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Building Community Well-Being
An Exploration of Themes and Issues

Appendix 1: Summary from local sites

Badenoch and Strathspey

Badenoch and Strathspey in Highland was chosen to ensure that the Capacity Building project incorporated a rural perspective. This area was not considered to have been over researched and was of additional interest in the light of the anticipated changes for local communities and in the local economy with the development of tourism and with the establishment of the National Park. The discussions with residents in Badenoch and Strathspey involved a wide range of community groups and local citizens.

Themes

These discussions covered the following key themes:

What is a community?

Participants identified primarily with communities at the most local level, and in Badenoch and Strathspey this involved the particularity of the place and its surrounding environment and geography. The very local and the personal were stressed as important throughout our discussions, primarily that local areas could not be 'managed' externally without some input from people at ground level who knew the area and the key issues affecting it. Throughout the discussions the overarching themes of rurality, remoteness and community spirit were threaded.

What is community well-being? Positives and barriers

People developed a comprehensive list of factors that they considered denoted community well-being. These factors were characterised by the following values of a thriving community.

• Safety and security
• Support
• Communication and community involvement
• Economic sustainability
• Equality
• Diversity

Barriers to achieving these goals of a thriving community were recognised as occurring in a number of spheres - at individual, organisational and societal levels. Examples of barriers included the following:

• Lack of choice across and between services; constrained by poor access to services
• Lack of opportunity and low aspiration
• Diversity of community needs/requirements
• Cynicism due to not feeling listened to and a lack of action after community requests

It was felt that barriers like these were not often recognised by single service providers or statutory bodies; and that different ways of working have to be developed to overcome them. There was a perception that rural areas such as Badenoch and Strathspey are often not well understood, appreciated or recognised by the Scottish Executive, and this in turn impacts upon policy development and implementation.

Badenoch and Strathspey now and in the future

When asked to rate Badenoch and Strathspey as a place to live, it was given an above average score. There was evident warmth towards the area from many, and a wish to uphold and improve quality of life for all in the local area. There was a feeling that quality of life had declined in the recent past; however, there was also a belief that action taken at the local level could have a significant effect in stemming this. There was significant enthusiasm when looking into the future about opportunities available to individuals and groups, and particularly about the resources that the area already has and that could be built upon.

Actions and responsibilities

At the stakeholder workshop participants worked through key actions and targets to achieve enhanced well-being and quality of life for all in the local community. People concentrated on five key themes developed in advance following the local discussions - services for younger people, housing and accommodation, local services and neighbourhood, work and money and economic sustainability.

Housing and accommodation

This topic was regarded by participants as of the highest importance and elicited a particular strength of feeling. Actions suggested included:

• Change in policy (including Local Authority support) to reinvest in affordable housing
• Financial incentives for first-time buyers
• Second home owners pay more Council Tax to help Councils find affordable housing
• Supported housing for people with special needs through joint working
• Alignment of funding cycles
• Council housing
• Council to have first refusal to buy back
• Limit the right to buy council houses and housing association houses
• Costs for buy back to be met in full by provider

Neighbourhoods and local services

Participants talked about quality, availability and access to public services such as:

• Shops
• Transport
• Leisure facilities
• Health and care

There was a particular emphasis on accessibility and choice. However, discussion around public services focused mainly on ability to be informed about service delivery, advice on appropriate choices and being involved in decision making about them. Issues mentioned included:

• Provision of appropriate information and communication and targeting to appropriate groups
• Involvement in decision making - particularly around Council priorities for spending and housing and leisure
• Support of individuals and groups to enable involvement in service provision - particularly carers
• Promotion of home care/independent living
• More transparent and meaningful engagement of local citizens in planning and decision making locally
• Co-location and integration of services with accessible transport
• Multi-disciplinary approach to domiciliary care
• Sustainable equality of opportunity for all local citizens
• Access to towns and services through robust transport systems
• parking availability
• innovative solutions to solve transport problems
• increase and maintain efficiency

