Communities Mental Health and Wellbeing Fund for adults: evaluation

Executive Summary

The Scottish Government commissioned Blake Stevenson Ltd. to undertake an evaluation of the first year of the Communities Mental Health and Wellbeing Fund for adults to understand the processes for delivering the Fund and its impact. The report presents the findings from the evaluation of Year 1 of the Communities Mental Health and Wellbeing Fund for adults.

The evaluation was, however, conducted at the end of Year 2 and as a result, the research was also able to take account of some of the developments that took place between Year 1 and Year 2 and draw out learning from this.

Throughout this report, the term 'community supports' is used to describe the wide range of support, activities and initiatives that seek to improve people's mental health and wellbeing in the community context. This term is used to differentiate it from the provision within mental health services.

Context

In October 2020, the Scottish Government produced the Mental Health Transition and Recovery Plan as part of its response to the mental health impacts of Covid-19. The plan addressed the challenges that the pandemic had, and would continue to have, on the population's mental health. It laid out key areas of mental health need that have arisen as a result of Covid-19 and lockdown. In February 2021, £120 million of funding was announced to ensure the delivery of the commitments set out in the plan.

As part of this, a new Communities Mental Health and Wellbeing Fund for adults (the Fund) was established in October 2021 to support projects that would help to develop a culture of mental wellbeing and prevention within local communities and across Scotland to contribute to the four key areas of focus in the Mental Health Transition and Recovery Plan.

The delivery of the Fund marked a departure from how mental health funding is usually distributed and it was managed by Third Sector Interface (TSI) led local partnerships so that the funding and support would be directed to grassroots community-based organisations. In Year 1 (2021/22), £21 million was disbursed to 1842 local projects across Scotland. In Year 2, £15 million was distributed to 1458 local projects. Funding for a third year was announced in April 2023.

Methodology

The evaluation approach included desk-based research and several activities to gather evidence and views from TSIs, funded projects, project participants/people with lived experience of mental wellbeing concerns and national stakeholders. Key evaluation activities involved:

• Online survey of all TSIs to increase understanding of the administration of the Fund, the involvement of people with lived experience, local capacity building activity, key learning and wider impacts of the Fund
• Online survey of funded projects to gain a clearer understanding of the profile of funded organisations and the range and type of projects being delivered
• One-to-one interviews with ten TSIs to develop a greater understanding of the TSIs' experiences of leading the Fund, their local partnership approach, and their considerations in developing and delivering a process suitable for their communities
• Twelve case studies of funded projects to depict a rich picture of a range of project and participant experiences of the Fund and two case studies about TSI approaches to delivering the Fund
• Four national stakeholder interviews to explore the wider strategic context for the Fund, their views on the new model of managing and distributing funding through the TSIs, and the impact of the Fund

The extensive qualitative data generated by these evaluation activities was analysed in line with the evaluation questions and a draft report outline was agreed which shaped the structure and content of the report.

Findings: Fund delivery and management

The national Fund criteria set out the broad parameters for how the funding should be allocated but it was intentionally flexible to allow the TSI-led local partnerships to identify their own priorities in line with local needs. Each partnership co-produced a local partnership plan which set out spending priorities in line with the Fund criteria, whilst ensuring that the local approach complemented existing provision and intended outcomes for community mental health and wellbeing support.

Approaches to managing the Fund

The TSIs received an administration and capacity building grant to support their management role and to build capacity amongst community organisations applying to the Fund. This helped to build new or reinforce existing grant management processes and support effective delivery of the Fund.

As well as providing the shape and context for the management of the Fund, the local partnership plans identified governance arrangements and detailed the wide range of partners involved in supporting delivery. The range of partners represented multi-agency and multi-sector organisations and brought a wealth of mental health, grant management, community planning and third sector expertise to the partnership. Partners fulfilled various roles including sitting on steering groups or assessment panels, awareness raising and undertaking capacity-building with community organisations.

In terms of the logistics of the application process, the TSIs developed their own approaches often using the administration and capacity building grant to invest in software to streamline functions for applicants and the TSI teams. They all took actions to encourage target groups to apply for funding, which included:

• targeting promotion and support and guidance
• working with specialist organisations to help reach specific groups within communities
• creating funding streams for the smallest community organisations
• ring-fencing monies for particular types of organisations

Most TSIs ensured that people with lived experience were involved in the planning and delivery of the Fund and this varied from roles in assessment and decision making to identifying local priorities. By Year 2 of the Fund all TSIs had involved those with lived experience in the Fund. TSIs identified learning and an increased understanding of the support and activities that were required to ensure that people with lived experience could meaningfully engage and be heard in the process.

