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Building Community Well-Being
An Exploration of Themes and Issues
5. Building capacity for mental health improvement
One of the core aims of the project was to consider the capacity required to achieve improvement in mental health and well-being. Capacity is not only about numbers of services and professionals. It is also about creating environments that promote progress, that ensure people survive and enable them to thrive. Capacity is used here to denote the skills, values, beliefs and behaviours that were identified as important for work in this arena. This section examines working practices and organisational practices before moving on to consider the capacity required at national level to guide and sustain mental health and well-being improvement.
Features of activity and interventions which have a positive impact on mental health and well-being
Discussions in many settings explored with participants the qualities and features which were considered effective in achieving improvement in mental health and well-being:
- Interventions that encourage self belief and reinforce capacity for self help/peer support
- Making people feel at ease, taking their concerns seriously, not 'fobbing people off'
- Creating a sense of hope and promise that is grounded (not unrealistic), gives people reasons to look ahead and believe that change is possible - managing money problems, taking action collectively on things which affect the health of the local community
- Focus on developing and valuing skills, in a wide range of settings not only in formal education and employment
- Recognising the value of social contact and company
- Flexibility and adaptability of response to match individual requirements
Features of organisations and networks that facilitate improvement in mental health and well-being
- Flat not hierarchical; localised presence not remote or centralised
- Demonstrable interest in people as individuals and in specific communities, as indicated by an understanding of the values, beliefs and traditions that matter to individuals and communities
- Relationships characterised by respect and trust; assumption of self efficacy of individuals, recognition of importance of peer support and social connectedness
- Ability to reflect and learn from past actions and behaviours
- Leadership and co-ordination within local areas and communities
- Funding streams that enable longer term investment in prevention and promotion, accepting the slow learning curve, being prepared to wait for results
- Geared to adopt more participative approaches, with support from senior level, reflected in measures of performance and of audit and inspection, e.g. peer review, community-led audit
- Feedback loops are essential in processes of consultation and dialogue with communities, to ensure transparency, to promote openness about how and why decisions are made
- Professional training that prepares and supports workers to interact with individuals, families and communities in ways that promote confidence and build capacity, that enable co-creation of solutions and that value relationships.
- Being open to uncertainty, recognising what we do not know for now but may come to know later
- Facility to work across traditional boundaries, take risks, hold on to the outcomes desired, build cross sectoral alliances - think and act out "of the box"
- Ensuring co-ordination and continuity of support to pick up on difficulties early, respond and refer on as required - connections between and within services where pressure points and risks for individuals are most acute
National capacity and capability
Participants were able to identify what was needed at national level, from the Scottish Executive, to guide and sustain work on improving mental health and well-being:
- Clarity and simplicity in policy landscape to indicate what really matters. The current agenda is perceived as too complex, and the pace too frenetic by those 'on the ground'
- Raising awareness across sectors and across Government Departments that mental health and well-being is everyone's concern
- Upstream investment and staying power
- Shift of focus from what works to why, how, and under what conditions
- Be prepared to legislate for things which are important - relying on voluntary approaches may not achieve the outcomes wanted
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