Message to government - let practice inform policy

One of the biggest lessons the charity has learned over the last 127 years is that if you have to wait for crisis before you take action it is probably too late.

Nevertheless, it was reassuring to hear the Prime Minister recently announce a comprehensive package of measures to transform mental health support in schools, workplaces and communities. Given that mental illness constitutes 23% of the national disease burden but has historically only received 13% of the NHS budget, this commitment is long overdue. With over half of mental health problems starting by the age of 14 the emphasis on early intervention for children and young people is also to be welcomed. It certainly makes sense to give mental and physical health equal priority in terms of government spending and to have this enshrined in law.

Whilst there is little doubt that community mental health services are under severe pressure with beds and other resources in scarce supply, merely throwing money at the problem is not necessarily the best solution. For too long there has been an over reliance on medication as a treatment where the onus has been more on maintenance rather than recovery. I believe that the solution lies in multi-agency working where the focus is on prevention and on helping those with enduring conditions to get their lives back on track. They say that necessity is the mother of invention and that is why some fantastic initiatives have emerged despite the chronic lack of resources. Now that funding will be made available, rather than re-invent the wheel, the Government should be looking to champion and replicate those innovative interventions that have emerged over the past few years to improve the lives of one of society’s most disadvantaged and marginalised groups.

One such intervention is Coping Through Football, a project we deliver alongside NELFT (North East London Foundation Trust) and Leyton Orient Trust in the London Boroughs of Waltham Forest, Redbridge, Havering and Barking and Dagenham, an area of just short of a million people. The project, which began in 2007 and is mainly externally funded, uses football to engage with individuals (service users) who are already in the mental health system. The project’s aim is to restore all those faculties that their condition has robbed them of, namely physical health, self-esteem, confidence, the capacity to interact with others and the ability to live more independent lives. For young people the goal is to prevent them falling into the abyss that is long term mental illness. The impact was immediate and by the end of the first three years it was reported that 44% of project participants had moved on to education/training, volunteering and employment. This focus on prevention and recovery has continued with all the beneficiaries claiming that the project has improved their lives and in some cases saved them.

What sets the project apart from other similar schemes is not the football as this is merely a hook for stimulating the interest of the target group. It is the environment created around the six football sessions per week at a community facility that makes it special. Firstly, service users feel a sense of belonging where everyone is welcome. Secondly they are not traditional mental health sessions delivered at one of the NHS hospitals but are about coming together in a “normal” way to play football. The same coaches, accompanied by the Project Coordinator (who is a trained clinician), are always present and this provides reassuring continuity for the participants. The sessions are inclusive and energetic where the coach aims for maximum involvement with an emphasis on enhancing self-esteem so as the session ends the participants leave with a greater sense of self-worth and achievement. In addition to the coaching sessions there are regular social events, organised largely by the service users, which in turn lead to opportunities to get involved in more mainstream activities. Being able to cope with life and doing normal things might not seem like a great achievement but to those who have endured poor mental health for years it’s like winning the Premier League, Champions League and World Cup all rolled into one.

From the outset we set out to be transformational and to provide a service with a difference but we realised that to turn the heads of Government the project had to be evidence led. So a successful application was made under NHS National Institute for Health Research to the Public Health Practice Evaluation Scheme to fund a two year piece of research to evaluate positive health outcomes, social inclusion and broader health economic benefits. We anticipate that the results, due in early 2019, will lead to the production of a guide that will help inform and inspire others across the country so that this shining example of a sustainable recovery model becomes the norm rather than the exception.

So our plea to Government is to come and talk us and let practice inform policy.