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Archive for the ‘Health’ Category

Building emotional resilience in young people across the capital

Thursday, April 6th, 2017

Community Links are hugely excited to have been awarded, by the Department of Health (DH), the opportunity to lead a highly innovative peer mentoring project, More than Mentors, which has recently started delivery in schools within the London Borough of Barking and Dagenham.

Addressing the current crisis in young people’s mental health and focusing on building resilience

Over recent years it has become increasingly evident that young people’s mental health needs to be seen as a priority for both health and educational services. Escalating demand against insufficient capacity within current services has created a growing crisis in mental health. As highlighted in our report: ‘Thriving Minds: Acting early on mental health’, the current crisis in mental health is as much a social crisis, as a medical or funding crisis. Mental health underpins so many aspects of our lives that, in order to tackle the causes of poor mental health, we need a far-ranging response beyond simply reforming mental health services. We need effective, evidence-based initiatives in the community that can deliver more preventative support and are focused on building resilience.

More than Mentors is a new and creative model of peer mentoring, which has been co-designed and co-delivered as a pilot study in east London. Through the Department of Health’s “health and social care volunteer fund” Community Links has been invited to take the lead in rolling this programme out in 5 boroughs across the capital – with Jo Richardson Community School and Eastbury Community School, both in London Borough of Barking and Dagenham being the first schools where we are delivering this intervention.

The programme draws on the best evidence from across the field, exploring peer mentoring as a way of preventing significant mental health conditions in young people. Peer mentoring – where older adolescents support their younger peers – has been shown to prevent the development of mental health problems in research studies. However, frequently in practice, little attention is given to the evidence around recruitment, training and support of these volunteer mentors. Community Links, with a wider partnership team, will work with adolescent volunteer as well as commissioners, to further co-develop, test, evaluate and subsequently disseminate an approach which sustainably delivers an effective voluntary peer mentoring workforce across London.

Rolling out More than Mentors across the capital

Over the next two years Community Links will be training peer mentors, offering peer mentoring and training the trainers as More than Mentors youth practitioners. The programme strives to prevent future mental health conditions in young people, and to ensure those who are struggling are able to access the support available across schools and community settings in 5 boroughs within the capital. By supporting students earlier, we are addressing early markers for mental health conditions such as depression, stress and anxieties, reducing associated symptoms and supporting students in feeling able to overcome everyday pressures. Furthermore, by connecting with the local transformation agenda for Children and Young People’s mental health services, we will also look to support the development of an approach that is focused on building resilience in young people.

The More than Mentors programme

This programme trains young people aged 14-17 years old in schools and community settings such as youth clubs, to become peer mentors through a 2-day/5 session accredited (NOCN) programme of learning. Mentors are then able to offer a 10-week programme of support for mentees (aged 12-16 years old) – a programme that offers both one-to-one support and group-based, positive activities. The mentors and mentees are supported throughout the programme by experienced More than Mentors Youth Practitioners and a mental health specialist. At all stages the mentors are supervised and supported in their development as a mentor, ensuring that they can offer guidance and support to their mentees.

More than Mentors is an ambitious programme, which aims to support many young people across the capital by taking a new and innovative approach. We are keen to keep you informed of how the work is progressing. We will be sharing regular blog posts so that young people and professionals can read about the project, and hear what young people and wider stakeholders feel about the work and its impact within their schools and communities. These are exciting times for Community Links, and we are looking forward to sharing this important work with you.

If you are interested in learning more about More than Mentors, then please get in touch.

Jason Turner – Project manager
jason.turner@community-links.org

Nick Barnes – Strategic lead advisor for More than Mentors
nick.barnes@community-links.org

Nurturing relationships: The test of a shared society

Monday, January 16th, 2017

How many contacts do you have stored on your phone? The head of an adolescent mental health unit once told me that his patients typically had 6 to 10 contacts listed and most of those people were likely to be professional helpers like himself. Social isolation could be both a cause and a consequence of his young patient’s ill health. It was certainly a common characteristic.

I was thinking about this when I read about the Age Concern research published last week revealing that “Half a million people over the age of 60 usually spend each day alone, with no interaction with others, and nearly half a million more commonly do not see or speak to anyone for five or six days a week”.

And whilst we are on the subject of alarming numbers an Action for Children survey of 2,000 parents in 2015 found that almost a quarter said they ‘always or often’ felt lonely.

