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Posts Tagged ‘early action’

Prisons and the supersize solutions

Friday, March 24th, 2017

“We try to remove whatever it was that caused the crime”

News this week of plans to build four new “supersized” prisons in England and Wales contrasts miserably with progress in the Netherlands where nineteen prisons have closed in recent years, five in the last year alone.

Jan Roelof van der Spoel, deputy governor of Norgerhaven, a high-security prison in the north-east of the Netherlands offers this explanation for the difference.

“In the Dutch service we look at the individual …If somebody has a drug problem we treat their addiction, if they are aggressive we provide anger management, if they have got money problems we give them debt counselling. We try to remove whatever it was that caused the crime. The inmate himself or herself must be willing to change but our method has been very effective. Over the last 10 years, our work has improved more and more.”

Justice Secretary, Liz Truss, justified her expansion plans with this analysis: “We cannot hope to reduce reoffending until we build prisons that are places of reform where hard work and self-improvement flourish”. Is she really saying that the only way to close prisons is to first build more?

It is certainly never too late to “try to remove whatever it was that caused the crime” but the prevention of first time offending is even better than preventing reoffending. It can be done and it should be: Speaking about creating an  “early action culture” in the police service at our Insight event last year  Andy Rhodes of the Lancashire Constabulary told us that “to prevent crime”, not to arrest more, is the first “Peelian principle”, it should be a police officer’s  primary goal.

Andy embarked on a mission to shift the emphasis after reading our Triple Dividend  report in 2011. Now he says early action is part of our language, it’s referenced on the crime plan, it’s in our recruitment, promotion and Learning and Development with a masters in Early Action at UCLAN and tons of frontline toolkits.”

At the start of his quest Andy was the deputy chief constable and there were a lot of sceptics. Now, not everyone gets it but we are getting there” and Andy is the new Chief Constable , promoted just last week to the top job in the Lancashire Constabulary.

And if Andy is right and we can reduce crime, what might become of our prisons? Again the Netherlands are setting us a shining example: Part of Amsterdam’s Bijlmerbajes prison has become a cultural hub called Lola Lik and part of it is now the Wenckebachweg refugee centre. Here activities for up to 1,000 refugees are aimed at “accelerated integration” – the so called “Amsterdam approach”. The Refugee Company is launching a coffee shop on the site, there’ll be a solar-powered cinema, and The Startup Kitchen, will host food start-ups from around the world.

It’s a remarkable transformation and vivid testimony to the idea that supersizing prevention is altogether better for us all than supersizing prisons.

A bill of rights for the next generation: What do you think?

Friday, March 3rd, 2017

Here’s a new idea which we are starting to think about.  Would it be useful, what might it contain and how could we make it work? We would welcome your opinion.

A Bill of Rights for Future Generations.

The Early Action Task Force is working in several ways to create the conditions, the understanding and the resources for early action to thrive. Our work is very practical. It is about doing what we can in the prevailing context – political, financial, cultural and legislative.  We wouldn’t want to abandon this pragmatic and practical approach but we are also thinking about opening up a new front:

The problem we want to solve:

We have a settled government with a political narrative that is dominated by Brexit. There are glimpses of other interests such as the PMs Shared Society speech but these are infrequent and insubstantial.

The opposition has very little influence.

It seems unlikely that either of the above will change before the next general election.

In this stasis we can support front line work and help to influence individual policies but building a society where problems are routinely prevented is an ambitious long term goal which will not be reached solely with the small pragmatic steps. We need to also think much harder about how we radically influence the direction of travel. We need to find a way of moving the conversation on to the big vision.

A bill of rights for the next generation.

All political parties need to offer a future that is better than the past but need and capacity are on irreconcilable trajectories. Likewise consumption and sustainability. Food banks, student loans, generation rent, trolleys in A and E, people sleeping on the streets – in different ways these are all symbols of a society that is moving backwards, not forwards. There is a political imperative, as well as a social, economic and moral obligation, for politicians to find a way of promising a better future, not as a rhetorical aspiration, but as a set of rights with a plausible plan for delivering them.

