PUBLIC HEALTH

There is a clear role for councils in helping to create mentally healthy places

An evaluation shows the Living Well UK programme for better mental health fills a gap for people needing help who bounce around the system, offering preventative early intervention support, says Dr Nick Webb.

At Innovation Unit, we're proud that our four-year National Lottery funded, Living Well UK programme has been shown to deliver significant mental health impacts for thousands of people.

Living Well systems for better mental health put people's strengths and lived experience at the centre of change and are designed to help people live well as part of their community. Nationally, despite many brilliant practitioners, too many people don't get help when and where they need it, leading to worse physical health, lost income, lower educational attainment, reduced quality of life and, for many, a much shorter life span. 

In Edinburgh, Luton, Salford and Tameside, we've supported people with lived experience, local authority social care and public health teams, third sector organisations, GPs and mental health trusts to co-design, test and scale new neighbourhood-based multidisciplinary teams. 

These teams combine clinical expertise with a range of social approaches, including mental health social work, social prescribing and peer working. In this way they are able to ‘see the whole person' and address wider social determinants. Housing, welfare rights and substance misuse services have all been critical here.

Our role has been to help citizens and professionals forge powerful shared vision for change; facilitate co-design, co-production, testing and scaling of new teams; support practice development and leadership; coach leaders, and build collaborative leadership between partners.

Despite Covid and the backdrop of increasingly strained health and social care systems, the brilliant local partners we have worked with have achieved impressive results. 

Our newly published evaluation report, from Cordis Bright, shows that between May 2019 and March 2022, almost 3,450 people accessed support. The report highlights how Living Well fills a gap for people who bounce around the system, offering preventative, early intervention support instead of leaving people on long waiting lists for services.

Within Living Well, average waiting times between referral and initial conversation were between 14 and 25 days - with people commenting that the short waiting time had been one of the most helpful aspects of the support they received.

The report found good evidence that the recovery-focused approach supports people to achieve positive outcomes and to make progress towards achieving personal goals. People experienced significantly improved mental health and increased ability to manage their own wellbeing. 

The report also notes how people have been helped to make their own choices through tailored support, with some returning to or gaining employment, claiming benefits, improving their housing situation or making social connections - some of the core elements of a mentally healthy and fulfilling life.

The benefits for practitioners have also been reported. It's not to say change hasn't been without challenge - creating new systems which are centred around people during a pandemic meant we had to think creatively as we shifted to online engagement and there's an acknowledgement that each site took time to understand and resolve cultural differences between professional groups and pathways.

Nonetheless, the report notes increased motivation and satisfaction in their work. In particular, peer workers and third sector staff were pleased to be part of a professional network with local NHS and statutory sector staff. Other colleagues appreciated the recovery-oriented approach and the chance to develop professional knowledge through sharing skills and expertise across agencies.

We're pleased we've achieved so much with some truly exceptional leaders and practitioners, and we're even more pleased this work continues to grow. Living Well is now influencing and supporting adult community mental health transformation across Derbyshire County, Greater Manchester and York, in line with the 2019 NHS England Community Mental Health Framework for Adults and Older Adults. 

In this way Living Well is supporting national NHS policy in England and Scotland to transform adult community mental health.

But genuinely transforming mental health outcomes requires renewed local authority leadership and visionary public mental health strategies that can combine the power of formal services with the innate caring capacity we all possess. 

Much of the agency and power of ordinary citizens to care for those in need is still untapped, despite the longstanding ‘civic core' of volunteers that we have relied on so much over the decades.

In the face of permacrisis, there is a clear role for local authorities to convene local partners around a problem that no one agency has yet solved or can solve alone - how to create mentally healthy neighbourhoods, towns and cities. 

In the New Year, Innovation Unit will publish a learning report so that everyone can benefit from what has been a remarkable programme. Contact us if you are looking for new solutions to improve community mental health and wellbeing in your area.

Dr Nick Webb is director of mental health innovation, Innovation Unit

nick.webb@innovationunit.org

@innovation_unit 

@drnwebb 

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