Back into society

Social and health care workers Ian Cameron,
Jeremy Pritlove and Jon Woolmore look at a Leeds-based scheme that
awards grants to projects that help people with mental illness
become more involved in the community.

Sustainable, socially inclusive communities
are central to the aim of enhancing quality of life and health. The
National Service Framework for Mental Health¹ highlights
the need for health and social services to promote social
inclusion. For people with mental health problems this should mean
having the opportunity to take part in activities that mirror the
kind of ways that other people choose to pass their time. For
example, going on holiday with friends, going to a social club in
the evening, helping others through voluntary work, accessing
sports facilities or taking part in poetry workshops.

Two things are important about these
activities. First, they take place in ordinary community settings
and not in places specifically defined for mental health services.
Second, special support is needed to help those handicapped by the
social effects of mental health problems take part. Drop-in and
outreach services, whether run by service users or agencies, can be
an important catalyst in enabling these needs to be met. However,
it can be a struggle to obtain the funds to afford the basic
resources needed, such as renting a room within a community centre
or publicity for a support group. Yet relatively small amounts of
funding can provide the opportunity to significantly help improve
the quality of life for service users.

In Leeds, the social services department,
health authority and voluntary sector responded to these needs by
running the Mental Health Drop-In and Outreach Scheme in
consultation with service users. Started in 1994, this scheme now
supports 67 projects across the city with an annual budget of
£23,000. The social services department provides funding.

Grants for running costs up to a maximum of
£900 are available annually. Each year, projects that provide
drop-in and outreach activities and support for people with mental
health problems are invited to submit bids to the scheme. Projects
are expected to identify the costs involved, outline the aims of
the group and, for those that receive support, report back on the
use of the funding at the end of the financial year. Some
long-standing projects that meet key needs are funded over a longer
period. Typically they have sustained a service for a period of
three years, been financially sound and have addressed the needs of
their service users.

The decisions about grants are made by the
scheme allocation group, which consists of one representative each
from the social services department, health authority and voluntary
sector. Those that have been unsuccessful in the past have either
primarily focused on non-mental health service users or requested
financial support for expenditure that statutory services would
normally provide.

The allocation group reviewed the progress of
the scheme in 1998 and identified a number of under-represented
groups from which it wished to encourage applications. These were
groups orientated to support young people, women, groups with
ethnic minority backgrounds, and those living in the outlying areas
of the city.

In 1999-2000, the 67 projects provided for
1,260 people a week in total. A considerable proportion of these
projects were targeted at a specific group of service users. The
biggest of these groups were people from ethnic minorities, and
women. There were nine projects dedicated to each of these target
groups. Groups for black and ethnic minority people covered the
African-Caribbean, Asian, Chinese, Jewish and Irish communities.
Other projects provided for parents, young people, those hearing
voices, people with manic-depressive illness and those bereaved
through suicide.

Importantly, a significant number of projects
have been set up in outlying areas, distant from the city centre
where most traditional mental health resources such as day centres
are located. A small but significant group of projects were largely
user-run. These included two drop-in centres catering together for
about 100 people per week. Most other schemes use current staff
from social services, NHS and the voluntary sector. This proves
cost-effective by providing clients with a service in a group
setting. They have been able to use the small amounts of funding
available to work in more creative ways with service users in
non-institutional settings, often closer to their homes.

The scheme also provided for out-of-hours and
arts projects, which included mental health survivors poetry and an
arts studio.

Feedback on the working of the scheme over
five years shows three main outcomes and learning points.

– The scheme is extremely cost-effective.
Every week 1,260 people with mental health problems are given
support for an annual sum that is less than the cost of one mental
health practitioner.

– The scheme helps provide a wide range of
support in a flexible way to match local needs.

– The scheme actively encourages a
community-based, outward looking and socially inclusive way of
working.

This scheme offers a practical approach to
tackling the social exclusion faced by so many people with mental
health problems and meeting the challenge of the National Service
Framework for Mental Health on promoting mental health.

Ian Cameron is consultant in public health
medicine, Leeds Health Authority; Jeremy Pritlove is development
worker (mental health) Leeds social services; Jon Woolmore is
deputy chief executive, Community Links (Northern)

References

¹ Department of Health, The
National Service Framework for Mental Health, DoH, 1999. View it at
website www.doh.gov.uk/nsf/mentalhealth.htm
 

Examples of the type of drop-in and outreach
projects that are supported by the scheme

The Hearing Voices Group

“Hearing voices can at times make you feel
that you are dealing with another world which overwhelms you and
blots out your power to reason, preventing you from getting on with
your everyday life, and at times becoming a frightening and
confusing experience.”

This is how the Leeds Hearing Voices Group
introduces the issue of hearing voices in its leaflet. The group
has 19 members and meets fortnightly. It is a self-help group for
voice-hearers, with the aims of offering mutual support, helping
members to develop coping strategies, and raising awareness among
professional staff.

The Drop-In and Outreach Scheme has provided
funding to enable the group to pay the travel costs and expenses of
its facilitator, and to support administration and publicity
expenses.

The Headingley Friday Support
Group

The Headingley Friday Support Group has been
running since 1987. An average of eight members meet weekly in a
local community centre, in the north-west of Leeds. The group
supports people with mental health problems who experience
loneliness and isolation. The group is facilitated by professionals
and has its own secretary and treasurer.

In 1999 the Drop-In and Outreach Scheme helped
to fund a five-day holiday for 13 group members in a Morecambe
hotel.

The Loss Group

The Loss Group supports people bereaved
through suicide. Its meets twice a month and draws on five
experienced counsellors as group facilitators. The group provides a
unique service for a group of people with very special needs.

The Drop-In and Outreach Scheme supports the
group through funding for hire of a room, printing, and the costs
of a tape about bereavement.

The Post-Natal Depression
Group

The Post-Natal Depression Group in Leeds has
42 users. It has three aims: “To listen and encourage one another;
to fight isolation and low self-worth, which are common feelings;
and to learn from others.” The group’s literature points out that
as many as 10 per cent of mothers suffer from post-natal depression
and “many suffer in silence”. A mother in east Leeds who suffered
post-natal depression started the group.

The Drop-In and Outreach Scheme has provided
the group with funding for printing, transport, postage, and
child-minding.

The Skill Share Group

The Skill Share Group is made up of members of
a mental health day centre who do gardening and decorating as
volunteers. The service is provided for people who cannot do their
own gardening or decorating because of disability or poverty. The
group works in south Leeds. Work is carried out every Thursday by
an average of eight group members.

The Drop-In and Outreach Scheme has supported
the group by funding transport to enable its members, with their
equipment, to get to the people whom they help.

Dosti – friendship group for Asian
women

Dosti means “friendship”, and it is the name
of a drop-in for Asian women that meets every Thursday morning at a
mental health day centre. An average of 25 women with mental health
difficulties come to Dosti every week to receive mutual
support.

Dosti has struggled to get sufficient funding,
and the Drop-In and Outreach Scheme has helped this popular
initiative to survive and expand.

Artlink’s studio three

The Drop-In and Outreach Scheme also supports
a variety of arts-based activities. Artlink West Yorkshire is a
voluntary agency that provides opportunities for art for
disadvantaged groups. At Artlink’s studio three, people with mental
health problems have time and resources to develop their artistic
talents.