Work and money

Participants spoke of opportunities for change through:

• Early intervention and support of the Credit Union to support debt problems
• Training and development to increase skills and opportunities, for example, an increase in apprenticeship and training schemes and raising awareness regarding mental health issues
• Improved employment opportunities
• Development of an employment strategy for the local area led by the Locality Planning Group and locality participation

Services for younger people

This particular group within the local community, that is 14-18 year olds, was perceived to have limited access to local services currently. Discussions focused on the following:

• A needs analysis is required to establish what young people really want and need
• Resources and funding for dedicated services
• Improved transport
• Creation of employment opportunities
• Retention of younger people remaining and working in the locality
• Support and incentives for those people who wish to set up activities for younger people, for example, child protection policies
• Changes in services need to be sustainable
• Standards and boundaries need to be set
• Local meetings for younger people more frequent
• Establishment of an internet café
• Leisure centre
• Clubs available at a reasonable cost
• Improved low cost transport
• Cinema
• Skate park
• Shared local database sharing information on younger peoples' services
• Better communication and advertising to support younger peoples' services
• Demonstration of joint working and pulling together
• Start increasing education training packages at a younger age group, staged to those who most need it
• Better links with/to national organisations that assist children and young people to work on their own issues and playing an equal part in contributing to the changes in their local area

Although many targets associated with actions were implicit and not spelled out by participants, targets which were suggested were both 'hard', quantitative performance indicators and more qualitative ones. For example, quality of life in an area would not just be defined by facts and figures about council services, but also the 'feel' of the area - stability, quality of environment and so on.

Economic sustainability

This theme came up consistently in all the discussions, where it centred around the economic vibrancy of Badenoch and Strathspey, and the need to promote it - through support for small businesses, lifelong learning, employment opportunities and so on. Specifically, participants mentioned:

• Promotion and support of economic activity of all levels/types - old and new industries/activities, supporting the small- and medium-sized businesses, promotion of an attractive environment generally; 'some of the old town centres are dying as some of the smaller local businesses are finding it hard to survive'
• Balancing economic development with the need to support sustainable communities, for example, recognising the distorting effects that the number of second homes have on community spirit, employment opportunities and affordable accommodation whilst supporting the part they have to play in local economic development
• Business support for community activities and education and training
• Badenoch and Strathspey to promote the area and act as advocate for local residents in the face of larger developments (e.g. the National Park)
• Lifelong learning - truly lifelong, increased access, better community facilities and choice

Increasing capacity to improve well-being

The stakeholder event discussed how the changes that had been identified as necessary to improve well-being could be taken forward at a local, Highland-wide or Scottish level.

Local level:
1. Robust needs assessment of employment issues

2. Collective agreement on addressing employment issues involving the following stakeholders:
a) Highland Council
b) NHS Highland
c) Locality Planning
d) Local Economic Forum
e) Local Enterprise Company
f) Local Business Association
g) Chamber of Commerce
h) Voluntary Sector
i) Community Safety
j) Community Learning
k) Other Agencies

3. Joint strategic plan to address employment and regeneration

4. External support to bring all relevant stakeholders together and openly negotiate agreed actions and support for implementation

Highland-wide level:
1. Secure capital funding for co-location
2. Integrate statutory and voluntary organisations
3. Change working practices, for example, increase job skills
4. Openness to change demonstrated
5. Establishment of joint appointments to support integrated working
6. Demonstrate an approach that is proactive rather than reactive
7. Demonstrate an approach that is less focused on bureaucracy and more focused on community involvement
8. Robust needs assessment of housing issues through liaison with housing associations, private developers and Council
9. Lobbying of interest groups, for example, carers for respite facilities
10. Funding to access good building practices

National level:
1. Political will to develop and ring fence affordable housing

Taking the work forward locally

Local citizens and the subsequent stakeholder workshop revealed a rich and diverse set of views, concerns and priorities for community well-being in the area. Outcomes were varied and included suggestions for improvement and development of services and policies, hopes and aspirations for the future, suggestions on ways of working, support for different groups and so on. Participation in the process differed between individuals and groups of people. Some views were conflicting or divergent. However, overall there was a clear sense of common ground, of a wish for Badenoch and Strathspey's communities to work together to achieve shared community goals.