Suppose we began to talk about a Bill of Rights for Future Generations to fundamentally change how government thinks and behaves. Suppose we imagine the Bill as the set piece of the first Queens speech from the next government in three years’ time. It would be the world’s most far sighted and ambitious programme for ensuring a better future for our children.

Some of the ideas which we have discussed regularly on this blog would have a place (Ten year planning, transition goals, an Office for Future Generations, early action testing, a Next Generation Investment fund etc) but, to justify the billing it would need to be significantly more ambitious.

Leading that conversation

Suppose we think of this goal as a way of inspiring a different conversation over the course of the next few years.  The big objective would be extraordinary. Some more limited gains on the way would be worthwhile.

How would it be framed and what would it contain?

Please post your comments below in the usual way or mail me directly at david.robinson@community-links.org

Fake relationships and Revolution 3.2

Monday, February 13th, 2017

The launch of the Jo Cox Loneliness Commission a couple of weeks ago attracted more media attention than might be expected for such an event. No doubt this was largely due to the appalling circumstances of its genesis: Ms Cox was deeply concerned about the issue and was planning the commission at the time of her murder. MPs Rachel Reeves and Seema Kennedy are now carrying forward the work that she began.

However I don’t think the tragic association accounts for all the attention: As I have written previously, at least one in five Brits are lonely often or all of the time. Loneliness is a twenty first century  plague and although almost all the press coverage over the last two weeks has focused on  older people this is, as I noted a couple of weeks ago, a misleading emphasis.  Study after study has shown that no age or social group is immune.

 

We have been thinking about the early action contribution to this conversation. Our Early Action in Later Life report stirred passions in 2014 with the assertion that “befriending schemes are to social isolation what food banks are to poverty”.

We meant no disrespect to befriending schemes or to Food Banks, both are an essential response to a crisis, but neither, on their own, offer a long term solution. Alongside the remedial work we need a deeper, longer term approach to redressing the causes of loneliness.  Just as we must ask “why are so many people hungry?” and tackle those issues, so too must we ask “why are so many people lonely?” and confront the causes

This takes us into the wider issue of social isolation which we need to address not only to beat loneliness but also to boost educational performance, enhance economic opportunity and social mobility, reduce health inequalities, improve social cohesion and indeed do almost everything that really matters.

And, far from making progress on social isolation, we are not even moving in the right direction. Instead we are, as Alvin Toffler wrote, “experiencing the dizzying disorientation brought on by the premature arrival of the future”.  Our every transaction is now automated from paying the rent to fixing a doctor’s appointment. Social media has redefined our understanding of friendship. We have limitless virtual networks but fewer real friends. Those that we do have are likely to be scattered and distant. We network but we don’t relate. And we have devalued our understanding of the concept of “relationships” to the point where I travel to Birmingham and Virgin Trains assure me that they “value our relationship”.

Fake relationships are as ubiquitous in 2017, and just as insidious, as fake news.

Across the sweep of history this sequence is not unfamiliar. First the agrarian, then the industrial revolutions disrupted social patterns and called for new ways of behaving individually and collectively. Social change followed but it took a while. Now we are again in the catch up phase. Part 3.2 as it were, of the technological revolution that has so transformed our lives in recent years.

We have to tackle the scourge of social isolation by fixing the cause. To do that we must begin with a two part question:

First, what is a real relationship?  I think it is one that nourishes with depth and meaning.  It is between people, possibly facilitated by a machine or an organisation but not with a machine or an organisation. And it is about more than kindness or reciprocity, empathy or solidarity although it is all these things. It may be closest to what in Africa is known as Ubuntu – “my humanity is inextricably bound up in yours. We belong in a bundle of life” Desmond Tutu.

And then, what is a real 21st century relationship? We can’t rewind the clock even if we wanted to. Our generation’s big challenge is to fathom out how we use and benefit from the recent advances in ways which don’t devalue our essential humanity but which value, sustain and enrich it.

Voluntary organisations like ours don’t have all the pressing mandatory duties of a statutory authority. We have the freedom, and with the freedom a responsibility, to try to understand not just how we manage or ameliorate a problem but how we build a better society. I’m not sure what Revolution 3.2 should look like but I do think  we should try to free the space to think about it not least because, as Dr Toffler also said, You’ve got to think about big things while you’re doing small things, so that all the small things go in the right direction.”

