With thanks to VODG members for their contributions, we have submitted a response to the call for evidence on the new mental health strategy.
In our response we highlight the importance of mental health social care, the pivotal role of housing and VCFSE organisations, the need for genuine integration and partity across the NHS, local government and VCFSE sectors and the vital role of the workforce.
We set out what good looks like, including:
- Real co-location, one team identity. The strongest examples do more than share a building: they put statutory and voluntary staff together in the same physical space, working as genuine multidisciplinary teams with professional boundaries properly dismantled. For example, a Living Well model where staff wear a single neighbourhood lanyard instead of separate organisational ones, so the public experiences one team rather than a collection of agencies.
- Start from community assets, not services. The VCFSE sector already runs the community hubs people use every day, so there is rarely a need to stand up new buildings. Good models co-locate teams inside those trusted spaces or, where none exist nearby, take the hub to people instead (onto a housing estate, for example), rather than expecting them to travel between several sites.
- Lived experience and community voice from day one. Bringing in the people who will use services, along with their families and carers, right from the start, on premises, transport links, design and delivery alike, was seen as one of the best ways to break down professional barriers. An expectation of a single, joined-up service carries more weight when it comes from the community itself than when the same message arrives from another sector, and members felt strongly that recruiting people with lived experience as colleagues was essential.
- Reach the people who are not ‘patients’ yet. The system is good at consulting patients and poor at reaching those who are nowhere near services, often the most marginalised people, from diverse communities, carrying the greatest health inequalities and the most complex needs. Genuine outreach means going to people who cannot or will not travel, who are wary of authority, or who trust no one at all.
- A social model, not a medical one. Services should be built around the whole person, not a diagnosis, and should take the wider social determinants of health as seriously as the presenting issue itself.
- An empowered and valued workforce. Neighbourhood mental health services will only succeed if planning, investment and workforce strategies extend beyond NHS services. Social care plays a critical role in supporting people with mental health needs to live independent, connected and meaningful lives in their communities, providing the relationships, practical support and continuity that enable people to recover and thrive beyond clinical intervention. A future mental health strategy should recognise social care and the care workforce, not as an adjunct to mental health services, but as a core component of a preventative, community-based mental health system.
In conclusion we call for a strategy that meets the needs of people of all ages, families and carers by:
- Being precise about integration. Make the case that integration, multidisciplinary working and co-location are different things, and that what the VCFSE and housing associations offer is real integration grounded in community, not co-location on its own and not a version of integration defined solely by the NHS.
- Starting from community and assets. Make the case for building on the VCFSE sector’s existing community assets and trusted spaces, putting lived experience and outreach to people who aren’t yet patients at the centre from the start.
- Championing the social model. Press for services designed around people, not conditions and diagnoses, and give proper weight to the social determinants of health.
- Naming positive risk-taking. Call for a shared culture, across the whole system, of holding risk well, so that supporting people to take risks doesn’t get commissioned out of existence.
- Putting housing in the frame. Insist that prevention and wellbeing depend on housing and support, both stock and revenue, and that local supported housing strategies, with integrated care boards actively engaged, are vital to making that happen.
- Funding sustainably. Argue for revenue funding alongside capital, longer funding horizons, protection for community provision so it isn’t first in line for cuts, commissioning that’s genuinely bold, and honesty that outcomes take five to ten years to show up.
- Fixing the evidence base. Warn against letting narrow, short-term metrics starve good provision of the recognition it deserves, and press for integrated data systems, while being clear that missing data doesn’t mean missing impact.
- Rethinking leadership and accountability. Consider whether the NHS continues to be the right lead for mental health, given the positive case for local councils and VCFSE sector leadership, and the need for greater clarity of accountability and leadership that runs across government.