Better Mental Health Fund: Oldham

Sitting in the Greater Manchester conurbation, Oldham has a population of 237,110. 29% of the population is from a racialised community, predominantly South Asian, with Pakistani heritage (10.1%) and Bangladeshi heritage (7.3%) as the largest minorities. Oldham has an Index of Multiple Deprivation score of 25, and nearly a quarter of areas in Oldham are among the most deprived in England. Life expectancy in Oldham is significantly lower than the England average. Unsurprisingly, the rates of poor mental health, notably the number of people with depression and those recorded as having a severe mental illness, are also higher than the national average.

Oldham’s joint strategic needs assessment, which gives a comprehensive insight into the health and social care needs of local people, can be found here: Oldham Joint Strategic Needs Assessment (oldham-council.co.uk)

Identifying the focus for the Better Mental Health Fund

Existing strategies and the JSNA were reviewed to identify potential areas for development. In addition, a survey specifically targeting Oldham’s vulnerable and diverse communities was conducted through doorstep engagement and community group feedback, and was coordinated by Action Together to provide insights people’s concerns. The interventions selected sought to address these concerns.

How was the Better Mental Health Fund used?

Projects were funded across the life course and included a mix of universal initiatives, early intervention, and support for people experiencing poor mental health. They were:

1. Togetherall: A mental health and wellbeing platform available on any device which includes peer support available to all Oldham residents over the age of 16. This is provided by Action Together, which provides a range of services to support the voluntary, community, faith and social enterprise sector in Oldham.
2. Social and emotional learning programmes in 106 schools, targeted to schools with higher rates of children with mental health needs.
3. Whole school or college approaches: Oldham Brokerage Service (OBS) is an online service directory of quality-checked service providers. It is intended to address the gap between the provider sector and schools.
4. A parenting programme using the Solihull approach, which aims to improve emotional health and wellbeing by supporting relationships. Free-to-access online courses are made available for Oldham residents.
5. Family Solutions: building on an existing service that offers family mediation to provide early intervention for families. This is being delivered by Tameside, Oldham and Glossop Mind.
6. Suicide and self-harm prevention interventions are led by Public Health at Oldham Council, and they have contracted with a range of community and voluntary sector providers to deliver:
   • Suicide First Aid – one course offered to staff working with children and young people, and one to staff working with Oldham’s most vulnerable communities
   • ASSIST training to prepare paid caregivers to provide Suicide First Aid interventions
   • Self-harm awareness: two half-day workshops to increase awareness of the risks and triggers for self-harm across all sections of the Oldham population.
7. Peer support community champions supporting any aspect of Covid recovery and the development of local peer support groups. This is being delivered by Tameside, Oldham and Glossop Mind.
8. Bereavement counselling targeted at racialised communities, delivered by Tameside, Oldham and Glossop Mind.
9. Physical health for people with learning disabilities: Building capacity in the physical health trainers’ workforce to provide support based on a personal plan to improve physical health over eight weeks, through swimming, guided walks, free cycle scheme and a gardening project. This is being provided through additional social work capacity in the local authority.
10. Mental Health First Aiders: Staff from Oldham Council, CCG and the third sector attended the MHFA Training Instructors Training to enable them to deliver MHFA
11. Living Well – Older People’s Mental Health: Protecting the mental health of people with long-term physical health problems through a bespoke Five Ways to Wellbeing approach to people aged 65+ using mental health services. This is delivered by Pennine Care NHS Foundation Trust. Two assistant psychologists were recruited to deliver the programme.
12. The Listening Space: an informal, comfortable setting and confidential space for adults who feel they need someone to talk to and get some early support. This is being delivered by Tameside, Oldham and Glossop Mind.
13. Training for trauma-informed approaches in non-health care settings, through an evidence-based online course.
14. Small grants were allocated to develop existing peer support groups, for example for a group of South African women. The funding was used to pay for venues for the groups to meet, training and preventive work, and for Andy’s Man Club.

Early Intervention: The Listening Space

The Listening Space offers an informal and confidential space on a drop-in basis, with 1:1 support provided by staff and peers. It is available four nights and one day a week. It complements other local services to ensure greater availability of crisis support.

It was developed as a response to reports of isolation, loneliness and crisis during the pandemic. The service has proved immensely popular and has become an attractive model for men, leading to an increase in the number of men getting support.

The impact on Tameside, Oldham and Glossop Mind (TOG) is that it has changed the model of service delivery from an appointment-based system to a flexible drop-in service. TOG’s view is that this is a positive move and has made their service more outward facing and client centred. Furthermore, they combine this with a trauma-informed approach, which reduces the risk of retraumatising people, and focus on recovery and movement.

Mental health support for older people: Living Well

Living Well is designed to protect the mental health of people with long-term physical health problems and older people through a bespoke Five Ways to Wellbeing approach. This is delivered by Pennine Care NHS Foundation Trust. Two assistant psychologists were recruited to deliver the programme.

Supported by The Innovation Unit, Oldham is a pilot roll out area for Living Well (https://www.livingwellsystems.uk/theprogramme), along with Salford, Tameside and Bolton in Greater Manchester. The Living Well programme in Oldham coproduced a new model for improving mental health support for Oldham’s older residents.

The Better Mental Health Fund was used to support and complement the Living Well objectives, which aimed to transform GP, community, and hospital services to enable people to achieve good mental health in community and primary care settings. As part of the pilot, Oldham received coaching to design a local Living Well system, and shared learning with the other pilot sites and the programme stakeholders.

What is the impact in Oldham?

Oldham recorded 6,524 beneficiaries against an initial target of 3,868.

Targeted efforts had an impact on communities that are typically excluded and marginalised. For example, Pakistani people, who make up 13% of the population, accounted for 33% of beneficiaries. Conversely, white British and Irish people, who make up 71% of the population, accounted for 39% of all beneficiaries.

There was strong reach into the most deprived areas. 59% of the population live in the top 30% deprived areas in England, yet 65% of beneficiaries lived in those places. Similarly, 33% of the local population live in the top 10% most deprived areas in England and they made up 53% of all beneficiaries.

78% of all beneficiaries were aged 5-17. 14% were 26-64 years old.

There were clear and demonstrable positive impacts on the mental health and wellbeing of local people who participated in the Living Well project for older people and those with long term physical conditions and/or the TOG-Mind community project which focused on improving family mental health. The scores for participants in the bereavement project were more variable, reflecting the complex and unpredictable effects of grief.

Key learning points

1. Having a strong understanding of local needs and community assets meant that staff in Oldham had a clear idea of how to maximise impact and were ready and willing to engage with the programme.
2. Public health colleagues designed and managed an ambitious and wide- ranging programme of work. Speedy implementation was supported by existing structures, a history of collaboration, and established relationships between the council and a range of statutory and voluntary sector providers.
3. The programme in Oldham demonstrated the value of flexible funding. Small grants enabled relationship building. They galvanised support for the programme objectives and validated the contribution of smaller groups.
4. Programme implementation in Oldham has highlighted how addressing inequalities requires local authorities to have the flexibility to bolster existing contracts, and to swiftly support grassroots organisations without administrative burden.
5. Sustaining successes will be challenging. Public health colleagues are supporting providers to develop bids for other sources of funding. They are also looking at ways of promoting the programme through the Integrated Care Board arrangements. Promotion events, including a mental health roundtable attended by the local MP, will enable the project to be profiled and help build the case for sustainability.

An independent local evaluation of the Living Well project and the physical health training for people who have a learning disability is being undertaken through the Faculty of Health and Education at Manchester Metropolitan University.