The impact on community-led health organisations
Given all the above, it is no surprise community-led health organisations we spoke to told us they were facing challenging times, with the three main ‘pressure points’ being:
the increasingly complex nature of mental health and wellbeing issues among community members they are working with;
having to support people who aren’t receiving the support they need elsewhere; and
challenges around funding.
More complex support needs
We heard from community-led health organisations that it isn’t always so easy to tell, when working on the ground, how the twin impact of increased pressure on mental health and strained services is playing out in communities. This is particularly the case when organisations have a ‘no ask’ policy to reduce stigma and ensure that community members feel welcome.
Nevertheless, as described in the ‘mental health crisis’ section, community-led health organisations are finding that increased pressures on mental health and wellbeing are leading to increased, and more complex, demands on their work on the ground.
The more intensive support required to meet these complex needs has knock on effects for the wider service provision of organisations. One manager of a community-led mental health project described how having to deal with the different crises people are experiencing can prevent them doing “fun stuff that folk want to do”.
Plugging the gaps
In the words of one respondent working in public health, the voluntary and community sector is being “left to plug gaps” from mainstream mental health services. They added that the level of complexity the community sector is being asked to support is not appropriate.
Some community-led health organisations reported having to support people who should be accessing other services.
“But I do think, yeah, we're we are seeing people that now don't meet the criteria perhaps for statutory services like they would have done previously.” (Manager of community-led health organisation)
If an organisation is spending increased time supporting people with more complex and acute needs this is likely to have a knock on effect on their ability to work with people in a preventative way. A CHEX network organisation supporting families in disadvantaged communities elaborated on this challenge, illustrating how pressure on staff and resources has a knock-on effect on the ability to do preventative work.
“If you're working with families with really complex mental health issues, the amount of time you spend with one family naturally just increases for, you know, a period of time that they're needing it. So instead of doing early intervention, quick work, shorter, more regular sessions or group work, you're ending up spending a lot more time doing intensive one to one.”
Another organisation we spoke to added that they were seeing increased numbers of people coming through their doors seeking support due to the level of trust people had in their organisation as well as their centrally located, accessible, provision.
“And although that's great because you're like, OK, do you know, you're, you're meeting these people, you're able to offer some kind of support, for the majority of services, for the majority of our staff, we're not fully trauma trained, we're not mental health providers or that's not our role in that setting. Do you know, and that can be really difficult and have a bit of an emotional toll.” (Manager of community-led health project)
Funding challenges
Community organsations are facing increased challenges when it comes to funding and sustainability. A picture emerged of funding being eroded gradually, with some organisations receiving no inflationary increases for some pieces of funded work and small reductions in others.
“And we'll be about to hear, we've got to retender for contract, right next year and we know the, you know you can forecast already that there's gonna be a funding cut, you know, so we are not unique” (Local mental health charity worker)
Other organisations were having to be creative or make use of the good relationships they had fostered with particular individuals in funding organisations.
“And like for us, our real example of that this year our funding was at standstill, so it's the same as last year when there's a 20% increase in everything else. So I went back to them and said “that won’t work. If that's what it is, then I need to cut my cloth accordingly” We're a flagship organisation in the city just now, without blowing my own trumpet, but like we've worked really hard to be good at what we do. And I told them they need to find more money, and they did.” (Manager of community-led health organisation)
A lack of funding had a direct impact on the level and type of support community-led health organisations can provide.
“We're able to do the work, but it puts a strain on staff resources. If we go back to budget cuts, not having the funding to keep staff or to expand your service when it's needed can be an issue.” (Manger of charity supporting families).
People we interviewed also described the impact uncertainty around funding has on staff moral and wellbeing.
“We're OK at the moment, but if you'd asked me in February this year, you might have seen me crying. We were in a really difficult situation, looking at whether the organisation could manage without a manager, without myself, and how we couldkeep going. And I think again that the mental well-being of, of staff and volunteers within the third sector, the roller coaster of funding is, yeah, not good for, for mental health.” (Manager of community-led health organisation).
