The Community Navigator Study: Results from a feasibility randomised controlled trial of a programme to reduce loneliness for people with complex anxiety or depression

Lloyd‐Evans, Brynmor; Frerichs, Johanna; Stefanidou, Theodora; Bone, Jessica K.; Pinfold, Vanessa; Billings, Jo; Barber, Nick; Chhapia, Anjie; Chipp, Beverley; Henderson, Rob; Shah, Prisha; Shorten, Anna; Giorgalli, Maria; Terhune, James; Jones, Rebecca

doi:10.1371/journal.pone.0233535

Cited by 36 publications

(47 citation statements)

References 27 publications

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“…There are a number of interventions that are thought to have the potential to affect the number or quality of social relationships which might be particularly worth investigating; these include Interpersonal Psychotherapy, 39 Dynamic Interpersonal Therapy, 40 and work with Community Navigators. 41 Further, future studies might investigate the impact of offering more regular reviews and more intensive treatments to those reporting a severe lack of social support, in order to mitigate the risk of poor prognosis.…”

Section: Implications and Conclusionmentioning

confidence: 99%

Is social support pre‐treatment associated with prognosis for adults with depression in primary care?

Buckman

O’Driscoll

Cohen

et al. 2021

Acta Psychiatr Scand

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Section: Implications and Conclusionmentioning

confidence: 99%

Is social support pre‐treatment associated with prognosis for adults with depression in primary care?

Buckman

O’Driscoll

Cohen

et al. 2021

Acta Psychiatr Scand

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“…This paper explores the views of programme participants: we acknowledge that other stakeholders, including the Community navigators, and involved family and mental health staff, might also have useful perspectives on factors influencing participation in the programme. A summary of stakeholders’ views on the acceptability of the programme has been reported elsewhere [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…The study involved three phases: development of the programme using a co-production approach [ 27 ]; preliminary testing of the programme with ten service users with severe depression and/or anxiety on the caseload of one of two community mental health teams; and a feasibility trial of the programme involving 40 service users from the same community teams. A full description of the Community Navigator programme [ 26 ], and results of the feasibility trial have been published [ 28 ].…”

Section: Methodsmentioning

confidence: 99%

Influences on participation in a programme addressing loneliness among people with depression and anxiety: findings from the Community Navigator Study

Frerichs

Billings²,

Barber

et al. 2020

BMC Psychiatry

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Background Loneliness is associated with negative outcomes, including increased mortality and is common among people with mental health problems. This qualitative study, which was carried out as part of a feasibility trial, aimed to understand what enables and hinders people with severe depression and/or anxiety under the care of secondary mental health services in the United Kingdom to participate in the Community Navigator programme, and make progress with feelings of depression, anxiety and loneliness. The programme consisted of up to ten meetings with a Community Navigator and three optional group sessions. Methods Semi-structured interviews were carried out with participants (n = 19) shortly after programme completion. A co-produced two-stage qualitative approach, involving narrative and reflexive thematic analysis, was undertaken by members of the study’s working group, which included experts by experience, clinicians and researchers. Results The narrative analysis showed that individuals have varied goals, hold mixed feelings about meeting other people and define progress differently. From the thematic analysis, six themes were identified that explained facilitators and challenges to participating in the programme: desire to connect with others; individual social confidence; finding something meaningful to do; the accessibility of resources locally; the timing of the programme; and the participant’s relationship with the Community Navigator. Conclusions We found that people with severe depression and/or anxiety supported by secondary mental health services may want to address feelings of loneliness but find it emotionally effortful to do so and a major personal challenge. This emotional effort, which manifests in individuals differently, can make it hard for participants to engage with a loneliness programme, though it was through facing personal challenges that a significant sense of achievement was felt. Factors at the individual, interpersonal and structural level, that enable or hinder an individual’s participation should be identified early, so that people are able to make the best use out of the Community Navigator or other similar programmes.

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“…The study involved three phases: development of the programme using a co-production approach (24); preliminary testing of the programme with ten service users with severe depression and/or anxiety on the caseload of one of two community mental health teams; and a feasibility trial of the programme involving 40 service users from the same community teams. A full description of the Community Navigator programme, and methodological details of the feasibility trial are reported in the published protocol (23); results of the feasibility trial have also been published (25).…”

Section: The Community Navigator Studymentioning

confidence: 99%

“…This paper explores the views of programme participants: we acknowledge that other stakeholders, including the Community navigators, and involved family and mental health staff, might also have useful perspectives on factors in uencing participation in the programme. A summary of stakeholders' views on the acceptability of the programme has been reported elsewhere (25).…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Influences on participation in a programme addressing loneliness among people with depression and anxiety: findings from the Community Navigator Study

Frerichs

Billings

Barber

et al. 2020

Preprint

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Background Loneliness is common among people with mental health problems and is associated with depression, anxiety and poorer recovery. In the absence of an existing evidence-based intervention, the Community Navigator programme was developed to help reduce loneliness among people with severe depression and/or anxiety using secondary mental health services. This paper presents a co-produced qualitative analysis of the factors that appear to influence participation in this programme. Methods The programme consisted of up to ten meetings with a Community Navigator and three optional group sessions. It was assessed using a feasibility trial. Semi-structured interviews were carried out with participants (N = 19) shortly after programme completion, by a researcher with experience of depression and anxiety. A two-stage qualitative approach to analysis was undertaken by members of the study’s co-production working group, which included service users, clinicians and researchers, using both a narrative analysis of three interviews to produce case studies as well as a thematic analysis of all nineteen interviews. Results From our case study analysis, it was clear how hard it was for participants to work with their feelings of loneliness. Six themes from the thematic analysis were identified to explain both motivation to and barriers towards participation in the programme, which relate to individual and structural factors: desire to connect with others or not; finding meaningful things to do; individual’s social confidence, particularly in group settings; accessibility of resources locally both in terms of practical considerations and financial cost; timing of the programme including in relation to people’s mental health; and, relationship with the Community Navigator. Conclusions We found that people with severe depression and/or anxiety supported by secondary mental health services may want to address feelings of loneliness but are aware of the emotional effort this entails. Interventions to address loneliness should be developed that consider the factors that enable and hinder participation and seek to build into their programmes the necessary support structures to address what may be a major personal challenge.

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The Community Navigator Study: Results from a feasibility randomised controlled trial of a programme to reduce loneliness for people with complex anxiety or depression

Cited by 36 publications

References 27 publications

Is social support pre‐treatment associated with prognosis for adults with depression in primary care?

Is social support pre‐treatment associated with prognosis for adults with depression in primary care?

Influences on participation in a programme addressing loneliness among people with depression and anxiety: findings from the Community Navigator Study

Influences on participation in a programme addressing loneliness among people with depression and anxiety: findings from the Community Navigator Study

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