Building capacity amongst community organisations

TSIs and their local partners played a key role in the capacity building of the community organisations through:

• Developing skills to apply to the Fund - There were wide ranging approaches to supporting community organisations to develop their understanding of and skills to apply for the Fund. These included roadshows, one-to-one support sessions to support organisations to review draft applications and provide feedback and hyper-local workshops in specific communities.
• Developing skills to apply for other funding - In addition to Fund-specific support, some TSIs provided more general training on writing application bids as well as evaluation techniques.
• Increasing organisational capabilities - There was a host of activities to help develop the organisations' knowledge and skills. These most commonly focused on governance and operational support to smaller organisations to assist them with creating constitutions, applying for charitable status, strengthening their business planning and reinforcing their volunteering.
• Increasing organisations' capacity to deliver supports which help address people's mental health and wellbeing.

Organisations' experience of applying to the fund was very positive. Access to the support and training further enhanced the capacity of these community organisations and improved the accessibility of the fund to less experienced groups.

Learning about the improvements to the delivery and management of the Fund

Reflections from TSIs and funded projects identified changes to some of the funding mechanisms that would further support community organisations to apply and accept funding. These included simplifying application processes, workshops and events to support the application process, and ring-fencing funding for small grants.

There were also requests for more timely communications about the Fund requirements and realistic timeframes to help with forward planning both at TSI and project level. The introduction of more standardised elements and additional guidance was viewed as important to improve consistency across TSI areas in the monitoring, e.g. what is collected from projects and decision-making on what can be funded.

The regularly held Fund National Network meetings were identified as a valuable source of learning and reassurance for the TSIs. The request from several TSIs was to provide greater opportunities within that setting for more peer-to-peer learning.

Summary

The evaluation findings showed that the TSI-led management model has worked well with involvement from multi-sector partners and people with lived experience to deliver a Fund that addresses local needs and priorities. The administration and capacity building grant was a valuable resource to build capacity internally and support capacity building in community organisations by developing their skills to apply to the Fund and other funding and increase their organisational capabilities. The learning from the experiences of the TSIs and the funded projects provides opportunities for the Scottish Government and TSIs to make small changes to enhance future delivery and management of the Fund.

Findings: Impact of the Fund

The monies from the Fund positively impacted on local people, community organisations and the TSIs. As a result of the Fund, mental health and wellbeing community support initiatives were newly created or extended to more or different beneficiaries. A set of case studies highlighting the impact of the Fund are included throughout the main report are also available in a standalone document.

Reach of the Fund

In Year 1 of the Fund 1842 projects delivered a range of community supports focused on improving mental health and wellbeing to an estimated 300,000 people across Scotland.

Local community supports for people's mental health and wellbeing

In the main, and in keeping with the primary focus of the Fund, all the projects identifed the preventative work they delivered to promote and support the conditions for good mental health and wellbeing at population level. They did this by:

• Creating connections – creating a safe space for their beneficiaries to engage in open and supportive conversations; creating a sense of community and the promotion of peer support; increasing people's social networks and strengthening support networks in the local community
• Providing support and self-help – providing access to mental health and wellbeing workers, offering courses and training programmes to support people to improve their mental and physical health

The funded projects also delivered activities and services that increased access to help, advice and support through staff/volunteers with the skills to provide that individual support or with the knowledge of where to signpost to other services; by working with organisations to provide support and through promotion and awareness raising activities.

Training of volunteers and staff was highlighted as critical to providing services and there were several examples of the funding being used to train staff and volunteers so they were equipped with the necessary skills to provide appropriate support to those accessing services.

The majority of projects provided support to help promote good mental health or signpost people to other advice and services, recognising that their work was often complementing treatments or care being delivered by health professionals.

Nevertheless, there were examples of projects working with health professionals that provided treatment and/or care or using their grant to fund professional roles as part of their service to ensure safe, effective treatment and care of people living with mental health and wellbeing concerns.

Outcomes for people with mental health and wellbeing issues

Many of the projects involved people with lived experience in their design and delivery. This ranged from lived experience-led organisations to working with beneficiaries to shape day-to-day project activities or influencing future service developments at a strategic level.

The organisations provided many examples of how their funded projects had positive impacts on their beneficiaries' mental health and wellbeing. Positive outcomes were identified for a vast array of project activities, including art therapy sessions, women's drop-in groups, inter-generational pilot projects, weekly cafes and music therapy services.

