Community Health Networks research
1. What was this research?
This was a large study in one London Borough and a part of the South West funded through the National Institute of Health Research (NIHR) Health Services and Delivery Research (HS&DR) Programme, to map the networks of 150 people with severe mental illnesses such as schizophrenia and bi-polar disorder. The study was carried out with Plymouth University.
We used a bespoke method that mapped three levels of network; an individual’s connections to people, to places and to meaningful activities using what we called the community health network approach. An example of one person’s network is provided below. We also carried out in depth interviews to understand networks from the perspective of people with mental health problems and practitioners. A key part of the study was exploring the role of mental health practitioners within their client’s personal networks. We hope the project will add something useful to the mental health recovery literature.
An example network from our study (anonymised):
“Working on the Community Health Networks project has been a fantastic experience and it has been a great team to work with, in particular I have valued the time spent with the research participants mapping and discussing their social networks. The study has been enriched by the inspiring narratives of hope people have shared with us, which have powerfully illustrated numerous ways in which people diagnosed with severe mental illness lead rich and fulfilling lives. Hopefully the community health networks methodology can be taken forwards as an important component helping to build and develop the social aspects of recovery”. Ian Porter, lead researcher Plymouth University.
2. Why is this research important?
Social factors are important in understanding the experience of and recovery from mental health problems. Many people benefit from strong supportive social networks and from engagement in meaningful activities as well as physical exercise, connections through meaningful places and support from community health services. Yet people with mental health problems remain less likely to be employed, more socially isolated and with poorer physical health than the general population.
At a time when health services are reconfiguring it is important to understand what resources and assets people have in their networks and the balance of formal and informal support that people with mental health problems need and can access.
3. What did we do?
We’ve been interested in what personal networks look like for people with mental health problems and how they are used to support health and wellbeing. We had a number of modules to the study which began in April 2011 and was written up for the funder November 2013.
1) We interviewed around 30 organisations and stakeholders to understand local mental health policy, drivers and strategies related to personal networks.
2) We mapped the networks of 150 people and evaluated their impact on health and wellbeing
3) We followed up with 41 people for in depth interviews to explore the meaning of their networks and how they change over time.
4) We interviewed 41 practitioners such as GPs, psychiatrists, care coordinators and voluntary sector staff to understand their role in developing networks
5) We interviewed key stakeholders at the project end point to gain feedback on our findings to steer our recommendations.
Our research questions were:
- How do people with mental health problems use their networks to support their health and wellbeing?
- How do community-based practitioners and organisations support people with mental health problems to use their networks to effectively support their health and wellbeing?
- How do organisations work together to develop more effective networks for people with mental health problems to improve their overall health and wellbeing? What are the barriers and enablers to achieving this?
A key part of the team has been our PPI researchers who used their own experiences of mental health services to guide the research team and help us collect and analyse data. A particularly important part of the study was the commissioning of an independent synthesis process based upon personal experiences of recovery interacting with the study data.
“This has been an extremely interesting project to work on, particularly during data collection when mapping the social lives of the individuals who took part, understanding what connections are important to different people and seeing the richness that is in so many people’s lives, regardless of illness or diagnostic labels. I think the Community Health Network approach has a lot to offer the understanding of social factors in recovery from mental ill-health and I’m looking forward to taking the approach forward during the PhD I’ve just started at the University of Manchester”. Daryl Sweet, Senior Researcher, London site.
4. What is the current status of the project?
We have completed the research and our report is published by the funder. A full copy of report is provided: FullReport-hsdr03050. It is very long so we have also produced two versions of a briefing summary on the study. One for each of our study sites:
We are currently working on writing peer review papers on this rich data set to publish.
“I am enormously proud of the team who worked on this project. We have benefitted from a committed PPI group who worked innovatively with us to help make sense of our data and write up the findings with clear recommendations. We want to take this work forward so will be looking for new opportunities to collaborate and take forward the community health network approach” Vanessa Pinfold, Research Lead.
5. What next?
We aim to deliver practical outputs from the study and in addition, our senior researcher Daryl Sweet is in his final year of a CASE ESRC funded PhD studentship to build upon the CHN study, examining how network connections support or restrict recovery from mental illness using a Qualitative Comparative Analysis approach, egocentric social network analysis and systematic reviews. We are also looking at how to take wellbeing mapping into mental health services – used by GPs, support workers, care coordinators and individuals themselves as part of a self management approach.
6. Who do I contact for more information?
You can contact the team via email@example.com