StobsWELLbeing

StobsWELLbeing is the name of the Equally Well test site in Dundee. The project is focused on improving community wellbeing and includes a mental health literacy programme, community picnics in the local park, a social prescribing pilot and community outreach work. 

What are the aims and objectives?

StobsWELLbeing endeavours for people to experience fewer inequalities and have better mental wellbeing.  The test site also aims to influence relevant local and national policies and service provision. 

The test site aims to ensure that:

• Actions are focused on raising the awareness of inequalities, within the context of how people live, ensuring people are placed at the heart of the approach.
• Focus is placed on taking a community development approach.
• Local services are well equipped to talk about mental health and wellbeing.
• Community engagement processes bring benefits for local people and service delivery.
• Existing working relationships are improved and enhanced. 

 

Why was the project set up? How has the approach changed over time?

The Equally Well report, published in June 2008 by the Scottish Government’s Ministerial Task Force on Health Inequalities, was followed by a national implementation plan. Dundee was successful in being chosen by the Government as one of eight test sites across Scotland linked to Equally Well priorities. Equally Well advocates tackling health inequalities by addressing the wider determinants of health and wellbeing as well as making improvements in health care services and treatment. The Dundee Equally Well Core Group recommended the area of Stobswell as the test site community for city.

“No matter how big a project is it won’t cut it.  We need services to change.”

The work of the test site began in November 2008 and was funded until the end of March 2012. The StobsWELLbeing proposal built on detailed discussions on mental wellbeing that had taken place over a number of years in Dundee with a broad range of local and strategic partners. Test site status was seen as an opportunity to enhance and capture local aspirations to focus more closely on community mental health and wellbeing.

Who are the participants and the partners?

Located in the Stobswell area of Dundee, StobsWELLbeing is an approach to improving the mental wellbeing of the whole community. Local service providers are the intended audience of the test site activity, with a clear focus on addressing how they work with local people. The area of Stobswell has both diverse and stable elements and a multi-ethnic population. The community has a range of community facilities, services and established groups which the test site has been able to work with.

“Starting where people are and starting where services are.”

The work of the test site is overseen and guided by a senior partnership, the Equally Well Core Group, which is chaired by Dundee Community Health Partnership and reports on test site progress to Healthy Dundee, the strategic group for the Health and Wellbeing theme in the Community Planning Partnership. Operational responsibility for the work of the test site is assigned to the working group, StobsWELLbeing, which is made up of services working in the Stobswell area and chaired by the test site Lead Officer, who is employed by Dundee City Council and also works with the Dundee Healthy Living Initiative.

The StobsWELLbeing group generated further working groups to implement the delivery of test site activities. These working groups aim to develop new ways of promoting and protecting mental wellbeing in the community. From the outset, the test site has been embedded in strategic planning processes. 

What does the project do?

With the aim of improving community wellbeing in Stobswell, close links have been established between the test site team and local service providers taking forward regeneration and other locally focused work and activities. The working group combining the Equally Well test site and these local services and activities is called StobsWELLbeing. This team work closely with a wide range of local workers and the community to identify influences, indicators and assets for mental wellbeing and to raise awareness of, and build capacity for, mental health improvement. The test site takes a complementary approach by providing local evidence of need and supporting a process of ‘learning by doing’ with services.

The test site is building on and extending the work of existing organisations, some of which do not have a direct mental health improvement role but have the potential to impact on the mental wellbeing of the people they work with. The test site also assists mainstream services in identifying and making small changes that will make a big difference to their users' wellbeing. A number of specific actions have been undertaken including working with service providers and local people to increase awareness of steps that can be taken to protect and promote mental wellbeing, supporting the establishment of a model of social prescribing, and developing indicators to measure community mental wellbeing.

“It’s about more than just interventions, we took an overall approach.”

The test site has also facilitated a community engagement process to enable local people to identify the factors influencing their mental wellbeing, issues of common concern and/or need, and to identify local priorities for action. The test site sought to involve local people from the outset in developing the work of StobsWELLbeing and gives local services and practitioners a better and shared understanding of the community’s assets, influences on wellbeing and priorities for improvement. The work of the test site has taken people on a local journey, helping them see that mental wellbeing is about them – integrating mental wellbeing across systems, supporting people to talk the language of mental wellbeing and taking a practical approach. An extensive community consultation process formed the basis for the identification and development of a range of local activities, including ‘Picnics in the Park’, a mental health literacy programme, social prescribing, and community outreach work to residents who would not usually engage in local activities. 

Picnics in the Park

Initial community engagement highlighted underutilisation of the regenerated local park.  The StobsWELLbeing group proposed the formation of ‘Picnics in the Park’ as a means of bringing the community together to share in green space activities to promote community mental wellbeing. Ten organisations took part and four picnics were held in summer 2010 with varying degrees of success due to weather conditions. The events were successful in encouraging social interaction, partnership working and better use of green space. The test site continued to organise picnics throughout 2011/12 and has now supported local organisations to take the lead, which has ensured that the picnics will become a sustained series of local community events. 

