Mental Health Crisis reimagined: We have the evidence to change the approach
4-minute read
A common refrain
Long waiting times, due to insufficient resources (both human and financial), have exacerbated symptoms of mental health for so many already in need. This lack of accessibility to essential mental health services calls for more cost-effective, community-based options, which can cater for greater numbers.
The cost-of-living crisis and the ripple effects of the pandemic mean that the number of those seeking support continues to grow.
A remedy?
There are benefits of community-based mental health services over clinical one-to-one support in meeting this need: they facilitate early treatment and rehabilitation. Moreover, they have shown to improve users’ satisfaction, better engagement with treatment and even preventing a sense of stigma or shame.
Community-based supported living services are one such example of community-based support that moves support away from a clinical setting. They provide time-limited independent, but supported, living arrangements for people experiencing mental health conditions. One organisation, KeyRing, has developed this idea further by creating networks of local community supports through their supported living provision. The support consists of ‘10 or more ordinary homes located within walking distance of each other’.
The aim is to enable members of the initiative to regain their independence and control over their lives. This is achievable through the assistance provided by community volunteers who also live in these supported housing schemes, while remaining well-connected to their local community. Numerous evaluation studies have proven the cost-effectiveness and success of these programmes–a 30% drop in members attending a psychiatric inpatient admission and 25% no longer needing regular visits or support from community psychiatric nurses or social workers.
There are community services that respond to individuals who are in a crisis by ‘assessing their immediate circumstances and providing short-term distraction, safety or in-the-moment support’. Such therapeutic communities are designed for short stays, allowing participants to undertake either individual or group-based therapy as part of their rehabilitation programmes. Marian, an ex-service user of these centres, has described the staff as being “completely accessible” and that it felt more of a “club than a centre.”
“Coming to the therapy, to community, and coming to an environment where people do care about you, and they tell you they care about you and they show you they care about you, has been quite a different experience to many of the different hospitals I’ve been in.”
Championing the benefits of community care
Community-based settings enable people experiencing mental health issues to meet fellow peers and connect over shared lived experiences regularly and over an extensive period of time. Peer support isn’t about fixing or diagnosing, instead it is about listening and creating a safer space, trying to explore solutions that can help others in looking towards the future and moving forward in the long-term. This is notably different to clinical supports, particularly for individuals with less severe mental health conditions.
Another advantage of community-based supports is that they can also be a great way for individuals to try out peer support first, before assessing whether they need further specialist medical help or a diagnosis. Studies show the highly cost-effective nature of such programmes, not least that more individuals can be supported per session. According to research across 6 studies analysing the cost of a Peer Supporter compared to the use of a psychiatric hospital bed, the average benefit to cost ratio was nearly 4:1 in favour of employing a Peer Supporter.
Further research conducted by a mental health charity in the north-west of Scotland revealed that people using their services (and their family and friends) comprehensively feel that crisis support should be more readily accessible, offer immediate response and be located close to people’s homes or communities. Moreover, these crisis support services should also be face-to-face with another person who can listen, reassure and offer swift, direct, and appropriate help.
Community support groups are not and should not be framed as a substitute for professional help for people with complex mental health needs. They are, however, a resource that can offer most people struggling with their mental health something unique: connection and the certainty that they are not alone.
All this goes to show that as a sector, community mental health provision is ready, experienced and evidenced in offering care options far beyond that of only hospital aftercare. It’s not only more cost-effective but, crucially, preferred by service users. That is why it makes so much sense to use community provision as the first step in the recovery process rather than the last.
With mental health making headline news stories and discussions about how to allocate mental health funding, now is the time to ‘bang the drum’ louder than ever for community-based supports and making this change of approach happen.
At Habitus, we have helped develop and design successful peer support and community programmes for various charities, health organisations and businesses both in the UK and internationally.
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