Adapting a social network intervention for use in secondary mental health services using a collaborative approach with service users, carers/supporters and health professionals in the United Kingdom.

BACKGROUND: Social integration, shared decision-making and personalised care are key elements of mental health and social care policy. Although these elements have been shown to improve service user and service-level outcomes, their translation into practice has been inconsistent and social isolation amongst service users persists. AIM: To co-adapt, with service users, carers/supporters and health professionals, a web-based social network intervention, GENIE™, for use in secondary mental health services. The intervention is designed to support social activity and preference discussions between mental healthcare professionals and service users as a means of connecting individuals to local resources. METHODS: In Phase 1 (LEARN), we completed two systematic reviews to synthesise the existing evidence relating to the i) effectiveness and ii) the implementation of social network interventions for people with mental health difficulties. We undertook semi-structured interviews with a convenience sample of 15 stakeholders previously involved in the implementation of the intervention in physical healthcare settings. Interviews were also conducted with 5 national key stakeholders in mental health (e.g., policy makers, commissioners, third sector leads) to explore wider implementation issues. In Phase 2 (ADAPT), we worked iteratively with eight service users, nine carers, six professionals/volunteers and our patient and public advisory group. We drew on a framework for experience-based co-design, consisting of a series of stakeholder consultation events, to discuss the use of the social network intervention, in mental health services. Participants also considered factors that could serve as enablers, barriers, and challenges to local implementation. RESULTS: Across the stakeholder groups there was broad agreement that the social network intervention had potential to be useful within mental health services. In terms of appropriate and effective implementation, such an intervention was predicted to work best within the care planning process, on discharge from hospital and within early intervention services. There were indications that the social connection mapping and needs assessment components were of most value and feasible to implement which points to the potential utility of a simplified version compared to the one used in this study. The training provided to facilitators was considered to be more important than their profession and there were indications that service users should be offered the opportunity to invite a carer, friend, or family member to join them in the intervention. CONCLUSION: The GENIE™ intervention has been co-adapted for use in mental health services and a plan for optimal implementation has been co-produced. The next phase of the programme of work is to design and implement a randomised controlled trial to evaluate clinical and cost effectiveness of a simplified version of the intervention.

"Traditionally you would be passing them from pillar to post": an evaluation exploring the Life Rooms model of partnership working.

BACKGROUND: NHS systems are under increasing, unsustainable pressure. In the context of rising demand, limited resources and changing population needs, partnership working across sectors is crucial. The Liverpool City Region has a richness of voluntary organisations and community based assets that the Life Rooms innovation draws upon to widen the base of health and wellbeing support. The Life Rooms therefore aims to facilitate the collaboration of NHS systems with arts, voluntary and community organisations in the local health economy. This evaluation explores the Life Rooms model of partnership working spread over in excess of one hundred partnerships with voluntary, community, and corporate sector organisations. METHODS: The evaluation drew on thematic analysis of semi-structured interviews with Life Rooms staff members (n = 10), partner organisations (n = 16), and users of the Life Rooms (n = 7). RESULTS: Five overarching themes were identified: Quality of partnerships; Benefits of partnership working; Facilitators; Challenges within the Life Rooms model; and Making things even better. CONCLUSIONS: One of the significant successes of the Life Rooms partnership working model is the way in which the service collaborates with a wide range of organisations with the aim of providing more effective and holistic support. The success of this approach illustrates how, led by NHS Trust innovation, multiple bodies can play a role in supporting health care by bringing unique skills, expertise and programmes together to ensure multiple options to support the multiple different aspects of people's health. These insights may be useful to other NHS organisations that may be considering a similar integration agenda.

Social prescribing for people with mental health needs living in disadvantaged communities: the Life Rooms model.

BACKGROUND: People live socially complex lives and have different health care needs influenced by socio-economic factors such as deprivation, unemployment, and poor housing. Lack of access to community based social care results in people seeking social support from health care services. This study explores the Life Rooms as a social prescribing model addressing the social determinants of mental health by providing support and access to resources in a local community setting. With an aim to identify key elements that contribute toward enhancing the effectiveness of the Life Rooms social prescribing approach. METHODS: Data were obtained through six semi-structured focus groups with mental health service users from two locations in the North West of the UK. Postcode data was collected to generate an Index for Multiple Deprivation (IMD) score, to understand their socio-economic background. Data were analysed using thematic analysis. RESULTS: A total of 18 participants took part in the study. The majority of participants came from disadvantaged backgrounds; 14 participants measuring 3 and below in terms of overall IMD scores and 9 participants belonged to the poorest decile (IMD score = 1). Participants reported on different elements of the Life Rooms which they found as an effective approach to care. Four main themes emerged from the data: 1) social belonging: being able to just 'be' 2) resourceful and accessible; 3) social inclusion and connectedness; and 4) moving forward: self-development and independence. CONCLUSION: Findings support the need and benefit social prescribing to improve mental health wellbeing and reduce the burden of mental illness.