The south London borough of Lambeth, with an estimated population of 330,000, has many diverse, marginalised and excluded communities that carry disproportionate burdens of preventable and avoidable ill health.
63% of residents describe their ethnicity as something other than White British. A large proportion of residents are from Black African, Black Caribbean and Black ‘other’ backgrounds, which form around a quarter of the population.
This makes Lambeth one of the most diverse boroughs in London and in England.
Life expectancy is decreasing in Lambeth. For men it is 1-2 years lower than the rest of England and London. The causes are deprivation; within the borough there is a gap in life expectancy of up to 19 years – 60 to 79 years – due to poverty and its associated challenges.
The number of deaths from suicide in Lambeth each year is 24 (average over period 2014-2016). The rate for men in Lambeth is almost three times higher than in women.
The cost of living in London, exacerbated by national financial challenges, is a major concern for low-income households who experienced additional difficulties during the pandemic, especially people working on zero-hours contracts.
For information about health in Lambeth, check out Lambeth Council’s Joint Strategic Needs Assessment
Identifying the focus of Better Mental Health Fund
Grounded in the strategic information they had collected and the priorities that they had identified, the Better Mental Health Fund provided opportunities for the strategic health partnership Lambeth Together to resource projects for which there had not been a clear funding source in recent times.
The projects were led by voluntary sector organisations that understood the needs and assets of the communities with which they worked.
How was the Better Mental Health Fund used?
Eight projects were funded:
- Loneliness and Employment Project: Using the lived experience of recently unemployed young people to inform the development of solutions to finding employment and reducing the harms associated with unemployment
- Youth Hubs: Mental health and wellbeing support for young adults through Lambeth Made youth hubs
- NWA Loneliness test and learn pilot – Connecting vulnerable and lonely older people
- The Black Men’s Consortium: offering working-age Black men a safe space to talk about mental health, wellbeing and the issues they face on a day-to-day basis through the means of art therapy
- Young Carers Support: providing relief to young carers and their families as well as connecting them to peers and promoting physical activity
- Adult Carers Support: providing relief to carers as well as connecting them to peers, promoting the Five Ways to Wellbeing
- Outreach Worker who worked on a wellbeing bus, taking messages into neighbourhoods
- Feeling Our Way: Covid-specific programme providing digital access (phones, data, minutes) and digital psychoeducational interactive resources to care leavers and asylum-seeking refugees.
Supporting families: Carers’ Hub
Carers’ experiences of isolation, loneliness and exhaustion intensified during the pandemic. This was especially acute for people whose loved ones were shielding or experiencing high levels of anxiety about going out.
Lambeth Carers’ Hub has a strategic objective to improve the wellbeing of carers – child and adult – and provides a range of activities. These include mindfulness, tai chi and sessions that focus on carers’ wellbeing and self-care – what one service user referred to as ‘a space just for me’.
The pandemic brought challenges in keeping carers engaged as they struggled to get out and find time for themselves. The Better Mental Health Fund has resourced a sessional worker to promote the facility, leading to an increase in interest, and new clients are accessing the project. The work is having a positive impact.
Measuring baselines and changes in wellbeing takes time and the carers are sometimes reluctant to engage in this. The Hub has developed its own measures in recent years which acknowledges the specific kinds of stress that carers experience and how carers might react.
The expansion of their business that the Better Mental Health Fund has supported was very welcome but, in its aftermath, there are immediate operational challenges.
What were the impacts?
The programme in Lambeth had a goal of reaching 1,074 beneficiaries; the final number recorded was 1,362.
Ethnicity was recorded for 94% of the beneficiaries. The proportion of the population in Lambeth who identify as Black Caribbean is 7.2%, yet the proportion of recorded Black Caribbean beneficiaries for the programme was 23.6%, suggesting that efforts to target activities were successful. Black African and ‘Black Other’ make up 12% and 4.2% respectively of the Lambeth population, and they accounted for 13.7% and 11.5% of all beneficiaries. White British and Irish together make up 39.8% of the local population and accounted for 12.2% of beneficiaries.
Three projects – the Carers Hub delivered by Lambeth Young Carers, the Black Men’s Consortium, and the Loneliness and Employment project for young Black men – each used standardised scores to measure impact, and demonstrated discernible positive outcomes for participants’ mental health and wellbeing.
The Black Men’s Consortium showed the biggest impact, an average increase of 8.8 points on the wellbeing score, indicating improvements in wellbeing for participants. The Loneliness and Employment project showed the smallest increase, but participants were starting from a significantly lower baseline score, reflecting the entrenched challenges that participants faced.
It has also been noted that, given the widespread negative impacts of the Covid pandemic, even maintaining wellbeing throughout the period was a positive outcome. For many people during lockdowns, their mental health worsened significantly; to hold it steady was a clear achievement.
What have we learnt?
The funding was welcome because it allowed the development of services and projects that otherwise would not have been funded. The stability that the Better Mental Health Fund has brought was welcomed during the Covid pandemic, a time of significant unpredictability.
Interviewees stressed how coproduction was the best approach to designing and embedding projects in communities, but they noted that it takes time and resource to do it properly – to build trust, to have real conversations, to build consensus.
Attention is now turning to the challenge of finding support for projects that have a natural life of two to three years, and ensuring that their legacy is not lost or weakened. ‘We want to maximise the impact of the work’. Guidance in securing continued support would be useful for voluntary sector organisations. Lambeth Carers’ Project is considering grant applications to sustain activity. As a result of the funding, projects have seen a steep increase in the numbers of service users they are helping. It is placing a burden on them now that the Better Mental Health Fund has ceased. Thinking about the future of their projects was, as one interviewee noted, ‘nerve-wracking’.
Lambeth’s public health team will take the learning from the Better Mental Health Fund to the partnership board, Lambeth Together, with suggestions of how different strands of the work can be progressed. This will be part of a broader conversation about reorientating resources towards prevention activities.
Local evaluation
The local evaluation is complete. It states:
“The amplitude of these projects reaches beyond the beneficiaries and inevitably affects the wider community. Through the investment in these projects, individuals can retain the learnings, create/propel discourse with other people, and infuse this knowledge into their community. For example, in the Black Men Consortium project, men were equipped with skills to provide support in their communities to other black men and to develop and lead community-based groups. Additionally, some of these projects worked with people who were close to the target groups and offered workshops and sessions to help raise awareness of the challenges they faced. In the Young Carers project, for example, assemblies and workshops were held to inform school staff about challenges faced by young carers and their impact on their education.”