Social isolation is not a problem for the young or for the old. It is a galloping crisis for us all

Last week we wondered on this blog whether a “shared society” is empty rhetoric or the PM’s genuine intention. If the phrase has any serious substance our collective ability to reconnect with one another, or at least to reverse the trends, must surely be the test.

The consequences may vary – loneliness, ill health, long term unemployment etc. – but the roots are the same. School performance, economic opportunities, physical and mental health, and ultimately life expectancy are all substantially influenced by the strength and depth of our social connections. Very few of us glide effortlessly through life without ever experiencing any difficulty. Our capacity for coping and bouncing back depends in part on our readiness, our acquired skills and strengths, and in part on the support around us, the networks and relationships which sustain and recharge us.

We often make the case for early action but nowhere is it more self-evidently essential. As the Early Action Task Force has noted befriending schemes are important but not sufficient. They are to loneliness what food banks are to poverty – an essential response to a crisis but not a long term solution. The early action response to isolation would involve a commitment to sustained community building throughout the life course – essentially what much of Community Links work on the ground has been all about for almost 40 years.

As we explored on this blog a few weeks ago technology has, in recent years, swept into every corner of our lives often, in the process, sweeping out friendships and relationships. We think people change lives, not transactions. Valuing and developing this element of deep value in our services here, and working to embed it more broadly across the public domain is another long standing priority for Community Links and now more urgent than ever.

The most useful work experience placements or internships are invariably shared across “warm networks” and as many as 8 out of 10 new jobs go to people known to the employer. The old cliché about it not being “what you know but who you know” is still a fair comment on the state of social mobility and, more broadly, on the distribution of opportunity in communities like ours. Building networks, and nurturing the confidence to negotiate them, is the focus of Community Links programmes like Future Links which won a Charity Times Award last October. It isn’t rocket science but it is important and it does work.

Incidental Connections showed that there is no single right way to build communities and to nurture effective and meaningful relationships but doing it better in 2017 may well be the single highest priority for organisations like ours, Jobcentres, GPs, police officers, schools, and indeed any agency in the public domain. Whether Theresa May is, or is not, seriously committed to building a shared society, we should be.

We can’t address ‘the burning injustice of mental illness’ without proper social investment

Tuesday, January 10th, 2017

Yesterday Theresa May made some welcome announcements about the government’s future direction on preventing mental illness and promoting positive mental health.

She rightly identified that not only is mental health a social justice issue, but that the best way to improve it is by making it “an everyday concern for all of us, and in every one of our institutions”. Taking an early action approach is therefore imperative to preventing mental illness, and in doing so “transforming the way we deal with mental health problems at every stage of a person’s life”. In doing so she recognises, rhetorically at least, that the current crisis in mental health is as much a social crisis as a medical or funding crisis.

Thriving Minds: Acting early on mental health

Just before Christmas the Early Action Task Force published its latest report looking at how we can act earlier on mental health. Central to the argument of Thriving Minds is that as mental health underpins so many aspects of our lives, we need a far ranging response that goes beyond simply reforming mental health services.

A useful way of thinking about this was best put by report co-author Rosie Hayes, when she asked is mental illness the ‘Great Stink’ of our time? She highlighted that since the 19th century the government has recognised the benefit of investing in physical infrastructure such as the sewer system to improve public physical health, arguing that today we face a comparable situation in mental health. Therefore, similarly to the areas identified by the Prime Minister, we argue in Thriving Minds that schools, the workplace, communities, money, and the criminal justice system are important areas for early action beyond – and in collaboration with – mental health services.

We would also add private renting to the Prime Minister’s list, as renters are 75% more likely to experience serious anxiety and depression than homeowners. This is largely down to insecurity in the private rented sector, itself a consequence of unaffordability, short-term tenures, and poor living conditions. If we don’t tackle these issues – and the issues identified in the other 5 areas mentioned above – then it is unlikely we will be able to prevent mental illness, let alone promote positive mental health. Legislative approaches like those found in Scotland with the Private Housing (Tenancies) (Scotland) Act 2016 and more local initiatives like co-regulation of private landlords are promising starts, but more must be done.

Was it all just rhetoric?

