000 among those diagnosed late compared to 4 per 1,000 among those diagnosed promptly.
What are the challenges?
For many Londoners HIV remains a stigmatising condition that negatively impacts on quality of life. Late and undiagnosed infection rates in London remain unacceptably high (34 per cent and 10 per cent respectively) and with considerable geographical variability across the city. Prevalence varies by ethnicity and by place of residence, with disproportionately high rates among black and ethnic minority (BAME) communities in poorer areas of the city.
The Mayor and representatives from NHS England, UK Health Security Agency and Office for Health Improvement and Disparities (formerly Public Health England) and London Councils, have committed to work with partners to:
Continue work to exceed the UN’s 90:90:90 HIV targets (90 per cent of people living with HIV knowing their status, 90 per cent of people with diagnosed HIV on treatment, 90 per cent of people on treatment with suppressed viral loads)
End new HIV infections in the capital by 2030
Put a stop to HIV-related stigma and discrimination
Stop preventable deaths from HIV-related causes
Work to improve the health, quality of life and well-being of people living with HIV across the capital
The next steps for the capital include delivering the action plan developed with all the partners and the HIV community, working with the support of the Fast-Track Cities London leadership group. The action plan is a roadmap, which outlines how London will reach the Fast-Track City targets.
London also has a Fast-Track Cities dashboard through which all cities report their progress against the initiative’s targets as well as locally set objectives and goals.
The Mayor has made tackling the stigma attached to living with HIV a key priority in his Health Inequalities Strategy. Not only is it important to ensure those living with HIV can live their lives without discrimination, but the fear of stigma can be a barrier to early diagnosis, which in turn negatively impacts the quality of life of those living with the condition.
Signing up to the Fast-Track Cities initiative will bring together all those already working to tackle HIV across the capital. More joint working will help to ensure that communities affected by HIV can access the prevention, testing, treatment and support they need.
We are supporting the Mayor of London’s new citywide movement to improve mental health and wellbeing in the capital. Thrive LDN aims to encourage Londoners to step up to tackle mental health so that every person in London can live happier, healthier lives.
Everyone who lives and works in London is invited to join the movement and take action on mental health and wellbeing to make London the happiest, healthiest city in the world.
About Thrive LDN
Thrive LDN is supported by the Mayor of London and led by the London Health Board, in partnership with Greater London Authority, Healthy London Partnership, NHS England (London Region), Public Health England (London Region) and London Councils.
The movement brings together health and care leaders, residents, businesses and community and voluntary organisations to improve mental health and wellbeing in the capital.
More than two million Londoners experience some form of poor mental health every year and report a lower level of life satisfaction and self-worth than the national average. Almost 10% of children and young people living in the capital aged between five and 16 experience a mental health issue and every week two Londoners take their own lives.
In 2017, Thrive LDN launched six aspirations for the capital. These include ambitions to make London a ‘Zero Suicide’ city, the development of training for youth organisations and student societies to help improve wellbeing in young people, and the development of a new programme to raise awareness of mental health and challenge stigma and discrimination.
Since March 2020, Thrive LDN has been coordinating the public mental health response to and recovery from the coronavirus (COVID-19) pandemic in London on behalf of the Strategic Coordination Group, Public Health England London, and wider partners.
Between April 2020 and March 2021, more than 685,000 people have taken part in projects, events and activities which the citywide movement has led or collaborated on. Just some of the activities outlined in the report include funding grassroots organisations, suicide prevention training, mental health first aid training, online webinars, sudden bereavement support, and a World Mental Health Day Festival co-developed with young Londoners.
Thrive LDN’s progress report, published on Thursday, 18 March 2021, sets out what Thrive LDN and partners have done to listen to the experiences of people whose voices are too often ignored, and respond with resources to help manage what for many Londoners has been the toughest year of their lives.
In September 2019, to mark World Suicide Prevention Day, a citywide Zero Suicide London campaign was launched by the Mayor of London, Sadiq Khan, to encourage Londoners to access free, online suicide prevention training.
Since then, more than a quarter of a million people across the capital have completed the training as part of the #ZeroSuicideLDN campaign.