Mental health literacy programme

The mental health literacy programme involves supporting local people and service providers to be aware of how to promote and protect mental wellbeing and to reduce the stigma surrounding mental ill health. A range of information and awareness raising sessions have been held with varying success. Sessions have included:

• Mind Yir Heid;
• drugs and drug use;
• mental illness, support and recovery; and
• Scotland’s Mental Health First Aid. 

Social prescribing scheme

The test site has developed and implemented a model of social prescribing in one medical centre located in the Stobswell area. This has allowed patients with poor mental wellbeing to be offered non-clinical methods of support. For example, an individual who presents at their GP surgery with low mood caused by social isolation may be signposted to a community group or organisation. The test site recognised that the scheme requires evaluation to assess whether the projected outcomes are being achieved and if they can be attributed to the intervention. An external evaluation is in place.

Community outreach work

The community outreach work of the test site aims to reach local residents who live in the most disadvantaged part of Stobswell, and who may not usually get involved in local community activities. The outreach programme attempts to engage these residents in meaningful activity and to promote the range of activities available for local people. This work has involved door step calling and facilitating community based social events. Outreach workers have spent time in communal back gardens as a way of meeting and speaking with people. Initiating these community conversations led to garden tidy ups and tree planting in back gardens with young people and older people working together, which built connections across generations. 

In what way is the approach ‘asset based’? 

StobsWELLbeing started with the assets and resources already existing in the community and is working to enhance them for the benefit of the whole community, specifically focusing on the importance of good mental wellbeing. The test site invests in local people as active participants, recognising that they contribute to sustainable, vibrant and healthy communities and that “people are always the biggest asset”. Furthermore the test site acknowledges the existing elements of the community which could be better utilised and the important role local services and organisations play as assets.  The approach taken by the test site supports the changing role of public services from top-down delivery to a model of co-production.

“Although the test site had little financial assets attached, we had people, relationships, time, local knowledge, enthusiasm…”

The approach taken by StobsWELLbeing supports new assets to be built through a range of activities and partnerships – a mental health literacy programme, the social prescribing approach and the building of new relationships between local residents and between the local community and local services. The test site brings people together across the board and has been built on integrating existing services along with “the voices of local people”. Furthermore, the test site seeks to reduce stigma and to challenge people’s expectations of and attitudes towards mental illness.

Through the activities delivered by the test site, the community has been brought together and new relationships and friendships have been built. This has resulted in creating stronger communities and greater cohesion between neighbours.

How has success been measured?

The work of the test site has been subject to ongoing evaluation since 2010 with measurement focused on community and service provider engagement and increased awareness of mental wellbeing and its determinants. 

Evaluation support is provided by Dundee University.  The evaluation involves service providers, staff and user groups and specifically investigates the processes which have been put in place and range of events that have taken place. The evaluation has included an online survey of test site stakeholders and service providers, analysis of wellbeing scores from 2009 and 2010 and tests of the levels of success of test site strategies. The second year of the evaluation included an assessment of the effects of the test site on capacity building, practice and behaviour changes and mental wellbeing changes in the Stobswell community. 

“Investing real time, effort and sincerity takes a slow burn approach.”  

With support from Health Scotland and the University of Edinburgh Business School, the test site also produced a theory of change diagram which highlights the test site contribution to the process of engagement, awareness and capacity building, which results in the long term outputs and outcomes for the project and associated services.

What are the strengths and challenges? 

StobsWELLbeing set out to improve community mental health and wellbeing by placing a focus on the determinants of health inequalities and by providing support to the local community and service providers to address them. By taking a very local focus and hands on approach, the work of test site is demystifying mental ill health and enhancing the importance of mental wellbeing.

The responsive nature of the test site, effective partnership working and information sharing across sectors has allowed StobsWELLbeing to flourish and gain recognition of its community led ways of working. Working in partnership with a diverse range of people and organisations has ensured that engagement has been meaningful. The balanced approach of the test site within a range of local action – “not doing but supporting” – is based on local evidence and addresses a locally identified need.  The work has linked into existing structures and built capacity in local people and service providers. 

“I’ve learned a lot about how to support services and do things in different ways.”

The test site is not a ‘project’ as no additional resources have been put into the area as a result of the test site work.  Although a small amount of funding has been provided by the Scottish Government for staff time, the approach taken has primarily been about more effective working between people and services in Stobswell. There is a continued focus on the legacy of the work going forward and in sustaining the momentum created by the work of the test site. 

Whilst it is recognised there is still much to be done, it is felt that a step in the right direction has been taken. Getting ‘buy in’ from some partners was highlighted as a challenge alongside ensuring sustainable investment for the future. The lack of attendees at some of the mental health literacy sessions was also identified as a barrier to being able to raise awareness of factors which can both promote and protect mental wellbeing amongst local people and service providers. 

On a personal basis, staff expressed that the test site allowed them to have the freedom to work differently, to do different types of things and to focus on the determinants of health. On the other hand, test site staff reflected that the work was stressful at times. A tension between the need to make progress within the time limited nature of the test site and allowing the work of the test site to be led by local partners and the community was also felt.

Staff spoke of the benefits of working more closely with people from other services.  They also value the transferable skills they have gained around health equity and on how to engage meaningfully with local people, allowing them to take the lead and supporting them in a receptive and responsive way.

Relevant links to other parts of the Understanding Glasgow site:  health, social capital