As other commentators have pointed out, we should be sceptical of these pledges – however welcome they are on the surface – when previous governments have at best consistently failed on mental health provision and, at worst, actively damaged it with cuts. David Robinson wrote on our blog yesterday that announcements like this – and Blair’s “Giving Age” – are sometimes pure rhetoric entirely lacking in policy substance. The mere fact that mental health was given such prominence in the Prime Minister’s first proper speech on social policy makes us optimistic, but equally we are wary about aspirational announcements with no new money to back them up. Only time will tell how serious this government really is about addressing our current mental health crisis and, ultimately, long-term investment in key social infrastructure such as schools, the workplace, and communities is the most likely thing to yield a triple dividend: enabling people to lead thriving lives, costing less, and contributing more.

Six ways society can act earlier for mental health

Friday, November 25th, 2016

On the 9th December, the Early Action Task Force will be publishing its newest report: ‘Thriving Minds: Acting Early on Mental Health‘. Within the report we’ve focused on six areas, although we could have doubled this list as mental health runs through everything in a circle of cause and effect. Below is a snapshot of our thinking on how society can act early on mental health.

 photo Six ways to act early on mental health_zpsndcbvjeb.jpg
1. Education

Half of all diagnosable mental health conditions in adults begin before the age of 14

Given the above statistic, our school years present a significant opportunity to promote positive mental health early. School can take measures to promote positive mental health, such as the whole-school approach of the Mancroft Advice Project. Local and central governments also need to ensure that their policies are focused on promoting positive mental health in children through collaboration with local services and reducing the pressure of exams.

2. Work

Mental health problems account for 47% of long term absences from work

If people felt they wouldn’t be stigmatised for having a mental health problem, they’d be much more likely to disclose this and take time off earlier to prevent their mental health from reaching crisis point. Training in Mental Health First Aid can aid understanding and reduce stigma, whilst organisational approaches such as ‘happier@work’ can make workplaces a more mentally positive place to be. Of course, some people may still fall ill and need time off work, so it’s also important that employment support services are tailored to those with mental health needs to enable them to get back into sustainable, good quality work.

3. Money

Problem debt makes a person twice as likely to develop a mental health problem

At present, a significant number of people are caught up in a vicious cycle of mental health problems and problem debt. By reducing the amount of problem debt people take on, improving early access to advice, and changing debt collection practices, we can act earlier to ensure the cycle is broken. CAB’s ‘Healthy Advice’ scheme is a good example of how services are innovating to ensure they are reaching the people who need advice as early as possible.

4. Criminal Justice

90% of prisoners have a mental health problem

The criminal justice system is host to many people at the sharp end of the collective failure to act earlier for mental health. Yet the system can play a role in creating an alternative for these people. We’ve come across excellent examples of Street Triage and Liaison & Diversion schemes which divert people away from the criminal justice system and into the care they need. Acting earlier also means making prisons mentally healthy environments, so they aren’t creating or exacerbating mental health problems for offenders who will eventually leave prison. Finally, the majority of offenders do not go to prison, so it is important that probation services are equipped to provide support in the community, as well as ensuring offenders are ready to re-enter society.

5. Housing

Renters are 75% more likely to experience serious anxiety and depression than homeowners

Insecurity in the private rented sector, as a result of a lack of affordability, short-term tenures, and poor conditions, is a significant damaging factor to private renters’ mental health. Accordingly, it is important that these issues are tackled in order to reduce the likelihood of mental illness and promote positive mental health – the Private Housing (Tenancies) (Scotland) Act 2016 is a promising start but more needs to be done.

6. Communities

Chronic loneliness is a comparable risk factor for early death as smoking 15 cigarettes a day

Local services can play an important role in preventing loneliness and fostering social connection, ranging from highly formal services explicitly aimed at connecting people, to the more incidental connections that are created through the varied community spaces and events that we might engage with on a day to day basis for other purposes entirely. Building these connections can positively influence the way that we think about ourselves and our communities, in turn promoting better mental health, as demonstrated by Haringey Thinking Space.

 

It is evident that if we are to act earlier to promote positive mental health, we need to be acting before people need to engage with mental health services. In order to achieve this, it is essential that we recognise the current crisis in mental health as a social crisis, as opposed to simply a healthcare crisis. In acknowledging that mental health is everyone’s responsibility, sectors should act together to share the cost of early action, as well as the resultant benefits – the triple dividend of enabling people to lead thriving lives, whilst costing less to public services and contributing more to our economy.