Leading from this, three principal themes emerge for Highland Council to explore and develop. First, the key values and principles developed by participants (centring around housing and accommodation, carer support, communication and community involvement, leisure, equality and diversity) are seen by participants as interrelated. There is an expectation that they should thread through policy formation and the development of any future community strategy.

Secondly, the focal point of community for many participants is at the very local level. It was thought important that the proposed developments in services and policy that emerged from the capacity building discussions should be addressed at the level of local neighbourhoods, to enhance.

• Access and availability of local services
• Basic service provision, especially to vulnerable groups and
• Information provision on, and involvement in, service provision

Thirdly, participants held that that local delivery should go hand in hand with joined-up working between the council and other agencies (council, health, voluntary and community groups) at a local level, to prevent issues and groups of people 'falling through the net'. Such ways of working should include influential community voices, with support provided for this participation and commitment given to build capacity and confidence in local citizens to contribute to these new ways of working.

East End of Glasgow

Context

The East End of Glasgow was chosen as one of three case study areas for the project because it represents an inner city Social Inclusion Partnership area including a number of wards with the highest rate of worklessness in Scotland, particularly adults claiming sickness and disability benefits; we were aware of long-standing problems of fragmentation across services/sectors and weak leadership; and we concluded it was not one of the most heavily-researched areas of Glasgow.

Capacity building in the East End

Community organisations

A series of group discussions was conducted with participants from six community organisations, five based in different areas of the East End and one serving minority ethnic residents across the city:

• Bridgeton, Calton and Dalmarnock Credit Union
• East End Community Carers Centre
• Mental Health Network
• Dalmarnock Youth Project
• East End Men's Health Group
• Mel Milwap Centre
• A number of other groups were approached but were unable to participate in the time available

Service decision makers and other stakeholders

A preliminary meeting was held in June 2002 with interested organisations to discuss the scope of our work in the East End. It was hosted by East End Health Action and included participants from Social Work Services (Glasgow City Council), Greater Glasgow NHS Board (Mental Health) and East End SIP Health Strategy Group.

Following the community group discussions, a small number of in-depth interviews was conducted with senior staff from Greater Glasgow NHS Board, East End SIP and East End SIP Health Strategy Group.

Stakeholder workshop

A half-day workshop for stakeholders was held at Templeton Business Centre, Glasgow on 22 October 2002. Participants from Phases I and II took part, in addition to a number of others who had been approached at an earlier stage and were able to contribute to the workshop (including participants from Social Work Services, a Primary Care Trust and the Public Health Institute of Scotland).