These changes included positive effects on socialisation, physical activity and skills development to emotional support. They also provided opportunities for creative expression, holding discussions around health and providing the support required for mental health issues, and enhancing the quality of life for beneficiaries.

Impact of the Fund on local organisations

Alongside the provision of community supports, there were other impacts on the organisations that received funding for their projects. These centred on:

• Increased organisational capacity and capability: by extending their services or creating new ones but also through the training and support provided by the TSIs which led to staff and volunteers who were better equipped and more knowledgeable.
• Better understanding of local need: projects had increased understanding of what was needed at a local level and by working with people with lived experience they were better placed to support the mental health and wellbeing needs of their local communities.
• New networks and partnerships: in many TSI areas funded organisations were encouraged to or brought together to create new networks and collaborations which encouraged cross-referrals and joint working.

Impact of the Fund on the TSIs

The TSIs identified several additional benefits to administering the Fund.

They had an increased profile and standing amongst local partners with strengthened relationships with the Health and Social Care Partnership (HSCP), local authority, and mental health teams. They had established themselves as effective fund managers with robust and appropriate processes, approaches and skills to disburse grants and capacity build and become recognised as an agency with a greater and more dedicated focus on mental health and wellbeing so that they can support policy and strategy development.

The Fund resulted in a strengthening of partnership working both in relation to delivery of the Fund (with partners, for example, supporting the TSIs to reach grassroots organisations), and in relation to the wider delivery of community mental health and wellbeing support.

TSIs also valued the stronger connections they now had with smaller organisations and the local community. The administration of the Fund, the work with people with lived experience and the capacity building with grassroots community groups have resulted in closer relationships with some organisations and new connections with groups that that the TSI had previously not engaged or interacted with.

The growth in those connections has provided insights into the need in local areas and how best they could provide support, a greater understanding of their local landscape and clearer intelligence of the third sector which will help inform and plan future services and support.

The adminstration of the Fund has increased TSI staff knowledge and understanding on various issues around effective fund management and systems that can support it. They were more skilled at community engagement activities to reach grassroots organisations and more effective in finding appropriate ways to engage people with lived experience.

Summary

The evaluation has shown that there were positive outcomes for people who accessed the funded community supports, the local organisations that received funding and the TSIs. The Fund supported a wealth and diversity of projects to deliver activities and services that promoted and supported the conditions for good mental health and wellbeing in the local population. It funded projects that led to positive effects on their beneficiaries' socialisation, physical activity, skills development, confidence and self-esteem and improved their ability to manage mental health and wellbeing. It also increased the TSI profile amongst local partners, created stronger connections and a better understanding of smaller organisations and the local community and augmented TSI capability.

Effectiveness of the delivery model

Placing fund management in a non-statutory body, like a TSI, has supported nimble and creative funding approaches with teams that could respond and deliver within the timeframes and parameters of the Fund.

Capacity building

The administration and capacity building grant enabled TSIs to invest in an appropriate infrastructure to adminster and manage the Fund and carry out extensive capacity building amongst community organisations to support and encourage funding applications. This capacity building went beyond developing organisations' skills to design and submit funding applications. Using the expertise across the TSI they also supported improvements in governance and management capabilities to strengthen the organisations within the sector and developed the capacity of organisations to deliver mental health and wellbeing support.

The Fund was designed to support grass roots organisations to deliver community based initiatives and this was achieved. The majority of funded organisations were small to medium sized and 31% of the organisations were classed as small with an anuual income of under £25,000.

Approaches to reach target groups

TSIs frequently worked with partners to ensure that they reached as many grassroots community groups as possible, which resulted in a wide range of organisations gaining access to the Fund in local areas. Some of these organisations were inexperienced, grassroots organisations that would have struggled to access the Fund without the support provided by the TSI and its partners. Ensuring these grassroots organisations had access to the Fund gave greater breadth to the programme and helped to ensure that programme target groups were reached. In some cases, it also contributed to more coherence across funding locally.

The 14 target groups ensured that a wide range of projects could be funded to address mental health inequalities and support the needs of those groups. The various capacity building and outreach activities employed by TSIs enabled them to effectively reach groups. These activities included focused work with seldom heard groups, local research into the needs of priority groups, sessions delivered in particular communities, working with advocacy partners to engage sections of the local population and ring-fenced funding, e.g for minority ethnic groups.

Collaboration and partnership working

The TSIs led this delivery model with the support of a variety of partners. A local plan was the guiding document for funding priorities within the overall Fund criteria. This approach allowed for a very local response to the Fund criteria and engagement. It also meant that local people with lived experience could have a voice in the decision-making process which would be less likely with a centrally-disbursed fund.

