Readers of my previous blog celebrating the extension and additional funding for Named Social Worker Pilots will already be aware of the Innovation Unit and their collaboration with SCIE as together they work to distil the learning thus far from the project.
Finding new and effective ways to support those living with mental health issues, autism and dementia is part of our brief as social workers. It’s part of Nick Webb’s too - he’s the Innovation Unit’s lead for mental health and he’s kindly agreed to share his team’s insights on ways to significantly improve the way we respond to mental ill health.
Nick: "We need to do two things.
First, we need to nurture everyone’s sense of identity, connection, purpose and enjoyment, because good mental health is not simply the absence of illness, but the presence of these things.
Second, we need to grow our ability to understand and support people who are struggling.
The default response when people are unwell is to refer them to statutory services that are generally only offered over the short term, and overwhelmingly deficit based (just as in physical health, help is provided when things have gone wrong).
This is curious because we know there are deep-rooted problems with those services, including: high or inconsistent thresholds, fragmentation and duplication, discontinuity of care, dispassionate care, doubtful efficacy, and, ultimately, poor outcomes.
Focusing on professional services obscures opportunities for improving outcomes that are created when people, families and communities are supported to collectively ‘hold onto’ and nurture their own mental health.
This is why Innovation Unit continues to be inspired by the work of the Lambeth Living Well Collaborative. Lambeth’s vision is a new system for mobilising the power of lived experience, community assets, resources and networks of support that can help people stay well, and by doing so, keep people out of statutory services (in the last two years Lambeth has reduced referrals to secondary care by +40%).
Focusing on ‘assets’ instead of ‘deficits’ is important, but risks idealising communities. People often become unwell because their networks and communities can’t sustain them. Innovation Unit’s work with Derbyshire County Council to build the coaching skills of local residents in Derbyshire offers a new approach to building skills and capacity for support.
Finland’s well-known Open Dialogue is a patient-centred model that allows clinicians, social workers, peer support workers and family members to work together on an equal footing to support someone in crisis.
It challenges traditional, two-way clinician-patient relationships, is associated with impressive outcomes and is now being introduced in a number of mental health trusts in England.
Our aspiration should be a ‘retooling’ of professionals so that they can work side by side with citizens and ‘service users’, exercising power in partnership, combining their different wisdom, compassion and skills in ways that develop our ability to look after ourselves and each other and deliver a more sustainable statutory sector.
Happily, we are witnessing a growing number of other initiatives in the UK that are dissolving the unhelpful barrier between professionals and everyone else. Norfolk and Suffolk’s Wellbeing Service is delivered by a multi-sector partnership and has clinicians and peer workers working in the same teams to provide the right person-centred care (clinical and social) at the right time.
There is an opportunity to make sure that social workers are part of these models. Within our work with Wigan Council to develop an asset-based model of children’s social care, we see real appetite for putting social workers at the heart of collaborative decision-making and shared risk taking alongside young people and their families, key workers, residential staff and clinical psychologists.
In Wigan, this will mean honoring social workers’ long standing role in supporting people through their experiences, and helping them to benefit from the strongest relationships in their lives.
The best solutions in mental health do something simple; they substitute professional hierarchy and rivalry for compassionate care. What really counts when times are tough is how we are supported to rebuild a sense of ourselves, and return to things that help us feel more connected, purposeful and fulfilled. Professionals and services can’t do this on their own."
Nick Webb is Innovation Unit’s lead for mental health. Innovation Unit is a social enterprise that grows new solutions for complex social challenges.