The Public Mental Health (PMH) research programme aims to improve the mental health of people across England by promoting mental health and well-being as well as preventing mental illness. Our ongoing research is generating new knowledge and growing the evidence base that practitioners and policy makers can use to improve mental health across the population. In honour of Mental Health Awareness Week (10 – 16 May 2021) we would like to highlight some of our recently published work.
Identifying promising public mental health interventions
In order to support mental health for everyone in the population, we need to know “what works” or what interventions have been shown to improve mental health. One of the core projects within the NIHR SPHR Public Mental Health (PMH) programme has been to identify promising public mental health interventions which improve mental health in adults.
What are public mental health interventions?
Interventions are any effort, action or policy that attempts to improve mental health at a population level. Public mental health interventions include, for example, workplace wellbeing programmes, parenting programmes, and debt advice services. Such interventions can be run by a variety of organisations, including health departments, private organisations, charities and local authorities.
Community interventions are any non-clinical programme or activity that takes place in a community setting and/or delivered by the voluntary sector. Some examples include homeless and women’s shelters, befriending services, and community garden projects. Community interventions are non-clinical in nature and may be a cost-effective way to positively affect mental health and wellbeing.
We know that there are certain groups who experience particular challenges to their mental health and for whom different interventions may be effective. Specifically:
- Adults from Black, Asian, and ethnic minority backgrounds
- Adults facing financial stress, including those who have recently lost their job, have debt, or housing insecurity
- Older adults, including those facing life transitions like retirement, bereavement, or new caring responsibilities.
The PMH programme has conducted three reviews to look at promising public mental health interventions for the groups mentioned above. These reviews summarise what is currently known about “what works” but also highlight what is not yet known.
Below we list the three papers, give examples of some of the core findings and provide links to further reading.
Ethnic minority populations
Title of paper: Community-centred interventions for improving public mental health among adults from minority ethnic populations in the United Kingdom: a scoping review
“This research highlights the lack of high-quality evidence published on community-centred interventions that improve the mental health and wellbeing of ethnic minorities in the UK. We hope to see progress toward ensuring that community organisations have the financial and technical capacity to either conduct or commission the evaluation of their services, so that knowledge may be shared.”
Cleo Baskin, lead author and research assistant at Imperial College London
- Evidence suggests black, Asian and ethnic minority populations find it easier to start conversations about mental health within their own cultural networks rather than with health professionals.
- Tailoring or adapting a programme or talking therapy to meet cultural needs made an intervention more successful. Addressing practical considerations, such as translating information and educational leaflets often increased participation.
- None of the studies included in this review specifically targeted men. No studies targeted ethnic groups, such as Chinese, Arab and Traveller populations among others.
Adults facing financial life stressors
Title of paper: Community-based interventions for protecting mental health of adults facing financial stressors, including debt, job loss, or housing insecurity
“While there is some evidence that community interventions may improve mental health outcomes during periods of financial difficulty, stronger evidence on the effectiveness and cost-effectiveness of these interventions is needed.”
Dr Jen Dykxhoorn, senior author and Senior Research Fellow at UCL
- 5 types of community interventions were identified:
- Advice services co-located in healthcare settings
- Link worker social prescribing
- Telephone debt services
- Food insecurity interventions
- Active labour market programmes
- Some of the studies, including co-located advice services, and link worker social prescribing, showed some evidence for effectiveness, but all of the studies were small with non-representative samples.
- In general, there was limited information on how effective and cost-effective interventions were at supporting mental health of those facing financial difficulties.
Title of paper: A systematic scoping review of community-based interventions for the prevention of poor mental health in older adults in the UK
“This research is contributing to a better understanding of what works, for whom, and in what circumstances or contexts. It is important to capture evidence of how best to make use of available resources and support joint-working in community–based interventions in a way that improves outcomes for older adults.”
Dr Caroline Lee, lead author and Senior Research Associate at the University of Cambridge
- The majority of interventions were aimed primarily at addressing social isolation or loneliness, followed by older residents in general, or where subgroups were not clearly specified. Some interventions focused on older adults who are caregivers, often where their spouse was living with dementia, and others on people with a physical health condition or sensory impairment.
- A range of community-based interventions were identified, including elements of: befriending; peer support; group support; creative/cultural activities; welfare advice; social enterprise, social prescribing and asset-based community development.
- Strong conclusions are hampered by inconsistent outcome measures, small samples, and lack of follow up. The evidence base for effectiveness is predominantly qualitative and descriptive.
Published paper: accepted for publication, coming soon