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.

Tackling racism at its root

Friday, November 25th, 2016

The murder of Jo Cox, which led to her killer being given a life sentence on Wednesday, was a shocking reminder of where racist thinking can lead. Yet, despite a concerning rise in far-right activity and hate crime against ethnic minorities, there appears to be little focus on preventing racism from taking root.

 photo Tackling racism at its root_zpssrwfy8cx.jpg

However, one small organisation in Swansea is acting earlier to tackle hate crime and promote better opportunities for young people. Through working with disadvantaged ethnic minority young people, the Ethnic Support Youth Team (EYST) noticed that the young people they worked with were experiencing increasing levels of racism and hate crime. They realised that nearly all the emphasis in this area was on encouraging victims to report hate crime, but little was being done to prevent it from happening. Furthermore, a rise in far-right activity in Swansea highlighted that it was a particular type of young white person being recruited into these organisations: extremely disadvantaged, often excluded from mainstream education, and sometimes within the youth offending system.

In response to this, EYST developed the Think Project, a targeted intervention for 16-25 year olds which mirrored the work they were doing in preventing radicalisation in young Muslims. The project stands out as one of the few programmes in the UK that solely focuses on targeting young white people who are most vulnerable to far-right extremism. Delivered through pupil referral units, youth offending teams, and schools, it is a three day educational programme that combines education about Islam, migrants, and asylum seekers with positive, first-hand experience of diversity. It is delivered by ethnically diverse youth workers and connects the young people with those they have previously feared or misunderstood, hearing their stories and challenging myths.

The importance of learning the facts and gaining these experiences couldn’t be starker. Of the nearly 500 young people that Think Project has worked with in the last four years, over half thought that immigrants make up 50% of the population of Wales before completing the programme, and a quarter believed it was around 75%. The reality is closer to 6%. This distorted perception of reality plays into the hands of far-right groups who claim the country is overrun with immigrants taking our jobs, homes, and benefits. Yet Think Project demonstrates that given the opportunity to learn the facts and gain positive first-hand experience of diversity, these opinions can be challenged. The project’s external evaluation showed that whilst most young people on the programme initially held strong and largely negative views about immigration, asylum and diversity, these views change significantly for the 95% of participants by the end of the programme.

The power of Think project is most clearly demonstrated through the stories of those involved:

‘Kayleigh’ took part in one of the group sessions delivered in Merthyr Tydfil, and by her own admission at the start of the programme, ‘just didn’t like people with different skin colours, didn’t like it when they talked their language, just couldn’t stand them’. After the 3 day programme she said ‘I feel completely different now, we’re all human, we’re all here for different reasons’. After the programme, the Think project workers supported her to take up volunteering opportunities with an international volunteering exchange charity. She thoroughly enjoyed a one week residential volunteering opportunity in Cardiff, meeting people she would never have met in her home town. She is now considering undertaking volunteering abroad with the same charity, something she says she would never have done without the Think Project. She volunteered to speak about the impact of the project at the end of project conference, and has applied to become a community organiser with Hope not Hate.

 

Key to the success of Think Project has been recognising that whilst these young people are potential perpetrators of hate crime, they are also victims of the failures of our education system and society more generally. By providing a safe space where they can air their real and perceived grievances and by treating them with respect, the Think Project enables their views to be debated and challenged without pushing them deeper into prejudice. During the programme, emphasis is placed on improving the participants’ confidence, understanding, and communication skills and once it is completed participants are encouraged to pursue volunteering opportunities. In doing so, Think project is further increasing their resilience to far-right groups as well as increasing their opportunities to thrive.

Think Project sets an example on how to act early to effectively tackle racism and create better outcomes for some of our most vulnerable young people. But it is only a small organisation, and its perception as an ‘add-on’ service means that the issue of funding is a constant challenge. Whilst there are also much wider challenges around poverty and inequality which must also be addressed, it is crucial that schools and educational institutions begin to act earlier on racism, and equip our young people with the tools they need to become positive and active contributors to society. In the words of Jo’s sister, Kim Cox, “Whilst we can’t change what’s happened, we can try and choose how we respond… with love, strength and positivity”.

