What are the barriers to, and enablers of, working with people with lived experience of mental illness amongst community and voluntary sector organisations? A qualitative study

Abstract

There is increasing emphasis on psychological and social approaches to managing and treating mental illness, including a growing evidence base on the effectiveness of communitybased social interventions including arts and heritage activities, library programmes, volunteering schemes, nature-based activities and community groups. However, there is a gap in understanding of what the barriers to, and enablers of, working with individuals with mental illness might be for the community and voluntary sector. A qualitative approach was used involving focus groups with non-profit organisations delivering social activities within communities across the United Kingdom. Behaviour Change Theory, the COMB model and the Theoretical Domains Framework, were employed as the theoretical framework, to develop interventions to address the barriers raised. Representatives of the organisations reported being motivated by the mental health needs of others, and by seeing the benefits of participation. Further motivations included expanding inclusion, and economic motivation to ensure sustainability. Strengths identified included offering innovative, responsive services that were distinct from conventional mental health services. Running these services demanded new and potentially challenging skills, such as understanding statutory responsibilities, and being able to train and support staff. Further challenges included maintaining boundaries between their roles as community organisations and clients' mental health needs and avoiding burnout. Ability to deliver this work was enhanced by support of peer organisations and opportunities to share practice. However, funding was often short term, and complex to obtain, which could destabilise organisations' sustainability. Lack of transparency around the process, differences in language between the community and health sectors, and confusion around commissioning pathways undermined the potential opportunity offered by social prescribing policy. Interventions to address these barriers were identified, including long term funding to support core costs, training on engaging with the commissioning process, around mental health support and safeguarding, and developing mentoring schemes and local cooperatives of organisations for developing partnerships with the health sector.

The impact of peer support work on the mental health of peer support specialists

“…Many PSS in our study believed that the ability to reflect upon their experiences of supporting their clients was essential. Our finding echoes those identified in studies seeking to identify strategies to improve the implementation of peer support programmes in the mental health sector [ 38 ]. Perhaps, introducing mentorship schemes could also serve to support this reflexivity as more senior PSS could serve as clinical supervisors for new PSS [ 26 ].…”

“I’ll meet you at our bench”: adaptation, innovation and resilience among VCSE organisations who supported marginalised and minoritised communities during the Covid-19 pandemic in Northern England – a qualitative focus group study

“…Whilst terminology can vary, here we draw on Buck et al [ 37 ], who define ‘lived experience’ as direct personal experience of a social issue/issues. Other studies have highlighted both the impact and importance of lived experience within the VCSE sector [ 38 , 39 ]. Whilst we are within broad agreement with this, our findings illustrate the potential for experiences, impacts and challenges to re-trigger or exacerbate existing hardship, emotional scars or trauma, a field of study which warrants further attention post-lockdown [ 37 , 40 , 41 ].…”

Comparisons of home-based arts engagement across three national lockdowns during the COVID-19 pandemic in England

“…In addition, while increases in online artforms emerged during the pandemic had made the arts more accessible, digital illiteracy and unequal access to reliable internet might have created additional barriers for some demographic groups. These changes have been shown to have affected factors relating to individual capabilities, opportunities and motivations, all of which have previously been shown to associate with individual characteristics such as mental health and age [23][24][25][26].…”