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Building Community Well-Being
An Exploration of Themes and Issues
1. Introduction
The project on Capacity Building for Mental Health Improvement was undertaken as an early part of the Scottish Executive's National Programme for Improving Mental Health and Well-being. The project was developed and carried out by three organisations in partnership: Scottish Development Centre for Mental Health (SDC), who led the work, Scottish Council Foundation (SCF) and the Office for Public Management (OPM).
Purpose and aims
The Capacity Building project was designed to find out:
- What people understand by the terms mental health and well-being (and other terms e.g. positive mental health)
- What activities/projects/initiatives people are currently involved in, to improve mental health and well-being in their local areas and communities
- Who is involved in working to improve mental health and well-being (agencies, services, networks, community groups, etc.)
- What the capacity is for local areas and communities to take forward this work in the context of the national programme
- Possible priorities for change and future action to enhance existing capacity and to improve mental health and well-being
The project's overarching purpose was to lay the foundations and create greater readiness for change and action within the national programme and beyond, at both local and national level, to improve mental health and well-being. The core aims are set out below:
Developing the vision and achieving better understanding of what is required
To explore the expectations and aspirations that people have for themselves and for those around them:
- What do people consider to be the main influences on mental health and well-being (both risk and protective factors)?
- What should be the priorities for future action?
Charting the ground to identify what is in place
To ensure that work in this area is grounded in an understanding of what is currently in place that can be built on:
- What is the range of activity already going on, that is contributing to the improvement of mental health and well-being?
- Who is involved in work in this arena?
Assessing capacity for change and action
To establish the capacity needed to support and sustain change of the order required to improve well-being, acknowledging that this may include developing new ways of working as well as building on existing approaches:
- What components make up the 'toolkit' of values, attitudes, beliefs and behaviours required to support work in this arena?
- What models of partnership between individuals, communities, and organisations can facilitate action and change to improve mental health and well-being?
- What are the respective roles of individuals, communities, organisations and government in promoting and protecting mental health and well-being and how do these roles inter-relate?
- What capacity is there currently within local areas, networks, partnerships and communities to contribute to the improvement of mental health and well-being?
- What else might be required?
Approach
The design of the Capacity Building project set out to incorporate the following key features:
- To work in a number of local areas to generate materials and ideas of wider relevance and application
- To create opportunity for dialogue and discussion that had the potential to be both exploratory and challenging
- Giving added value, not just conducting yet more consultation with 'the usual suspects'
- A desire to gather insights and ideas as an iterative process, engaging with local issues and opportunities to ensure relevance and aiming for the co-production of local agendas for action
Choice of areas
To ensure that the project was able to generate ideas and learning that had wider currency and application, the sites selected included:
- an inner city area - the East End of Glasgow
- a freestanding town - Livingston in West Lothian
- a rural area - Badenoch and Strathspey in Highland
In addition to these three geographical areas, work was also undertaken in a New Community School in East Renfrewshire.
Method
The project entailed a series of layered discussions in each of the sites. In the three geographic sites, discussions included:
1. Community groups and networks
2. Services providers
3. A large event involving all stakeholders
In the school site, discussions were held with pupils, support staff and parents. The work was carried out using a common methodology which was shaped differently in each site, to ensure fit with local structures and processes.
Details are given in an appendix of the themes explored and of the range of groups and services included. Separate reports are available providing an account of the work in each of the four sites. A broad range of groups and services took part in the discussions and in the stakeholder events. The project set out to take a whole population approach. In selecting groups to take part, several considerations were taken into account:
- Ensuring a spread of age ranges
- Using what is known about risk and protective factors that impact on mental health and well-being to identify key life stages of critical importance
- Incorporating a range of settings where people live, work, learn and interact
Core group
The project was informed by a Core Group whose role was to bring to bear experience of, and knowledge about, activities and interventions relating to mental health improvement. The Core Group was built into the Capacity Building project to advise on the initial selection of settings and refinement of the approach and, more importantly, to contribute ideas and insights on the themes emerging from the local area work. Membership of the Group was drawn from a range of sectors and disciplines ( see Appendix 2 for details).
Reflections on the process
The Capacity Building project was able to create a space for people to explore issues in some depth and provided opportunity and structure for dialogue and debate. In some sites and with some groups this was very positively received as a chance for people to reflect, explore and generate ideas and solutions outside of more formal structures. The project managed to engage in the process a broad range of age groups and people with a variety of experiences.
However, it was not able to reach people who were not part of community groups and networks. Further, the local discussions were less well received by those whose previous experience of consultation exercises had engendered disappointment and frustration.
The Core Group proved to bring considerable value to the project. This Group met three times between March and October 2002, bringing together a cross section of people who would not ordinarily have had opportunity for discussion. The Group found considerable common ground but also had a function in challenging assumptions. Informal feedback from those who participated in the Core Group indicated the perceived benefit of space for reflection and to explore ideas. It was considered a rarity to be able to take time to talk without being driven by requirements of task completion. This was consonant with the benefits some people described that flowed from the project work in local areas.
Structure of the report
This overview report draws on the rich information that was gathered in the course of the project from the many different discussions in the four sites. It begins with a consideration of the factors that were perceived to influence mental health and well-being and then goes on to highlight the changes that would be required to achieve improvement in mental health and well-being. The next section explores issues of responsibility in the following spheres: public services, schools, employment and economic development, civic society and policy/decision making.
There then follows a discussion about capacity which draws attention to the features of interventions which have a positive impact on mental health and well-being and the features of organisations and networks that facilitate improvement in mental health and well-being. This also includes consideration of the capacity and capability needed at national level. The concluding section presents a set of measures to gauge success and track change in a range of settings: in communities, in work and employment, in interventions with children and young people, in the activities of support services.
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