The TSIs valued the opportunity to manage the Fund and identified the organisational benefits that were realised as a result of their role – the increased profile and stronger connections with statutory partners; greater connections with grassroots organisations and the local community; and increased capability across their organisation.

The organisations that received funding welcomed the TSI-led funding approach and the capacity-building that they received. Projects did identify changes that would improve their experience and these related to clarification of some elements of the process, the timeframe for applying and using the funds, the short term nature of the funding and more cognisance of the demands on smaller organisations.

Improving effectiveness

With locally developed approaches to fund management and different monitoring systems in place, some of the benefits that a centrally managed fund would bring were lost – for example, the detailed knowledge of how many people benefitted from the funded projects and the economies of scale of a single system and team. There are some changes that could further improve the TSI-led delivery model:

• introducing more consistency in aspects of fund management (without the loss of local flexibility to address local needs),
• increasing learning and collaboration across the TSIs,
• applying the learning from work to reach target groups and engage people with lived experience, and
• ensuring that the local partnership plans act as a working document to inform funding decisions (which was done more effectively in some areas than others in Year 1)

Performance against the Fund aims

The overall outcome of the Fund is to develop a culture of mental wellbeing and prevention within local communities and across Scotland with improved awareness of how we can all stay well and help ourselves and others. The Fund also sought to contribute to the four key areas of focus from the Mental Health Transition and Recovery Plan, with the first two areas as the primary focus of the Fund - promoting and supporting the conditions for good mental health and wellbeing at population level; providing accessible signposting to help, advice and support.

There were also priority issues of suicide prevention, social isolation and loneliness, prevention and early intervention and 14 'at risk' groups whose mental health inequalities had been exacerbated by the pandemic. With such broad parameters for the Fund's criteria a rich variety of projects has been funded, ranging, for example, from improving the accessibility of a community garden to working with adults with an acquired brain injury.

In keeping with the Fund's focus on prevention, there were many examples of the the tapestry and volume of support delivered that promoted and supported the conditions for good mental health and wellbeing in the local population and activities that provided accessible signposting to help, advise and support communities. Some of these community supports were provided by organisations that were not mental health organisations but were now undertaking focused activities that supported mental health and wellbeing outcomes, widening the range of provision and the number of providers.

Although a minority, there were project activities, and examples in the case studies, that focused on responding to those in distress or that provided treatment and care of people living with mental wellbeing concerns. The lesser focus on these areas is a reflection that the majority of the funding was directed, as intended, to the preventative work.

Accounts from funded projects and the case studies exemplify the positIve impacts on participants' socialisation, skills development, confidence, self-esteem and ability to manage mental health and wellbeing.

Improving delivery

The Recovery Plan was published in October 2020 and Year 1 funding was disbursed at at time when Covid-19 restrictions were still in place. In Year 2, there was a greater focus on addressing issues arising as a result of the cost-of-living crisis. The issues in 2023 are different and, with Year 3 funding announced, there is an opportunity to consider whether changes should be made to channel the Fund into the most pressing areas of need at either a local or national level.

Year 1 of the Fund allowed for a very wide range of community supports to be delivered at a local level. There were more cohesive local approaches in some TSI areas than others. At a local level, clearer alignment to local mental health strategies would be helpful. At a national level, a refresh of the Fund priorities to one or two focus areas and clearer alignment to local mental health strategies would sharpen the focus of the support and services being delivered. With greater Fund clarity and the introduction of consistent monitoring across all TSI areas, there would be a more tangible understanding of the impact of the Fund.

Conclusions

The TSI-led local partnership model has delivered the Fund creatively and collaboratively to suit local circumstances and need. It has worked well with local partners and increased the capacity of grassroots organisations to deliver services within local communities.

The Fund has supported activities and developments designed to support mental health and wellbeing in local communities. With four key areas, four priority areas and 14 priority groups, the funding has supported a diverse range of projects.

The delivery model could be further strengthened to maximise the Fund's impact with

• more shared learning and collaboration across the TSIs and more formal ways that could capture elements of TSI approaches
• additional national guidance to ensure consistency across common areas and improve understanding of the impact of the Fund.
• continue to build on the learning and work to reach target groups and engage people with lived experience in the design and delivery of the Fund
• review elements of the process at TSI level to minimise the demands on the smaller organisations
• ensuring that the local partnership plans are refreshed and act as a working document to inform funding decisions so that at a local level the priorities align with other mental health and wellbeing activities within local areas
• consider what changes can be made to channel the Fund into the most pressing areas of need at either a local or national level