For commissioners and policy makers
1. Recognise that simple, social interventions can have a big impact on mental wellbeing
The big lesson from Target: Wellbeing is that these types of projects have a particularly big impact on mental wellbeing. We’ve seen our beneficiaries report positive mental health outcomes across the board and we have collected case studies demonstrating that getting involved in our projects has had a major impact on people with serious mental health conditions. Previous research into community wellbeing projects has identified that improving mental health is often a necessary precursor for adopting a healthier lifestyle.
It is important that any serious attempt to tackle poor levels of mental health in the UK considers positive social activity as part of the treatment mix. Social activity also needs to be focused at a broader group than just the mentally ill in order to gain the full benefits of people with different levels of skills, confidence and life experience coming together within their community.
2. View wellbeing projects as a vital step towards employment
Projects such as those developed by Target: Wellbeing are highly effective at building confidence levels, personal efficacy and social networks. These are vital precursors to successful engagement in mainstream employment support, and ones which many people with mental health conditions lack. The government-commissioned report into evidence relating to mental health and work states “People with severe mental illness who do not believe they are ready for paid employment should... have access to meaningful occupation such as voluntary work... of a nature that builds work skills and confidence.”
Referral to community wellbeing schemes, especially those which offer forms of progression through volunteering, could be an effective way of providing a realistic pathway towards sustainable employment.
3. Value community assets
Some of our projects are based around valued local assets – both environmental such as parks and allotments and buildings, such as community centres. These assets are often at the centre of a network of skills and knowledge created over decades and that capacity has helped our projects to be successful. When such an asset vanishes or is radically scaled back, it is likely to have a huge knock-on effect locally. We welcome the increasing focus on asset-based approaches in many local wellbeing strategies.
4. Commission projects that address multiple strands of wellbeing
We have found that projects focused on physical activity also benefit mental wellbeing and encourage healthy eating despite not being designed to do so. This mirrors other research by the Big Lottery Fund. It may be most effective to commission projects which address multiple strands of wellbeing, since these are likely to lead to lifestyle changes and create a positive self-reinforcing cycle of improved wellbeing.
5. Fund longer term initiatives
The longevity of Target: Wellbeing has allowed greater learning, investment in interventions and a level of financial stability for delivery organisations while considerable change took place outside the portfolio. To some extent we have been able to refine our ideas and therefore be more effective. We would recommend to funders such as the Big Lottery Fund that future programmes are designed with long-term (five years+) funding, but with an initial pilot phase that tests models of delivery before final commissioning.
6. Accept that nothing is free
We’ve come to understand that projects will require ongoing funding whether that’s Vvolunteers athat require ongoing support and training or target beneficiaries that cannot afford to pay for valued services. crucial to success of these type of projects.
Many of our projects have examined co-payment as an option but have found it would not be viable because of the limited disposable income of the target group.
7. Stick to the principles of intelligent commissioning
Small local voluntary-sector projects are often best funded through grants and cannot compete with organisations with deeper pockets. For example, the introduction of personal budgets is challenging to many organisations as they are not able to take the financial risk of being unable to fully cover their costs.
Commissioners need to stick to the principles of intelligent commissioning and ensure that services are procured using a variety of funding models and approaches including grants where appropriate.
8. Be clear on how to measure impact
There is widespread confusion within the third sector organisations that we have worked with about the best way of measuring the impact of this type of project.
Commissioners should be clearer about the standard of evidence required and help develop the capability of providers to meet those standards. This nuturing will help ensure a diverse supply chain of providers.
9. Cutting local community projects is a false economy
While almost all of our projects will continue in some form, the majority will do so with reduced capacity to make an impact. The continued pressure on local authority budgets makes this type of project vulnerable to austerity measures. This is a false economy given costs of treating poor mental health.
In England alone, mental illness costs over £105.2 billion a year, through the costs of medical or social care, and production output losses. It is estimated that 35 per cent of those with depression and 51 per cent of those with anxiety disorders are not in contact with services. If those people were to improve their conditions and reduce their days of sickness or return to the labour market the reduction in lost employment costs should outweigh treatment costs.
Our projects’ boost to mental wellbeing costs around £90 per outcome on average.
10. A portfolio approach can create added value
Research has shown that working collectively within this type of initiative improves the performance of providers. A portfolio model allows greater learning and flexibility within a programme. Funders and Commissioners should invest in the strategic management of networks of
providers as this increases skills and capacity locally.
For delivery organisations
1. Volunteers are vital to success
In many projects we have seen the crucial role played by volunteers in adding value to projects. Volunteering has allowed beneficiaries to develop their skills and provide a progression pathway towards employment, and creating a network of volunteers can help sustain some level of activity during times when funding is reduced. Organisations should ensure that volunteers are properly supported and trained and that funding strategies take account of this resource requirement.
2. Understand the marketplace
Our less successful projects have usually failed to hit their outcome targets due to poor planning in the early stages. Enthusiastic staff and excellent delivery can fall flat if improperly targeted and many organisations need to better understand the market when planning their interventions. This means understanding current service provision, local need, and designing projects that will meet that need in a format that is accessible and communicable to the target audience.
3. Get a robust evidence base
Providers need to be better at systematic evidence gathering. Robust data collection is challenging in community settings but we need to be able to demonstrate sustained behaviour change. Groundwork believes that we can create a wellbeing return on investment model and we hope to work with other organisations in developing this in the future.
Read the full Impact Report (PDF)