Communities Mental Health and Wellbeing Fund for adults: evaluation

5. Discussion and conclusions

In Chapter 3, we described the TSI-led funding partnership that ensured that the fund was administered and disbursed effectively and in line with local mental health and wellbeing needs. In Chapter 4, we identified how the Fund has led to increased provision and the impact on the TSIs, the organisations and the people the services were designed to support. In this final chapter, we consider the key evaluation questions about the effectiveness of the delivery model and the performance of the Fund against its aims.

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 partnership funding model and a local plan was the guiding document for local priorities within the overall Fund criteria. Which partners engaged and forms of engagement varied by area, with some participating on steering groups and others active on the decision making panels. The use of the plan as a reference point and the methods for identifying local priorities also differed:

• some aligned with existing local strategies and plans;
• some were formulated through collaboration with communities and those with lived experience;
• others used a combination of both.

The delivery model led to increased recognition and strengthened connections with the statutory sector which was considered to have wider and longer term benefits for the TSI across the range of its work.

The delivery model also allowed for a very local response to the Fund criteria. In their lead role, the TSIs could engage and access grassroots community groups that an external fund management organisation or even a local authority might not reach. 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 partnership approach helped to strengthen TSI relationships with public sector and third sector partners on mental health and wellbeing, building on existing structures and networks that will continue beyond the Fund and, in some cases had already extended into new areas of work.

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.

We feel that one of the best decisions Scottish Government made in administering this fund to TSIs was the freedom and flexibility it afforded us in devising and responding to local need and local sector make-up,developing a programme of partnership and delivery that worked best for the region. TSI

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 elements that a centrally managed fund would bring were lost – the oversight of what has been funded across the country, 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:

• more consistency in aspects of fund management by standardising elements like the data collection and monitoring requirements of funded projects
• increase learning and collaboration across the TSIs through the networking opportunities and more formal ways that could capture elements of TSI approaches e.g. use of software packages, innovative community engagement processes, that can be shared and replicated
• 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
• ensuring that the local partnership plans act as a working document to inform funding decisions.

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. In Year 1 of the Fund 1842 projects across Scotland delivered a range of community supports to tens of thousands of people facing mental health and wellbeing challenges which supported recovery and built on existing community supports.

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.

The Fund was also designed to tackle the four priority issues within the Transition and Recovery Plan of suicide prevention, social isolation and loneliness, prevention and early intervention and support 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 have been funded ranging 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 work that promoted and supported the conditions for good mental health and wellbeing in the local population and activities that provided accessible signposting to help, advice and support. 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.

The vast majority of funds went to organisations or projects that wouldn't necessarily associate directly with Mental Health and Wellbeing… That will show positive impacts in terms of early intervention and prevention. TSI

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.

The tapestry and volume of support delivered in communities across Scotland as a result of the Fund, will inevitably have helped to develop a culture of mental wellbeing and prevention and demonstrated creative solutions to addressing local need.The 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. With more standardised monitoring, there would be more robust evidence of the wide range of outcomes and impact that are a result of the Fund.

Improving delivery

The Recovery Plan was published in October 2020 and Year 1 funding was disbursed at at time when Covid-19 restrictions were lifting and there were particular challenges at that time.

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. The first two years of funding have created a stronger foundation of services and support and a greater understanding of mental health and wellbing issues which Year 3 can build on.

Funded organisations were not perceived to be delivering mental health services prior to the Fund but are now able to identify how their work can benefit mental health. TSI

Whilst there was a more joined-up approach in some TSI areas, 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 community supports 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.

To maximise local alignment, all partners within the local partnerships could revisit their Fund criteria to ensure:

• local mental health needs assessment recommendations are considered
• the priorities within their local mental health strategies are reflected and
• where possible, consideration of the funding decisions of the Children, Young People and Families Mental Health and Wellbeing Fund disbursed by their local authority.

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
• the opportunity to review the Fund's focus so that the resources are directed towards, or parts ring-fenced for, particular issues or groups, rather than the current 14 priority groups, so that those facing the greatest need receive community supports.