Key issues for mental health and well-being in the East End

• Jobs: wider access to jobs with prospects; attract new businesses to the East End
• Housing: big investment in social housing stock needed, with proper management and repairs/maintenance; find better ways to address the problems caused by anti-social tenants; most investment should go into housing with back/front doors and gardens rather than more flats - helps encourage greater responsibility and sense of ownership; preference for an independent body like a co-operative to combine debt write-off with responsive management and protection of tenants' rights: but will the Glasgow Housing Association stock transfer really provide this?
• Health and diet: continue to raise awareness among children and families; enough money to afford healthier diets
• Education: greater access to college places from an earlier age; information on subjects that really interest people (dancing, games); invest in ethos and leadership in schools; more young people supported to go to FE/HE and become role models
• Good basic infrastructure: housing, transport, environment (e.g. action on vandalism caused by a minority), backed by successful organisations which are trusted, credible and effective; schools, shops and public buildings all giving people a sense of confidence in how they are run
• Greater awareness and understanding of mental health (public attitudes, health professionals, media reporting)
• User-friendly services: personalised approaches in statutory agencies
• Local networks and true partnerships with cooperation between groups of professionals (removal of jealousies)
• Full range of services and alternative therapies available (e.g. Mental Health Forum for the East End, Positive Mental Attitudes project, network of carers of people with mental health problems)
• Greater accessibility of services: e.g. having an interpreter in services, as well as teachers in English and other languages, regular GP outreach to day centres, addressing transport difficulties and the needs of people requiring daily medication; extended opening hours for support services/centres during evenings and weekends, outside office hours
• Facilities for young people: centre or group in each local area
• More localised access to leisure and shopping services, e.g. if can't use sports centre due to problem of gangs
• Financial support without a fight: knowing what you're entitled to and getting it; payment of expenses to volunteers recognising costs incurred
• Greater focus within support services, more and better activities: keeping busy, more classes, not wasting time, more games, more opportunities for gentle exercise
• More information: increases ability to cope
• Greater willingness to legislate: don't rely on voluntary approaches if something is really worth doing
• Build on success: extend capacity/remit of organisations with a proven track record rather than creating new ones from scratch (e.g. Healthy Living Centre)
• Leadership, representation and coordination: emphasis should be on overall responsibility for how the East End is faring, rather than parcelling out a large number of small grants to short-term projects; promoting the East End as a place to live; politicians at each level of government who are motivated to do a good job, instead of being sure of a job for life

Priorities for attention and action

Money and work

• Higher awareness and better information - how to get (back) into work without putting benefits at risk and being worse off
• Role of secure employment and Temporary Employment placements to ease step back into work
• Need a range of options to support moves into work: mainstream provision plus specialist projects and 'stepping stone' activity
• Aiming for financial independence
• Being able to stay in work: changing attitudes of employers
• Outreach to Incapacity Benefit claimants: approach tailored to needs, concerns and capacity; involvement of GPs in referral and role for money advice in health centres
• Review of how current and new resources are actually used
• Aspirations for work and careers developed through schools, further education and training, aiming for more than low-paid and low-skilled jobs; widening choices; bringing further education to community learning centres
• Recognising and valuing the skills gained through voluntary work: rewarding, satisfying, confidence-building
• Ambitions should no longer be suppressed - people should be encouraged to 'go for it'
• Leadership and vision for the East End around creating work opportunities and boosting household incomes

Improving neighbourhoods

Housing

• Involve local community in area regeneration
• Choice of housing stock
• Improvement to existing housing stock (where not ear-marked for demolition)
• Address anti-social attitudes and behaviour
• Challenge stigma

Shops

• Wider selection of shops at neighbourhood level
• Employing local people with early training
• Improving effective access (challenging territoriality)
• Support to community-based initiatives (e.g. Fruit and Veg Co-op)

Transport

• Align transport links to health services (e.g. getting to Stobhill Hospital)
• Developing community transport options
• Equality of transport access/mobility

Evidence of significant progress

• Feedback from local community (how should it be sought and given?)
• Match resources to community needs (housing investment)
• Improved access (number of people actually using services)
• Better ratings for self esteem, health and well-being
• Number and sustainability of community-based initiatives
• Number of local people trained and employed in new developments
• Increased range of shops in neighbourhoods
• Community transport initiative established and well used
• Support services for adults
• Realistic checks on cost of service user and carer involvement - e.g. providing personal support, facilities and amenities to enable preparation and taking part in meetings, to host meetings (take the initiative and make invitations rather than waiting to be asked), clerical support and development support
• Massive improvement in information availability and sharing
• Touch-screen technology to enable wider use of e-mail, etc.
• Alternative stress and other support services: out-of-hours access should be available
• Lack of vision from service providers and commissioners needs to be addressed

