Effective involvement in services project
'Effective involvement in mental health services: the role of assertive outreach and the voluntary sector'
Introduction and aims
This research project focused on people with serious mental health problems who get labelled as 'hard to engage'. It looked at assertive outreach services provided by the National Health Service and other outreach services provided by the voluntary sector. The main focus was on the views of people using services and of those avoiding them. The study aimed to find out how services could make sure that people found them easy to access and use. It was run by Bristol Mind from 2005 to 2008.
Who took part?
64 service users and avoiders took part. This included 20 people using assertive outreach services, 12 people using voluntary sector outreach services and 15 people who had gone out of contact with mental health services. There was a focus on people from black and ethnic minority groups, including Gypsies and Travellers. 21 people from black and minority ethnic groups took part, 9 were from the Gypsy and Traveller communities. The study also included carers/supporters and staff.
The study managed to recruit and interview a large number of participants who were all supposed to be 'hard to engage'. This has created a full picture of what supports good connection with both NHS and voluntary sector outreach services.
How was it done?
This was a mainly qualitative study. Most people took part in in-depth interviews structured by a topic guide. Staff took part in group discussions. The conversations were recorded and typed up. What everyone said was listened to and analysed for common themes.
Who did the research and where was it done?
This was a research project led by people who had used mental health services. The study took place from 2005 - 2008 in Bath and North East Somerset, Bristol, North Somerset and South Gloucestershire. It was based at Bristol Mind and supported by the Big Lottery Fund. Following the research there was an implementation process, which aimed to improve services in the study area.
What did the study find out?
Despite being labelled as 'hard to engage', most participants wanted help focused on their own concerns. Building and maintaining relationships with staff was very important. Participants also wanted help with everyday life, including help with housing and money.
Many people liked outreach services
Participants described positive experiences with both assertive outreach and voluntary sector outreach staff. Outreach services were generally seen as better than other more conventional appointment-based services that participants had used in the past.
Areas for improvement
Access needs to be improved to specialist help for people with more complex needs. This includes increased access to mental health support and more joined-up care for people who have both mental health difficulties and drug and alcohol problems. In addition, there was insufficient access to decent housing with appropriate support.
What put people off services
Emphasis on prescribed medication for mental health problems put a lot of people off mental health services. Some found such services intrusive and controlling. Being forced to go to hospital, being forced to take medication and staying in hospital were often experiences that undermined participants' willingness to engage with statutory mental health services.
Follow up
The study made a number of recommendations for improvement, focused on staff, service providers, planners, policy makers and commissioners. The findings of the study have been shared widely with service users, service providers and commissioners. This included discussions of how some of the difficulties identified in working effectively for people with complex needs might be addressed. What came out of this process was written up in a separate report.
Project reports
"Effective involvement in mental health services: the role of assertive outreach and the voluntary sector"
- Summary report (pdf)
- Main Report (pdf)
- Background Information (pdf) this document provides all appendices referenced in the main report
Easy to read version of Gypsies, Travellers and Show People report (pdf, 3MB)
If you would like paper copies of the reports please email officecoordinator@bristolmind.org.uk
Contact details for the study
As this project is now completed there is no longer paid staff cover. Nonetheless, we will try to respond to any enquiries as soon as possible.
Rosie Davies
Bristol Mind
35 Old Market Street
Old Market
Bristol BS2 0EZ
Telephone: 0117 980 0370
officecoordinator@bristolmind.org.uk