If you’re interested in the ideas we’ve raised here and would like to know more, please sign up to our mailing list to ensure you receive a link to the report when it is published. You can also attend our discussion on early action for mental health, hosted by the Big Lottery Fund, on Friday 9th December from 9.30am-12pm. For further information and to register for a free ticket, please visit our Eventbrite page.

Surviving today, jam tomorrow

Monday, November 21st, 2016

Speaking today at the Confederation of British Industry (CBI) conference, Jeremy Corbyn will argue for long-term public intervention for “the common good”He will highlight how the Prime Minister’s mantra of people “just about managing”, now known as ‘Jams’ in Whitehall, doesn’t ring true for many who instead find themselves “just about surviving”. A combination of policy changes and market failures mean this group are forced to continuously cope with immediate challenges rather than being enabled to find sustainable ways out of poverty.

Back in 2014, we published our third report analysing the cumulative impact of welfare reform in East London. It was called “Just About Surviving”, and explored the ways in which individuals and families were struggling to cope with changes to the social security system.

We found that the reforms were putting people into highly stressful situations, often left feeling powerless and trapped in poverty. People were cycling in in and out of poorly paid and precarious employment, constantly juggling diminishing incomes, and making choices that no-one should be forced to make; going without meals so that their children could eat, washing clothes by hand as they couldn’t afford to replace a broken washing machine, and walking long distances to work in the early hours of the morning.

These coping strategies meant that most of them were just about getting by. But only just. People were living on the edge, drawing on finite sources of support where it was available, and increasingly reliant on friends and family as official support was – and is – cut closer to the bone.

The worsening situation

As Corbyn will note, low wages, precarious employment, and high housing costs are pushing these strategies beyond breaking point. Our research shows that this isn’t a new story, and has been a feature of life in the UK for several years now. Structural issues with the labour and housing markets combine with regressive and counter-productive social security reforms to ensure that people are trapped in a cycle of survival; making short term choices that just about keep them afloat for another week or two, but often reduce their possibility of escaping in the future. This short-termism is mirrored in policy making. Measures such as Discretionary Housing Payments (DHP), for example, provide a vital lifeline for many, but rarely come with the support to make sustainable improvements to their lives like finding secure and adequately paid employment or more affordable housing.

As research by Policy in Practice shows, families are set to be £2,500 a year worse off by 2020 due to welfare reform. Whilst this is an important figure and illustrates the scale of the problem, it only tells us part of the story. It doesn’t get at crucial information such as what kinds of coping strategies people may or may not have exhausted. It won’t tell us how the cuts affect individual adults, children, or communities. Nor does it tell us the broader effect on local organisations who are already struggling to meet demand in an increasingly difficult funding environment. We will therefore continue to shed light on these issues through our qualitative research on the cumulative impact of welfare reform, focussing in particular on how Universal Credit affects both those in and out of work.

We are also going to start looking at some of the underlying issues that cause and exacerbate problems for those who are just about surviving. Over the next year we will be conducting in-depth research into the private rented sector, aiming to understand how poor quality housing, overcrowding, and unaffordability can affect people’s health, education, employment and communities. We hope that by doing so we will be able to show that a lack of action by government on these issues is self-defeating and short sighted, as not only will it damage lives, but will increase costs as the demand for services continues to soar.

Moving beyond survival

The problem with the depiction of people as “just about managing” is that it evokes an image of relatively secure individuals and families who face the occasional high fuel bill. It insinuates that they can easily work their way out of their predicament if they just put their minds to it. In turn this leads to policy responses that are partial, short-term, and ultimately unable to enable people to find a sustainable route out of poverty. These responses are also unlikely to solve our low productivity problem, also highlighted in Corbyn’s speech.

The reality for those who are “just about surviving” is far worse than the Prime Minister seems willing to admit. Until we act earlier on the root causes of the problems that this group faces, any progress made via tweaks to the system is likely to stutter and stall before too long. If we want people to thrive, then a long-term investment in society is what we desperately need; more affordable housing, greater job security, better relationships, and a social security system that promotes opportunity rather than acts as a last resort.