Evidence of significant progress

• Legislative changes introduced as soon as possible; development of support service for mental health service users
• Meaningful feedback from service users, themselves commissioned to gather feedback
• Visible signs of things having changed, e.g. projects at the local level to meet local needs (timing, accessibility, location)
• Action - not words that users cannot understand
• Realistic timescales: sense of urgency about action, with enough time to allow service users to provide feedback
• Services for children and young people
• Better training for people working with young people, i.e. confidence and capacity building
• Ownership - young people involved in identifying needs and shaping their services in ways they want to use
• Long-term planning: innovative services need to become mainstream and strategic
• Sharing of information and good practice, in order to avoid constant reinvention and enable transfer of good projects more widely
• Rising confidence levels among young people through better parenting skills (building on learning from the Starting Well demonstration project)
• Need greater support for parents of teenagers
• Expansion of mentoring projects in schools
• Truancy: Voluntary organisations are in a good position to help; statutory organisations and education providers need to recognise their skills and contribution through better partnership working

Evidence of significant progress

• Crime rates falling
• Delinquency and vandalism reduced
• Number of young people using services on the increase
• More young people in trades/apprenticeships and further/higher education
• Truancy down
• Numbers presenting to mental health services down because need is down

How can these changes be taken forward: locally, citywide, at Scottish level or beyond?

Stakeholder Workshop participants considered how to take action to achieve these goals at different levels:

• East End SIP strategic structures: ensure key ideas from today and earlier are fed in and become part of an action plan, with clear priorities
• Programme of ongoing consultation and training should develop skills of local people
• Ensure links are made to key city-wide structures, e.g. Glasgow Healthy City Partnership; Greater Glasgow NHS Board
• Networking of user forums
• Development of Mental Health Forum in East End
• Define what is 'local' (East End including Easterhouse, East End SIP, neighbourhoods within East End?) and build agreement on area for action
• Greater awareness of overlap and gaps in boundaries, e.g. Primary Care Trust, Council, Social Work Services, LHCC, etc.
• Identify who could make changes locally and city-wide (e.g. MHNGG) and improve communication between them
• Exchange of information and good practice (internationally)
• Make the process of learning and changing fun for all involved
• Make sure the challenge of tackling stigma is not confined to mental health service users: 'public service workers are people with feelings too'; avoid unhelpful stereotypes
• At a local level, we all have a responsibility as individuals to change our attitudes and perceptions
• Strategic responses are needed, avoiding individuals and groups working to further their own agendas
• Challenge stereotypes, especially perceptions of, and among, young people

Responsibility for change: who needs to be involved?

• Public service funders and staff: Greater Glasgow NHS Board; Primary Care Trusts; SIP Board and SIP Health Group; Social Work Department; Schools and Education Director (good quality material on mental health); Health Centres and GPs; City Council: Chief Executive and Councillors; Locality Panel; Police
• Voluntary and community support service staff; Arts Forum/Arts Team
• Housing associations and local businesses
• Communities Scotland, Jobcentre Plus
• Family members and service users, along with Mental Health Network Glasgow
• Government

East Renfrewshire New Community Schools

Background

New Community Schools (NCS) based in Thornliebank Primary School and Woodfarm High School in East Renfrewshire were chosen as one of the places to carry out the process of exploration and inquiry. The Integration Manager for the New Community Schools was a member of the Core Group for the Capacity Building project and she undertook to liaise with key members of staff and parents involved with the Schools in order to set up a series of discussions with young people and parents, teaching and support staff.

Discussions were held with:

• Parents of children at primary school
• Two groups of girls in S2 and S4
• Two groups of staff

Themes from discussions

The issues which sparked off most discussion in the group meetings included:

Safety

Parents were concerned about the safety of their children walking to and from school and going into town by themselves. Some do not allow 15 year olds to go by themselves into town. Parents take them in by car and both parents and young people have mobile phones to keep in touch with. Parents said that young people are not going out at night because they have nowhere to go and they get moved on by the police if they stand talking on the streets. When older people don't know the young people, they phone the police to complain and young people then begin to think:

'Been tarred with that brush, might as well behave like that.'

