Naomi Williams, Investment and Commissioning Manager at Orbit, discusses the increase in demand for mental health services during the COVID-19 pandemic and the benefits of taking a more proactive approach to mental health.
The COVID-19 pandemic has had a profound impact on mental health and how it is perceived. Many have been affected, whether that has been a personal experience or with someone they know, and demand for mental health support has soared.
A review of the available literature on the impact the pandemic has had on adult mental health in the UK by Public Health England, revealed a decline in mental health across the UK population since the beginning of the pandemic. COVID-19 has affected people’s mental health and wellbeing in different ways and at different time points, with some negative impacts likely to persist long-term*.
Supporting this view, figures published by the Office of National Statistics (ONS) in August 2020, showed that rates of depression doubled during the pandemic, with 1 in 5 adults (19.2%) likely to be experiencing some form of depression during the pandemic in June 2020, compared to 1 in 10 (9.7%) before the pandemic (July 2019 to March 2020). Feeling stressed or anxious was the most common way adults experiencing some form of depression felt their wellbeing was being affected, with 84.9% stating this.
Breathing Space launched in 2017 and is part of Orbit’s Better Days programme, which has been developed and commissioned over the past six years, working with behavioural insight and marketing specialists, our customers and employees. When we set out to create this offer it was essential to ensure that we understood the day-to-day lives of our customers, the barriers to engagement and how to overcome these. The programme was built on this research and now includes a range of services that continue to support our customers in the most effective way we know, with an always evolving set of external partners who are experts in their field.
A dedicated Mental Wellbeing Programme Lead manages the Breathing Space service, to ensure that the project meets business needs, represents value for money and that contracts are well managed. Our Mental Wellbeing Programme Lead has extensive experience in mental health and facilitates the continuous evaluation of the Breathing Space service for improvement and impact.
The service is currently delivered by mental health charity, MIND, and supports customers in a range of ways to ensure the service is accessible and meets their requirements, including offering support one-to-one, in groups, digitally and by phone. It delivers support based on emerging evidence which shows that better outcomes are gained when people control their own mental wellbeing. Solutions include social prescribing, peer support and involving the customers wider social networks. By promoting the customers interests and independence, they are supported to access a range of activities to connect with and contribute to their local community. This delivery gives people the information, power and control they need to stay healthy, manage their wellbeing and choose their own support.
Since the start of restrictions being introduced during the pandemic, we have seen a 42% increase in referrals to Breathing Space, while it has achieved a 95% engagement rate for customers referred who were suitable for the service. Key outcomes include that 87% of customers who used the service saw an improvement in their mental wellbeing, and 72% experienced a reduction in social isolation.
In May this year we set out to further explore the impact of Breathing Space on our customers, with the aim to establish if the service helped reduce safeguarding issues. To do this, we conducted a Randomised Control Trial (RCT) with 853 customers, all of whom had had safeguarding cases opened on their behalf. Participants were split into either the trial group, which engaged with Breathing Space, or a control group, who did not have the opportunity to engage with Breathing Space. We looked at 12 months of data for each group, comparing the number and severity of safeguarding cases opened in both the six months prior to a customer’s engagement with Breathing Space and the six months following the end of their programme.
Through the research, we found that customers in the control group continued to have new safeguarding cases opened on their behalf, with many seeing a significant increase in safeguarding cases. In contrast, those in the trial group saw a significant decrease in new cases, a 29% reduction in complex cases and a reduction in safeguarding issues overall. We were also able to see a statistically significant pattern of increasing debt before Breathing Space engagement and decreasing debt after the Breathing space engagement.
The trial demonstrated that where there is an issue and a case is opened, we should expect more cases to follow at an increased rate over time, unless there is an intervention by Breathing Space. This analysis doesn’t merely prove a correlation or a link, it proves causation. It has given us tangible proof that Breathing Space works for our customers.
Offering this type of support is absolutely the right thing to do for our customers, but the research also demonstrated that this proactive approach to mental health has real business benefits too, reducing future safeguarding cases and helping prevent larger issues, enabling us to focus on more complex cases. And by demonstrating improvements to customer debt levels, it has shown that it can have a positive impact on areas such as rent arrears and tenancy sustainment too.
* UK Parliament Post (2021) ‘Mental health impacts of the COVID-19 pandemic on adults’ https://researchbriefings.files.parliament.uk/documents/POST-PN-0648/POST-PN-0648.pdf