The Second Revolution

Wednesday, October 19th, 2016

The driver of the 214 bus last night greeted us warmly, stepped off the bus to help a passenger who was partially sighted, roared with laughter when he played the recorded message that says “no standing up stairs” and then explained the joke (you had to be there, the 214 is a single decker), thanked us for travelling on his bus and, at the end of the route, wished us all a safe journey home.  As we motley strangers traipsed round from Finsbury Square to Liverpool street station we talked about what a nice man he was and said good night to one another.  The driver of the 214 had built a community in five bus stops.

Of course all this was very trivial and transitory, but I don’t suppose I am the only passenger who has wondered today how different life might be if all our routine interactions were infused with such humour and humanity.

As it happens I had been reading on the bus Gaby Hinsliff’s Guardian piece about the “Internet of Things”. Her sub-heading had tempted me in: “We are a generation struggling to look after elderly relatives. Maybe technology can ease the load?”

The internet of things is essentially the networking of everyday devices, already allowing the uber cool to start boiling the kettle before they get home and the fridge to order more milk when the bar code isn’t showing on its shelves.  The same kind of technology might be used to send out a message if an elderly relative hasn’t followed their usual routine.  Hinsliff imagines how useful this might be in a world where the “harassed care worker has 15 minutes to get you fed or bathed or dressed but not all three” and where “the state simply can’t guarantee to look after older people in any half-decent manner and nor in many cases can their children”.

Hinsliff isn’t wrong about the children, or the state or the harassed care worker but surely if we think smart white goods are the answer here then we haven’t understood the roots or the dimensions of the crisis. In recent years technology has swept into every corner of our lives. Every transaction is automated from paying the rent to fixing a doctors appointment. Social media has redefined our understanding of friendship. We have limitless virtual networks but fewer real friends. Those we do have are likely to be scattered and distant. We network but we don’t relate. Our organisations and our social systems are more efficient but less human. We are more atomised and automated, more comfortable with technology but more remote from one another.  We spend 10 hours or more, every day, looking at a screen.

The internet and all that it has spawned are wonderful things transforming our lives in many positive ways but they are just that – things, not a replacement for human relationships.  Our generation is allowing technological progress to become so disconnected from social progress that we are rapidly approaching the point where the damage it does will exceed the good that it serves.

We are not the first to reach this kind of disjunction. The industrial revolution is the obvious comparison. It wasn’t only about entirely new ways of working but also about entirely new ways of living. At first the essentially rural population struggled to adapt but in time our great great grandparents began to learn how to embrace and exploit the advantages of industrial progress and  how to manage and redress the disadvantages.  This, the second, social revolution, was no less seismic and significant in the evolution of our society than its industrial predecessor.

This is not a silly plea for the techies to slow down. It is a hurry up call for the second revolution. Every pound that is spent on the universities, the industries, the speculative punts that are driving the technology should be matched by another. These funds should be dedicated to reimagining the world in the light of our enhanced capacities and to directing the revolutionary forces in ways which don’t undermine our essential humanity but which value, sustain and develop it.

If we don’t, and if it is to be only the kettle that notices when I am dying at home on my own, I think I might prefer to be left to get on with it.

Is mental illness the “Great Stink” of our times?

Monday, October 10th, 2016

Last week, we argued that investment in social infrastructure is equally important as investing in physical infrastructure for our economy. Today, on World Mental Health Day, it seems appropriate to explore how early action can be applied to mental health – and how this can create better outcomes and deliver significant savings too.

The ‘Great Stink’ of London. Image by David Holt.

Since the 19th century, the government has recognised the benefit of investing in public health. The “Great Stink” of 1858 led Victorian reformers to make the case for investing in public sewage systems – physical infrastructure that enabled healthier lifestyles and reduced the significant costs of disease. These reformers recognised that poor public health not only had a terrible human cost, it was also bad for the economy as people were less able to work.

Today, we are facing a comparable situation in mental health. Mental health problems represent the largest single cause of disability in the UK, affecting one in four adults and costing the economy around £105 billion a year – roughly the cost of the entire NHS. Yet mental health budgets in the NHS and Public Health remain low, and despite mental health gaining increasing prominence in the public realm there still seems to be little recognition from other sectors that mental health is also their concern.

We’re making the argument for society to act earlier – by acting before mental illness occurs and stepping in quickly when problems arise – ensuring people are ready to both deal with setbacks and seize opportunities for flourishing lives. We’ve realised that many of the broad tenets of early action can be applied specifically to mental health, some of which are outlined below.

