Mental Health in Lambeth. Making it Different and Better -19th & 20th July 2011

“We need to go right back to the basics and ask ourselves about our relationships”.

“The health service is a bit of a dinosaur. It’s used to telling people what do and being the one that knows”.

“We’re coming just to the very brow of the hill, and we can almost see over the top, and what’s waiting for us on the other side of the hill – although it might not be funded properly – what will happen will be a really exciting time. Good things are on the way.”

These are just a few quotes captured from people who attended the recent 2 day event, ‘Mental Health in Lambeth. Making it different and better’. Organised by the Lambeth Living Well Collaborative, people who use Lambeth’s mental health support services, their carers, professionals and staff from a variety of support services came together to help shape the future of Lambeth’s mental health support services. Co production in action, in Lambeth, hoping to start making things different and better in mental health.

So what happened?
Prototyping, a process normally found in the design industry, has been picked up by The Collaborative as a quick, hands on approach that allows us to get to grips with what changes might work and what we perhaps should steer clear of. 

On day one, we prototyped how our future support systems could work differently to nurture more immediate positive outcomes for people who use support services and their carers, like social inclusion, active citizenship and being seen as assets rather than a set of needs. Supported by trained actors, groups used real life situations that will soon be common place – like GPs having more social support responsibilities or services being led by the people who use them – to think about, act out and film new working relationships, ideas for change and possible outcomes.

From the prototypes, we put together a few emerging themes to shape the way ahead.
They included:

  • The need to understand the future of Lambeth’s relationship with mental health as a whole system approach
  • The challenge of supporting what are often considered to be low-level mental health needs
  • Putting ‘user-focused’, ‘everyday goals’ at the centre of support work
  • Seeing social networks as rich sources of support, but then the challenge of adopting them in everyday support work
  • Using a disruptive change to the way people are supported as a way of sparking innovation in mental health support

Reshaping the system
Many people see mental health support having followed a well trodden path for some time now – a national strategy is announced by central government, local commissioners devise some new services, service managers tell the front line staff how to make it happen and service users and carers might have a quick chance to tell us what they think of the new service design before they start using it.

During the next session, participants had a chance to turn the system on it’s head and tell us how it should be. By thinking about what’s working and what’s not working, the following ideas seemed to be central to reshaping the system to take account of real lived experience:

  • We need to visualize the system starting with the person who uses it
  • Every part of Lambeth has a role to play in supporting peoples’ mental health needs
  • We need to stop focusing on risk so much
  • The system needs to work faster
  • The system needs to be flatter (less heirachical) and work with everyone involved from the very start: from people who use the system, to the people who tell us about a strategy that’s thought to be the next big thing.

Reshaping the system wasn’t so straightforward though – one person’s new idea for change was another’s headache and vice a versa. Which leads us nicely onto day 2…

Challenges & Opportunities
We wanted to delve a little deeper into what needs to happen to effect real change in Lambeth, finding out through further group work from the perspectives of people using services, how we might get over ‘the brow of the hill’.

Having shelved our current support systems for a moment, groups set about looking outside the box and exploring what assets everyday people have across Lambeth that have been largely missed until now – from the people wanting support, to the people in their communities, and from universal services to private businesses. A lot was on offer, and considering concepts like peer support and timebanking, the groups were asked to consider what challenges and opportunities there were to link these assets to more formal support. Here are some of the headlines:


The Road Map Ahead: now, next and wow!
Both in the lead up to the event and on the days, people were concerned that the Collaborative’s efforts aren’t just well meant. So to help put weight behind the aims and goals of the Collabrative, we’re developing a roadmap to develop a clearer sense of where we’re going with all this and how we’re going to get there.

The fina

l group session on day two helped us to start thinking about what the roadmap will need to take account of. Each group was asked to to think about how things can and should be different, from what could realistically happen today, tomorrow, and then some real blue sky thinking!

Below are the themes that will help shape the roadmap:

  • The over-arching theme was one of ‘ordinariness’ – we need fully personalised support that offers support for every area of my life and values the notion of ‘wellbeing’ rather than health or ill-health
  • Moving from ‘now’ to ‘WOW!’ requires workers to have permission to do things differently – to listen to what people say they need and not be tied to agendas and protocol. This includes an open and positive approach to risk
  • Agencies and workers need to be able to work more closely together and for red tape and bureaucracy to be challenged. This might also be about merging services and support and enabling a ‘one stop shop’ approach to support
  • All of this means that people need to be supported and encouraged to use natural and peer support, to offer their skills and knowledge to support others and to really think about if and when they need paid support

So in a nutshell, there were some radical ideas, ideas that have been around for a while but struggling to find momentum and many seeds for ideas that are yet to be thought of. And that’s where we hope you’ll join in.

Please email Natalie.Sutherland@lambethpct.nhs.uk if your keen to lend your time and ideas to connect, experience, build and plan with the Lambeth Living Well Collaborative.

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