Bullying

Girls talked of how pupils make fun of others for things such as their appearance, the way they speak, being too good or not good enough at PE. They described going into class feeling happy then their feelings changing when the only people not laughing at them were their friends. The girls particularly disliked people who are two-faced - being a bully in school but 'pally' out of school. One girl described how she had been bullied in more than one school. To deal with bullies, one girl thought:

'You should get bullies in a group, ask them why they do it and how they think it feels'.

One girl, however, thought that bullies often know how it feels because they were once bullied themselves. The girls felt that they would like more support in class:

'Teachers should be more aware. They don't deal with bullying in class. If someone is being insulted, the teacher just says stop and does not follow up with the bullied person after.'

Discipline and respect

The girls thought it was important for teachers to deal with disturbances in class such as children throwing things. They also mentioned that teachers sometimes spoke to them in class in a disrespectful way, which they minded very much.

When they have done something they shouldn't, the girls said they did not like it if the teacher gets angry and shouts. They thought the teacher should just tell them what they have done wrong.

Ethos

The attitude of the school was seen as a key factor in the well-being of pupils. Staff groups emphasised the difference that staff who have aspirations for the pupils can make and contrasted this with an attitude in some schools of:

'Why bother, they aren't going to succeed anyway.'

Guidance and pastoral support

Emotional support for children is more often available at primary school than at secondary school. Secondary school is a larger and more anonymous environment, so that young people are not so clear who to go to for support. Guidance staff are available for only part of the day, as they also have responsibilities for teaching and for careers guidance as well as for pastoral support. The lack of pastoral support affects some children and young people more than others - schools tend to be structured for pupils without disruptive backgrounds. There are also gender issues in relation to guidance staff, as girls will often not go to men for support.

Staff talked about the difficulties of balancing pupils' need for support with the current focus on classroom activity and the curriculum. Attainment in school is seen as very important and pupils are tested frequently. Some pupils stay off when there are written tests. The focus on attainment is a pressure on young people. It also creates stress for teaching staff which has a knock-on effect on young people. Some participants thought that the new National Priorities provided a healthier focus for schools than the previous target-driven agenda.

Access to health services

Staff spoke movingly about young people's difficulties in accessing health services, especially:

• GP services

They acknowledged that, as young people don't go often to doctors, it is easy to think they don't have any health issues. However, young people do not always know how to talk to GPs about their own health concerns, having previously been accompanied by their parents/guardians.

• Child and adolescent mental health services

Children are not always seen when needed by Child and Family Clinics and the reasons given, it was felt, are sometimes inadequate. There are also problems with definitions of mental health problems in children and young people by staff working in Child and Adolescent Mental Health services. Some participants thought that support should focus on pre-school children who are having difficulties. By the time young people in S1, S2 and S3 show that they are having problems, it can be too late to help them effectively.

Main issues for mental health and well-being locally

• School as a power for positively influencing young people's well-being
• Young people's lack of confidence, lack of self esteem and poor body image
• Bullying and how to deal with it
• Guidance and pastoral support in school settings
• Support for parents in raising children of different ages, particularly young people over 12 years
• Gender issues, especially for girls
• The positive impact on mental health and well-being created locally by parents, children and young people participating in sports, drama and art.

Priorities for attention and action locally

• Recreation: the local need for more groups, clubs, play parks and other opportunities for out of school learning, development and enjoyment was raised by all groups and most strongly by parents
• Access to services, particularly specific mental health services but also access to primary care services and support for emotional and behavioural problems. This was raised by both young people and staff
• Personal and social development curriculum - this was raised by both staff and young people. There are opportunities for a consultation with young people to see how this topic might be used to provide information and advice for pupils on concerns identified by young people such as bullying
• Information management and confidentiality within the school system. This is a key issue for schools aiming to become a focus for all children's services as the information flow will only increase.

How can the work be taken forward?

1. The renewed Scottish Executive focus on the concept of the Health Promoting Schools provides an opportunity to embed the good practice established in these schools and to develop it across all schools in the authority. Much good practice has been developed in many schools in the area of physical well-being - these examples show how schools can practically promote emotional well-being.