Make mental health everyone’s responsibility

A key ingredient for effective early action is breaking down siloes and promoting ‘joined-up’ services. To ensure that support is provided at the right time it is crucial that mental health is seen as everyone’s responsibility – embedded at every scale and in every activity. Whether it’s by placing talking therapies within the community like Haringey Thinking Space, taking mental health into schools like Mancroft Advice Project, or addressing mental health in the workplace like happier@work, it is clear that extending mental health beyond the health sector enables earlier action to support people’s positive mental wellbeing. We are not arguing here that all service professionals, for example, should be experts in mental illness and therefore able to deal with acute mental distress: that is the remit of referral routes and specialist services. However, we are saying that everyone should have some understanding of good mental health, ensuring that those who don’t qualify for specialist support aren’t neglected until they reach the point of crisis.

Focus on transitions throughout the life course

In our previous early action work, we’ve talked about the need to focus on transitions throughout the life course. Some of these transitions are universal, such as starting school or work, or facing retirement, whilst others are experienced by particular groups, such as leaving care, having a child, or leaving prison. People can be particularly vulnerable at these transition points if they are not prepared for them, and this can negatively affect their mental health. Ensuring people are prepared to face these transitions not only means they are resilient to such shocks, but also that they are ready to seize opportunities when they arise. Not only can this deliver savings as people are less likely to suffer mental health problems, it can also stimulate growth in the economy – as Cliff Prior argued in our blog series, a Question of Growth, with regards to supporting people back into work.

Make ‘deep value’ relationships central to delivering services

Whilst researching for our case study gallery, we have constantly been hearing about the importance of long-term, trusting, and compassionate relationships between service providers and recipients – what we call ‘deep value’ relationships. This can take a variety of forms, such as the peer-mentoring undertaken by SOS Project or the long-term relationships that Includem builds with young people. It appears that these type of relationships make interventions more effective because they have the underlying benefit of improving people’s mental wellbeing, often relating to their confidence and self-esteem. Tellingly, the standards for ‘enabling environments’ created by the Royal College of Psychiatrists to promote positive mental wellbeing in any setting, including schools, hospitals and prisons, state that the ‘nature and quality of relationships are of primary importance’.

The case for early action on mental health

It appears that we are facing our own version of the “Great Stink” today, as the public increasingly recognises the crucial importance of positive mental health and the current crisis in mental health care. We believe that an early action perspective on mental health presents the moral and economic case for investment, and the themes above indicate the beginnings of what our social infrastructure could look like.

We’ll be building on this work in our upcoming themed paper on mental health, following on from ‘Secure and Ready’ and ‘Looking Forward to Later Life’. The series aims to provoke new ways of thinking and acting earlier, beyond just the realm of experts already working in and around the topic. To support this aim, we are exploring mental health through the settings of education, work, money, housing, communities, and criminal justice. If you would like to discuss the report further with us, or you have any interesting case studies you think we should feature, please do get in touch.

Acting early this Breast Cancer Awareness Month

Wednesday, October 5th, 2016

“If Julie hadn’t detected her cancer early what would have been the cost? Not just to the NHS, but the loss of income to her family, let alone the human cost of her suffering. She worked full time, had a family, two children and a partner. What would have happened to them?”

Community Links Health Projects Manager, Frances Clarke, knows all too well the importance of detecting cancer early. This is a particularly pertinent issue in Newham, which has some of the worst cancer survival rates in the country, with only half of women over 50 in the borough attending breast cancer screening, compared with almost three-quarters of women for the rest of England.

In 2010 Community Links decided to take tackle these unacceptable figures, and establish two new programmes dedicated to Detecting Cancer Early. The first telephones people at risk to persuade them to attend screenings, as letter invitations and other reminder services weren’t working. The second acts even earlier by going into schools to explain the signs and symptoms of cancer, the importance of self-examining, and to encourage students to raise awareness with their parents.

A culturally sensitive calling and health advocacy service

Our calling project contacts women five to seven days before a breast screening appointment. Team members can speak a variety of languages and have a detailed knowledge of their local communities. It began as a reminder service, but soon evolved into health advocacy, as callers recognised that people were often unaware of screening services or had practical reasons stopping them from attending. Now callers reschedule appointments, give house-to-clinic travel directions and tell people about local services if they are carers. Funded by NHS England, the breast screening project now reaches 20,000 women every year, working in Camden and Newham.

