How do we take collective responsibility for our mental wellbeing?
Good mental health matters to everyone. It has a deep and profound impact on our quality of life and life outcomes, and is essential if people, communities and places are to flourish. A thriving society is one in which the mental health of everyone, however challenging, is nurtured, understood and accepted.
But despite living at a time of unprecedented focus, energy, investment and creativity in the world of mental health services and support, our collective mental health is getting worse, and many people don’t get the right help when they need it.
¾ of people
with mental health problems receive no support at all
Only 14% of adults
feel they are provided with the right response when in crisis
Over ½ of parents
with children in mental health hospitals say they have not improved and 24% say they are worse
1 in 4 girls
has depression by the time they hit 14
NHS services are often fragmented, difficult to navigate and disempowering. Staff are struggling to keep up with demand, which is being driven by complex social and cultural forces. Support is often narrowly clinical and medical, and doesn’t engage holistically with the wider determinants of health.
Statutory resources are focused on responding to mental ill health and crisis, rather than preventatively securing mental good health. High thresholds and strict eligibility criteria stop people getting help until they are very unwell.
At the same time, there is under investment in primary and community-based solutions that have the potential to open up access, manage demand more effectively, improve outcomes and drive down cost.
Specialist, well-trained professionals are only part of the answer. We need to shift investment towards primary and community-based models and build the capacity of people and communities to manage their own and other people’s mental health over the life course.
We want all communities to embrace and nurture everyone’s mental health. This means
- Communities where there is common ownership of mental health – so that people and professionals work together on an equal footing to make sense of, and respond to, mental health problems.
- Mental health (good or ‘bad’) is understood as a source of inspiration, growth and expression – so that people become deeply self-aware about their own mental health and skilled in using their personal struggles as opportunities for growth and change.
- Professional services, when needed, provide compassionate and genuinely person centred care – so that people feel listened to and are supported to recover well.
NEW SOLUTIONS WE WANT TO DEVELOP
Professionals and citizens side by side – services and support in which expertise, insights and perspectives from professionals, service users and their carers are combined to offer more compassionate and holistic responses to distress.
Example: Open Dialogue, a patient-centred model that allows clinicians, support workers (including peer support workers) and family members to work together on an equal footing to support someone in crisis. It fundamentally challenges traditional, two-way clinician-patient relationships.
Citizens as leaders and innovators – citizen-led movements in which people ‘own’ responsibility for each others’ well being, not always passing it on to trained professionals.
Example: Torbay Lion’s Barber Collective, an international collection of top barbers using the special trust between hairdresser and customer to engage men about their mental health. An example of innovations that come from, and are given life by, the everyday environments in which people ordinarily live, work, buy, share and socialise.
Whole system redesign – designing and building new interlinking organisations, refocusing investment in early intervention, prevention and community solutions and actively modelling positive human values of compassion, inclusion, recovery and therapeutic optimism.
Example: Trieste, in north-east Italy, almost magically re-engineering its entire approach to mental health, blurring the distinction between crisis and community care, achieving great results at lower cost and creating a vibrant culture of collective ownership of everyone’s mental health.
HELPING SYSTEM-LEVEL INNOVATIONS FLOURISH
Lambeth CCG and Council are in the process of establishing a new Living Well Network Alliance – an intensive partnership of commissioners and providers who will oversee continued transformation in the way that adult mental health services are delivered in the borough.
Between October and December 2017, Innovation Unit completed work with Lambeth’s Alliance partners to support service transformation in three priority areas:
- Build an integrated and stronger ‘front door’ to mental health services
- Improve targeted, specialist care coordination for people who need more intense, medium-term support
- Improve rapid response support, especially out of hours and alternatives to bed admission
We brought together stakeholders, including people with lived experience, in a series of design group workshops to enable Lambeth colleagues to imagine ideal future approaches to these priority areas.
EXPLORING OPPORTUNITIES TO GROW AND ADAPT INNOVATIONS
We want to support the development of new solutions and help spread tried and tested innovations to new places. We are experts in models that have proven impact on outcomes and cost.
Specific areas of interest include:
- Supporting system transformation that increases investment in primary and community services.
- Developing partnerships to co-design new solutions for children and young people that work below the threshold of CAMHS services.
- Scaling proven models for suicide prevention.
- Improving university mental health.
- Running leadership programmes that support talented senior leaders to deliver change and innovation in their localities.