Over the past four years, we’ve been creating new systems of community mental health in Living Well sites across the UK including Edinburgh, Salford and Tameside and Glossop. So far the programme has supported some 2,500 people who might not otherwise have been helped and generated over five million pounds of additional investment in local mental health systems.
Our story, however, starts 10 years ago when our team worked in partnership with Lambeth, south London, to build the pioneering Living Well approach.
Here we helped establish the initial collaborative group, supported them to develop and implement their radical vision for mental health - and here we started our own learning about the complex, sometimes messy, human experience of transformation.
In this blog, Living Well senior practice lead, Stacey Hemphill, reflects on her experience of, and learning from, transformation.
Being the new kid on the block
When I applied for the job as Triage Worker in the initial ‘go live’ team Lambeth’s Living Well Network Hub, I was hungry to do more to address the systemic problems I could not just see, but feel on a daily basis.
We began as a small fringe initiative with big strategic aspirations - we were the new kids on the block. We were given some permission to work in new ways whilst carrying high expectations for the wider system. We took our learning on the road - sharing our successes and failures. It was great to have an opportunity to talk about change and we felt that we were spreading a sense of hope.
Becoming the lightning rod for the conflict in the system
Challenging the system has its risks. As our vision and learning was increasingly shared across the system, it began to uncover a powerful, but seemingly dangerous idea, that there is more than one way to support people with their mental health. We stopped being simply a curiosity and became a threat - particularly when we started to draw resources away from traditional community mental health team offers.
Learning from Lambeth
Our experience of Lambeth led to our partnership with The National Lottery Community Fund to support sites across the UK to begin their Living Well journey. We have taken what we learned from Lambeth into our sites, creating ways of working that enable others in the system to accept these ‘new kids on the block’ as allies in a wider process of change and to recognise the need for leaders to support people through processes of adaption and integration.
Here are five ideas to build positive relationships throughout the process of transformation, recognising that the human experience needs as much attention as the process itself:
Build bridges not walls Cults and cliques feel safe and protected and let you get on with building your version of the world. But any ‘us’ deepens a sense of ‘them’. People need to feel part of the change to own it and take responsibility for it - an experience we heard in our storybook ‘Working for Something Better’ which captured practitioners’ stories of change. In sharing her story, Wendy, Chief Executive of Health in Mind, Edinburgh, described equality of voice and valuing all contributions as being “so important in bringing the different strengths, skills and experiences from each of the organisations involved.”
Tolerate hostility Those who do the work lead change - and change is often met with hostility as it challenges people’s status and identity. This can come from all parts of the system - from those receiving support, to strategic decision makers. Hostility needs to be met with humility and empathy - a point echoed by Trudy, Luton Live Well Network Coordinator: “Regardless of our backgrounds it's about how we can work together to help this person. It’s really important we have trust and respect for each other.”
Don’t think you are the only game in town It’s easy to slip into the mindset that our new practice is the best thing since sliced bread and that our way of working is the right and only way everyone should work. This mindset is experienced by others as telling them ‘they are no good and they don’t matter’. Instead our role must be to champion autonomy, diversity and creativity. Reflecting on the shared experience of different organisations prototyping a new service, Linda, Strategic Programme Manager for Mental Health and Wellbeing, Edinburgh said: “It’s given me a greater understanding of change management. It’s given me an opportunity to develop good peer relationships with people outside of my immediate surroundings.”
You are never the finished article You are never a 10/10. Being defensive about how great you are will only ever exclude people. Telling yourself you are a 2/10 can be motivating and energising. Always striving to learn and develop creates an invitation for people to join you in this learning. It creates a space for people to see themselves in as part of your shared endeavour. As Judd, Assistant Director, Integrated Commissioning in Salford, explained: “I might be in this role, I might be leading it, but I’m not the expert in this.”
Pace yourself As your new practice starts to demonstrate potential, the demand for you to scale at pace grows. Growing too fast, too soon is one of the greatest mistakes to make. Taking a stepped and paced approach enables you to grow, whilst embedding your new ways of working into the wider system. As Wendy reflected: “There were days when we came away thinking ‘this machine is too big it will never change. I can’t hold the responsibility of making this difference’. Other days we’re all in the same boat and it feels like we can do this!”
Experiencing the benefits The experience of transformation might be challenging but, as Linda explained, the emerging benefits of change: “... really inspired me to keep going and it really validated a lot of the pain that we had been through. All the endless governance I had to do, writing papers, etc. Ok, so it was all worth it!" “Seeing what it’s been like - really powerful quotes from staff. For example ‘This is why I went into nursing or occupational therapy in the first place …’ and ‘I’m looking forward to coming to work in the morning’.”
If you’d like to talk to us about Living Well, including developing a programme in your area, then please email lwuk@innovationunit.org and we’d be delighted to start a conversation.
Living Well UK Programme is funded by The National Lottery Community Fund, the largest funder of community activity in the UK.
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