Working with children and parents in schools

Our schools project has raised awareness of breast and lung cancer in eight schools in Newham. It’s different because rather than visiting for one-off lessons, it works with staff to embed the project into school activities over the long-term. It runs field trips for pupils to see cancer screening and interactive peer-led health lessons with cancer survivors, incorporates cancer awareness into other lessons, and spreads its message through newsletters, displays and social media, engaging parents at performance and parents’ evenings.

Increasing awareness, uptake of screening, and self-checking

The screening project increased women’s uptake of breast screening by 15% in consecutive years, whilst the schools project found that girls’ knowledge of breast cancer symptoms increased by 58% and by 54% among mums. The number of mums who self-check monthly also rose to 46% and their awareness of local screening services increased by a third.

This dual approach demonstrates that everyday social interactions, a friendly phone call or family conversation can literally save lives by encouraging early detection. Frances Clarke said “we’re saving people’s lives immediately, but we’re also giving people skills for life to continue self-examining and spreading information to the generations above and the generations below. Grounded in Community Links core principles of early action and deep value relationships, this approach also reduces demand on already overstretched NHS cancer services, freeing up vital resources for those who need it most.

With Breast Cancer Awareness Month upon us again, it is more important than ever to focus our energies on practical early action solutions to beat breast cancer.  Our ‘Detecting Cancer Early’ programme is just one of many early action projects that we are featuring in our online case study gallery.

Going beyond the food banks

Friday, July 22nd, 2016

“To search for solutions to hunger means to act within the principle that the status of a citizen surpasses that of a mere consumer.” City of Belo Horizonte, Brazil.

 photo Play Sow and Grow_zpsssgrwc2i.jpg

At Tuesday’s report launch from the Trussell Tust, the Q&A focused on what can be done to prevent the rise in foodbanks. Currently, according to the findings of the report, our welfare system not only fails to prevent problems before they arise, it also struggles to deal with crisis. At Community Links we see this every day, with clients often needing food parcels due to benefit delays or some other crisis. The use of foodbanks continues to rise despite a reduction in sanctions, and it appears that foodbanks are increasingly being incorporated into the welfare system, as we previously feared.

Quite rightly, the discussion covered the need for the DWP to improve the benefits system as well as the expansion of foodbanks remits to include wider support and advice on debts, budgeting, and developing coping strategies. Yet I couldn’t help but feel that calls for central government to improve our welfare system are somewhat undermined by other crisis-causing policies. So what would an early action framework for food look like?

The city that ended hunger

The Brazilian city of Belo Horizonte, known as the ‘city that ended hunger’, declared food a ‘right of citizenship’ in 1993. A city agency involving local people was established to devise solutions to end food poverty, including directly linking up farmers and consumers, establishing low-cost, high-quality ‘people’s restaurants’, and enabling extensive community and school gardens as well as nutrition classes.

In only ten years, Belo Horizonte cut its infant death rate—widely used as evidence of hunger—by more than half, and today the initiatives benefit almost 40 percent of the city’s 2.5 million population. In the same ten years, Belo Horizonte was the only locality in Brazil which saw a rise in the consumption of fresh fruit and veg and local small scale producers increased their revenue despite farmers in the rest of the country seeing incomes drop by almost 50%. The cost of these efforts? Around $10 million annually, or less than 2 percent of the city budget. That’s about a penny a day per Belo resident.

Reasons to be hopeful?

A differing economic and agricultural context means that the Belo Horizonte model may be difficult to directly replicate in the UK. Yet it demonstrates that significant action can be taken to reduce food poverty despite an unfavourable national context.

In the UK, the burgeoning ‘food sovereignty’ movement is equipping communities with the means of producing their own food, thereby reducing barriers to fresh fruit and veg in spite of spiralling food prices, and simultaneously delivering multiple social, emotional and health benefits. For example, the Women’s Environmental Network is running a number of projects in Tower Hamlets which are empowering local women to work together to access affordable fresh food, whilst improving their physical and mental wellbeing and combating social exclusion.