 

You can read more about Think Project on their project website here.

You can see more examples of early action in our case study gallery.

 

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.

What do Community Links and the punk movement have in common?

Monday, October 17th, 2016

Community Links is turning 40 in 2017. That means we’re a few months younger than the punk movement, whose 40th anniversary is currently being celebrated. 

While Community Links may admittedly have little in common with the Sex Pistols, the beliefs animating this charity’s founders and the rather more legendary Sid Vicious were rooted in the same decade of forgotten industrial peripheries and broken ideals that followed the 1960s, with their passionate rejection of postwar injustice, their popular struggles, the widespread student demonstrations and all the local-yet-global mass protests. The ultimate goal of this – then small – group of activists from east London might have been justice for all rather than a rebellious call for anarchy in the UK, but the irreverence and DIY ethos animating some of the first actions organised by Community Links had perhaps something to share with the ripped-up T-shirts and gravity-defying mohawks that still define the punk era.

“With £360 we bought an aging Routemaster, unscrewed the seats, sold them, bought art supplies, knocked in some benches and a couple of moveable tables,” remembers David Robinson of those early years. The bus could soon be seen parked on council estates around Newham, as a diverse group of community workers, activists and volunteers entertained children, listened to people and gave advice. When, in the early 1980s, the tower blocks campaign was set up in collaboration with local residents who were tired of being isolated in low-quality, high-rise forms of social housing that tended to sway in the wind, the loudspeaker became Community Links’ most prized possession; leaflets and other campaigning material were hand-drawn, glued together and published as zines; and protest strategies also included gathering a group of people, having them dress up as cardboard blocks and shout loudly, at the demolition of two high-rise estates, “2 down, 107 to go!”

Radical beliefs and radical action required radical means. If the system wasn’t working, the only way to escape alienation was to go back to the roots, back to the people, back to the community. To do something radical yourself. To do-it-yourself.

A lot has changed since then. Forty years are a long time for a human life, let alone in the existence of an organisation. The Greater London Council, Europe, Thatcherism, Gordon Brown and the coalition meant doors were opened then shut abruptly; that funding abounded then was hard to come by. Community Links has indeed grown then shrunk again, but that initial DIY sensitivity still pervades it – though it’s expressed in different styles, ways and forms. The work on how third sector organisations should live their values, published in the mid 2000s, is one such example: “It was produced as a report,” says Richard McKeever, who oversaw much of Community Links’ editorial output through the years, “but it has a toolkit at the back. It’s go-and-do-it-yourself stuff.” Not too different from some of those early National Tower Blocks Directories, which included constructive stories of empowerment and how-to guides on a wide range of topics, from getting rid of cockroaches to regenerating green spaces on high-rise estates.

And it’s precisely these local stories, these ground-up perspectives, these simple human insights into complex social issues that have characterised the work of Community Links since 1977, while the political context has continued to change around. Gone are the days when the charity resembled more a spontaneous movement than a mainstream organisation, and the same is true for punk – which last summer was curated into exhibitions at the British Fashion Council and the British Library. But structural definitions aside, the imagination of those who’ve participated in both likely remains the same. It remains radical; it remains open to rejecting and reinterpreting the system as a whole if needed; it remains focused on the acquired awareness that alternative – and sometimes more effective – solutions can be found in the pragmatic knowledge of local communities. That’s why Community Links has never ceased to gather stories, amplify the voices of the disempowered, propose constructive narratives, bring local people in touch with Downing Street, and Downing Street in touch with Newham. And that’s also why we’ve been working, for the past five months, on a book that will hopefully act as a collection of thoughts, recollections and learning narrated through the voices of some of the people who have interacted with Community Links for the past four decades. To inspire, despite the adverse context stifling most changemakers today, a different policy framework. A systemic, go-and-do-it-yourself type of framework.

The book will be released next year, in time for our 40th anniversary celebrations. Keep checking this blog for updates!

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.