Connecting People Pilot Study
Background
There is growing evidence that the social context of people’s lives is important for their recovery from mental health problems. As mental health services are increasingly involved for a limited time, and people are supported more at home and in their communities, it is important for practitioners to support people to develop networks which can help to foster and sustain their recovery.
Connecting People is a practice model for developing and enhancing access to social networks but its effectiveness is not known. This study aimed to pilot Connecting People in a diverse range of health and social care services. It sought to evaluate its effectiveness and cost-effectiveness in services for adults with mental health problems or a learning disability, and older adults with a mental health problem. This also facilitate an exploration of its applicability in different contexts.
Methods
The research team conducted systematic reviews of social participation interventions to identify any potential enhancements for the Connecting People model, or alternative effective interventions.
The researchers then used focus groups of people with a learning disability and older adults with a mental health problem, and practitioners who worked with them, to explore if Connecting People was relevant to them. They also developed information about the model in accessible formats for both groups.
The research team developed a questionnaire to measure the extent to which practitioners were using Connecting People in their practice – otherwise known as fidelity to the model.
Connecting People was piloted in 14 health and/or social care teams in England. Each team, working with adults or older adults with a mental health problem, or a learning disability, were provided with training in the model. Service users were invited to participate in the study who were receiving services from these agencies for the first time, or who had not previously experienced the practice articulated in the Connecting People model. Participants were interviewed after practitioners had been provided with training and again nine months later. The fidelity measure was used in the analysis to separate those who experienced high fidelity Connecting People from those where fidelity was low or moderate.
Findings
The systematic reviews found generally positive findings for interventions which reported social participation outcomes, though it is possible that studies with positive findings were more likely to be published. The reviews included a small number of papers which indicates that the evidence base for practice in this field is limited.
155 people with a mental health problem or a learning disability received care and support from health and social care practitioners who were trained in Connecting People. This study found that participants exposed to practice with high fidelity to the Connecting People model had significantly higher access to social capital and perceived social inclusion, and lower service costs, after nine months than those exposed to low fidelity to the model. On average, participants from both groups had significantly higher mental well-being after nine months. These findings suggest that, when fully implemented, Connecting People can improve social outcomes for people with a mental health problem or learning disability.
The study found that Connecting People worked better in some organisations than others. In most community mental health teams, for example, the development of social networks of people with mental health problems did not have the same priority as managing symptoms, medication and risk.
Service users’ experience of Connecting People varied between individuals and teams. They reported barriers to developing new social contacts such as poverty, discrimination and other needs, such as housing, taking a higher priority. On average, though, they reported feeling more included in society where fidelity to Connecting People was high.
Research sites
Somerset Team for Early Psychosis
Derbyshire Healthcare NHS Foundation Trust
Lincolnshire Partnership NHS Foundation Trust
South West London & St Georges Mental Health NHS Trust
Coventry and Warwickshire Partnership NHS Trust
Waltham Forest Day and Community Services
East London NHS Foundation Trust
South West Yorkshire Partnership NHS Foundation Trust
Research team
The study was conducted by Professor Martin Webber (University of York) with Meredith Fendt-Newlin and Sam Treacy (University of York) and Sharon Howarth (University of Central Lancashire).
Professor Paul McCrone (Institute of Psychiatry, King’s College London) and Professor David Morris (University of Central Lancashire) were collaborators.
The study was funded by the NIHR School of Social Care Research.
Publications
Webber, M., Morris, D., Howarth, S., Fendt-Newlin, M., Treacy, S., & McCrone, P. (2018) Effect of the Connecting People Intervention on social capital: a pilot study, Research on Social Work Practice, online early
Howarth, S., Morris, D., Newlin, M., & Webber, M. (2016) Health and social care interventions which promote social participation for adults with learning disabilities: A review, British Journal of Learning Disabilities, 44, (1), 3-15.
Newlin, M., Webber, M., Morris, D. & Howarth, S. (2015) Social participation interventions for adults with mental health problems: A review and narrative synthesis, Social Work Research, 39 (3), 167-180