Accelerated by austerity, the Covid-19 pandemic, the cost of living crisis, climate anxiety, public workforce discontent and a turbulent political leadership, the demand for - and therefore strain on - NHS mental health services is at an all time high.
Between 2021-2022, in England alone, secondary mental health service referrals were up by 26% from 2018-2019 and are predicted to have increased further during ’22/’23. Thinking disorders more than doubled for 17-19 year olds between ’17 and ’22, this rapid deterioration in the space of just 6 years has accelerated an increase in the share of UK adults that are living with a mental health condition, so much so that by 2040 it will be 1 in 5.
The stress that this puts on our mental health services is causing protracted patient waiting times, delayed treatments and limited access to care which, in turn, has given rise to feelings of apathy, mistrust, isolation, and preventable crises among many of those seeking support.
The broader systemic disparities related to social determinants like postcode, class, race, age, and digital literacy are further hindering accessibility to mental health services. These disparities disproportionately affect the UK's migrant populations, particularly those grappling with the intersectional impact of forced displacement and associated trauma. This community, already acutely affected by inequality, faces the added barrier of political hostility that actively discourages engagement with health services.
Even in the absence of these social determinants and stigmas, an overworked and underfunded health system has a reduced capacity for cultural competency. This, in of itself, marginalises migrant populations and cultivates an epidemic of underreported, untreated, fearful, and isolated mental health experiences for the hardest to reach.
despite the indisputable correlation between equality and health, there seems to be growing disparities and divisions between those with access to support and those without
The UK's voluntary, community and social enterprise (VCSE) sector plays a crucial role in addressing the deficiencies in our public mental health service provision but it too faces significant barriers securing funding, recognition, and the capacity for growth. Despite the considerable £15.55 billion allocated to NHS mental health services in the '22/'23 fiscal year, a recent report by the Mental Health Foundation and the London School of Economics and Political Science recorded that mental health costs the UK's economy a staggering £117.9 billion. The UK's dependence on the VCSE sector to address the shortcomings of statutory providers is further tested by an economic and philanthropic landscape that stifles social entrepreneurship and the potential of the third sector.
Having established a health and wellbeing focused social enterprise myself during this period of turbulence, I’ve been witness to the Brexit, Covid-19 and economic crisis related challenges to the marketplace, all of which have made the UK a difficult environment in which to survive as a small business, non-profit or impact enterprise. The landscape has changed somewhat in just a few short years, social innovation start ups face new challenges in effectively collaborating with the UK's public sector and finding the resources to design sustainable wellbeing services for the most underserved populations.
There is an indisputable correlation between equality and health. Increasing multi-dimensional wellness among communities most acutely affected by inequality serves as a preventative measure. Not only does investing in social innovation models for mental health represent money saved for the health and social care services but also signifies significant public value for the social fabric.
In light of this understanding and despite the challenges faced in the VCSE sector, I firmly believe that community-based non-clinical interventions offer a sustainable path to cultivating an enriched sense of agency and connectedness for those facing barriers to multi-dimensional wellness.
So, to increase resilience, emotional stability, and self-determination among communities affected by systemic inequality is to reduce reliance on strained clinical services and, as such, lift the psychosocial experience more universally. Approaches such as somatic, mind-body methods, circle-based restorative practices, and peer support are increasingly used to achieve this rippling, grassroots impact.
It is my interest in these ideas that shaped the questions I sought to answer through my Churchill Fellowship research.
Can non-clinical, participatory interventions, including restorative practices inspired by indigenous traditions, be effective in promoting long-term collective healing, and what is their capacity for sustainability in diverse contexts?
What is the potential for these interventions, particularly story sharing, to drive systemic change and transform trauma among communities affected by displacement and social isolation, and how can this potential be harnessed effectively for mental and behavioural health improvement?
In search of answers, I chose to visit two pioneering organisations working in two very different economic, social and political contexts so as to get a broad overview of efficacy, engagement and acceptance of these emerging ideas.
In Colombia, I spent time with Fundación Dunna (Dunna). Dunna have been designing social innovation models for mental health and peaceful coexistence for communities affected by violence in Colombia for more than 13 years. Their programs combine restorative and somatic practices to transform the psychosocial experience of the many communities that they engage with.
In the USA, I connected with Southcentral Foundation (SCF), a nonprofit healthcare provider in Anchorage, Alaska. SCF integrate trauma informed behavioural health consultancy, tribal medicine and therapeutic storytelling into their primary care services for the Alaskan Native population.
The content of the following findings and field notes is based on my time spent with the expert community leaders, beneficiaries and facilitators that I met in both Colombia and the USA.