Of course, such projects are generally small-scale and the structural conditions in which they operate, such as deprivation and job insecurity, also need to be addressed to achieve lasting change. Sustain’s campaign, ‘Beyond the Foodbank’, calls on central government to improve the benefits system, but also advocates for local living wages and city-level partnerships to address the root causes of food poverty in their locality.

This kind of systems change is already ongoing at Brighton & Hove City Council, who have relatively recently adopted a Food Poverty Strategy and Action Plan, co-produced with the local population and delivered by a wide range of local agencies. The plan has a distinct flavour of early action, recognising that the city needs to address food poverty now to save major costs later on arising from poor mental and physical health, poor educational attainment, obesity and malnutrition. Promisingly, a number of other councils have since replicated the model.

From passive recipients to active citizens

Evidently, whilst central government continues to deny any link between issues with benefits and the rise in food banks, there are still actions we can undertake to reduce food poverty; building people’s resilience and enabling them to lead thriving lives. Services shouldn’t reduce people to passive recipients but enable them to have active control over their own lives so they’re prepared to deal with setbacks and seize opportunities as they arise. And emergency food aid should remain just that.

Wales: Good reasons to be hopeful

Monday, June 13th, 2016

I met Sophie Howe – the Future Generations Commissioner for Wales – last week. Sophie started work at the helm of the newly minted Commission 4 months ago. I had been looking forward to our meeting for some time. The Act which created the Commission had been in gestation from the earliest days of the Task Force in 2011. Now the powers and responsibilities of the new Commissioner are wider and probably stronger than any of the small number of offices elsewhere in the world that are at all comparable.

Peter Davies previously held a much more limited role as the Commissioner for Sustainable Futures. He was a prime mover in the development of the legislation which created the Future Generations Commission and has been generous in his acknowledgement of the influence of the Early Action Task Force: “The work of the Early Action Task Force has been really influential in the development of the Well – being of Future Generations Act. The concept of early action should be at the heart of sustainable development. The Triple Dividend perfectly captured the essence of this approach and brought much needed focus on action that can take place now, preventing long term consequences and setting a pathway for a more sustainable future.”

Five “ways of working” were outlined in the act. Public bodies need to be demonstrating these in order to show that they applying the sustainable development principle. In essence it is the Commissioners job to ensure that they are and to help them do it well

These “ways of working” are intended to “help us work together better, avoid repeating past mistakes and tackle some of the long term challenges that we are facing”:

1) Long term: The importance of balancing short term needs with the need to safe guard the ability to also meet long term needs

2) Prevention: How acting to prevent problems occurring or getting worse may help public bodies to meet their objectives.

3) Integration: Considering how the public bodies well-being objectives may impact upon each of the well-being goals, on their objectives, or on the objectives of other public bodies.

4) Collaboration: Acting in collaboration with any other person (or different parts of the body itself) that could help the body to meet its well – being objectives.

5) Involvement: The importance of involving people with an interest in achieving the well-being goals and ensuring that those people reflect the diversity of the area which the body serves.”

It would be understandable if many of the leaders of those public bodies, and the list that are named in the act is very comprehensive, felt dispirited by a fresh set of demands on staff teams and departmental budgets that are, almost invariably, smaller now than they were when the Senedd first began to talk about the bill. However I spoke to a mainly public sector audience at the Equality and Human Rights Exchange Annual Conference in Mid Wales earlier in the day and, in the margins of my contribution, discovered that delegates were well informed about the purpose and the requirements of the act and almost unanimously enthusiastic. One told me that the act was “the most positive development in public services since devolution” and another that it was “the boldest thing that the Welsh government has ever done.” Ruth Marks CEO of the Wales Council for Voluntary Action, who I met on Wednesday, had been similarly affirmative.

Of course at the moment everyone was talking about the potential. It will be at least two years before anyone can begin to consider consequences but appetites were keen

The government guidance note answers its own question “Why do we need this law?” with this statement:

“Wales faces a number of challenges now and in the future, such as climate change, poverty, health inequalities and jobs and growth. To tackle these we need to work together. To give our children and grandchildren a good quality of life we need to think about how the decisions we make now will impact them. This law will make sure that our public sector does this”.

It is an ambitious objective and I left Cardiff conscious of the burden of expectation now resting on the Commission but also, and most importantly, impressed by the level of commitment on all sides. There are good reasons to be hopeful.