2. New Community Schools (NCS) have provided new opportunities for agencies to work together with communities to bring about change. The mainstreaming of NCS provides an opening to take locally developed examples of good practice to a strategic level.

Livingston

Background

Livingston, a New Town in West Lothian, has experienced rapid population growth over the last 20 years. The town has a relatively young population profile, which brings particular issues and challenges for mental health and well-being improvement. Teenage pregnancy rates, and rises in the rates of homelessness among young people are relatively high compared to other parts of Scotland. West Lothian as a whole has been through periods of economic growth with a rapid shift from declining traditional industries to electronic and service industries. The area has experienced a number of large plants and factories closing down and although most people re-gain alternative employment, there is evidence of a lasting, underlying sense of insecurity. Many young people in West Lothian move from school to employment without training or further education.

Capacity Building in Livingston

The initial contact for the work in Livingston was the West Lothian Mental Health Improvement Group, which reports to the West Lothian Health and Lifelong Learning Management Group, chaired by a consultant in public health.

Groups who took part in the discussions included:

Community groups

People involved with the following community groups took part in the discussions:

• Gaalbaat, a health, fitness and beauty project for ethnic minority women
• West Lothian Advocacy Representatives
• Craigshill Neighbourhood Network
• Lay Health Training Initiative participants
• West Lothian Youth Action Project
• Barnardos

The discussion also involved staff who worked at ASDA WALMART

People working in services and interagency networks

• West Lothian Council Occupational Health
• West Lothian Council Health Development Team
• West Lothian Council Social Policy
• West Lothian Youth Housing and Support Team
• West Lothian Mental Health Promotion Group
• West Lothian Advocacy Project
• West Lothian Youth Action Project
• Social Inclusion Partnership Network
• Deans Community High School Integration Network
• Suicide Prevention Alliance

Key themes

The series of discussions considered what would be required to improving mental health and well-being in Livingston in the following areas:

• In the workplace
• In local communities
• In families
• Among young people

Local infrastructure

• Importance of effective local and regional transport networks that link communities and that work in the interests of local communities not of profit
• Need for meeting places and for information points
• Safety on streets remains a concern for many members of local communities. This relates to the divisions and the lack of trust between different communities/groups/generations and can be reinforced by persisting territorialism. There is a need to break down such divides and build bridges between generations
• A further factor would be to consider how the design of housing and the built environment can facilitate contact between generations

Recreational amenities

• There is scope to develop cycle paths and walkways. There needs to be more attention to how people can be encouraged to enjoy the natural environment as complement to the built environment of the town
• People often want family-friendly facilities and events, such as Gala days or fun days that can include the whole community. Livingston FC does not allow swearing in its stadium. Family season tickets are affordable compared with other clubs
• Places where families can do things together are reinforcing. 'You can't become a community if you do not interact as a community'

From the cradle to the grave

• Let's get away from the compartments to work across structures and across systems with individuals and communities. This needs a change in mindsets to adopt more person/family/community-centred approaches to strategy and service delivery. It may entail services and staff coming together in new forms of partnership to develop project teams that cut across agency and service boundaries. This would in turn require flexible funding to facilitate this and would also require that recruitment and professional development takes a different view of professional identity
• To work more holistically with communities requires better lateral communication within existing structures, supported by funding streams that are for whole communities
• There are lots of pockets of work going on, often relatively localised and small scale. With better co-ordination and communication these could achieve a lot more

Taking well-being seriously

• We all need to develop better understanding of our own emotional needs and those of other people who live, learn or work with us. This includes understanding the gamut of normal/natural experiences and reactions to life events and stressors and being able to recognise when help is needed
• It also implies an increased awareness of the emotional health and well-being of children from an early age, recognising that the emotional health and well-being of all members of our communities is a social responsibility

Priorities for attention and action

Arising from the series of discussions in Livingston with community groups, people working in services and those who took part in the Workshop, are a number of areas for action, to achieve improvement in mental health and well-being.

• Developing a stronger, shared vision of the direction for mental health improvement locally
• Improving communication and co-ordination of those services and workers already involved in mental health improvement
• Promoting greater awareness of mental health and well-being among key decision makers and among non-specialist staff in a range of settings
• Devising more effective ways of engaging with and promoting the participation and influence of young people
• Sharing and promoting good employment practices to support mental health in the workplace
• Pursuing community-led developments that enable communities to address the issues of concern to them
• Devising family-friendly public spaces and workplaces

For the Scottish Executive to do:

• Continue to provide a lead and to set out expectations for mental health and well-being improvement, giving legitimacy to local work
• Help to sustain commitment, by not overloading local areas with new initiatives but enabling them to follow through and consolidate what has been started
• Promote more, high-profile attention to mental health to disabuse public apprehensions and misunderstanding of mental health
• Give a lead in enabling local organisations and partnerships to have the courage to invest in long-term preventive work that will serve as an investment for mental and well-being in the future. The focus on well-being and emotional health has to start with children in their early years and even before birth and be carried through into adolescence and adulthood
• Establish mental health and well-being as a cross-departmental responsibility. This helps give a mandate to promote the local involvement of those sectors and organisations who need to be part of improving well-being

For local organisations to do:

• Public sector organisations need to think about the role they should be playing and the relationship that they need with local communities to foster mental health and well-being. Be able to demonstrate that the way you work with local communities has a positive impact on mental health and well-being
• Identify which groups or sets of people find public services least accessible and responsive to their requirements. Focus effort on overcoming the blocks that affect these groups
• Winning over those whose interest and endorsement is important locally to achieve mental health improvement is essential
• The Mental Health Promotion Group has a key role in seeking to influence priorities for development and to attract resources to achieve the outcomes desired for mental health improvement
• There is value in affirming and making more play of the work that is already happening to improve mental health and well-being. Improve communication and co-ordination among those organisations and agencies that are already working on this agenda. Develop the tools, resources, skills and knowledge base, ensuring that these are accessible and relevant
• There is also scope to tap into resources of all agencies, who bring skills and experience of different types to this work, from community education to community safety, from public transport to parks and recreational facilities
• Stop segmenting people's lives: a holistic, cradle-to-grave approach would involve family friendly policies, places and services. Focus on developments that are community centred, that build bridges and create links between generations

For professionals:

• Consider the way you work with, and relate to, local groups and local communities. Listen to them more and show you have heard what they say. Be clear with them about what you can do to respond and what you cannot do
• Promoting confidence and self esteem has to be a primary aim and key responsibility for all those working in public service in their relationships with the communities they serve
• Professionals need to look at their own mental health to identify sources of stresses and of support

For employers:

• Promote developments in the workplace that encourage flexible working patterns, that facilitate the work/home life balance and that ensure employees are listened to and respected

For opinion formers (media, politicians and decisions makers, schools, parents):

Culture and attitude change is needed to:

• Rehabilitate the image of young people
• Tackle the taboos associated with mental health and with emotions
• Enable people to appreciate difference and to have the imagination to 'stand in other people's shoes' and see things from others' perspectives

For local communities:

• Tap into the skills, resources, passion and energy that exists - use formal services to support and sustain what you want to achieve
• Use as your allies the services and resources that work respectfully with your community
• Be prepared to 'stick at it': change does come but takes time
• Ensure you know enough about how services work and where decisions are made, so that you have the best chance of having an impact and being heard where it matters

How the work is to be taken forward locally

The ideas and issues from the Capacity Building work have been fed back through the Mental Health Promotion Group. Work on developing a shared vision and identifying key action points will be taken forward in 2003, linking into the work of the Mental Health Promotion Group, the Suicide Prevention Alliance, the Social Inclusion Partnership and the Children's Services Management Group.

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