Over the past four years, we’ve been creating new systems of community mental health in Living Well sites across the UK including Edinburgh, Salford, and Tameside and Glossop, thanks to the National Lottery Community Fund. So far the programme has supported some 2,500 people who might not otherwise have been helped and generated over five million pounds of additional investment in local mental health systems.
For these pioneering sites, transformation has meant developing new processes, creating new roles, building new services, and developing different ways of operating.
Such transformative change in any system - especially mental health systems - is deeply challenging. Mental health systems in the UK are highly complex and it’s difficult to understand how they work currently let alone to change how they work in the future.
The human response to change
When faced with such high levels of complexity, it is a very natural human response to feel overwhelmed. We are hard-wired to avoid such feelings and so our response is to find ways back into a state of stability and equilibrium - and we often attempt to simplify, to separate, even to detach:
We try to simplify people’s needs and we try to avoid too many parts of our system being dependent on others
We seek to separate elements of the system from one another, often creating silos and lines of separation
We even find ways to detach ourselves and others from the responsibility for the overall purpose of the system, opting instead for being accountable for a technical function or measurable output.
Such responses, although understandable, have inhibited many attempts to transform our mental health systems so far.
Through our work in Living Well systems over the past decade, however, we have learned how to hold and navigate complexity, to embrace connections and dependencies and to maintain a deep relationship to our purpose. We place the power of people’s stories at the heart of our approach.
We’ve explored what we’ve learned from people’s stories in our previous blogs - firstly understanding the needs of people with lived experience, then reinvigorating shared purpose among professionals and practitioners and finally changing leadership practice.
In this blog, we’ll share how this culture of storytelling can help accelerate and sustain transformative change.
The power of stories
Stories can hold within them high levels of complexity. People’s shared experiences help us to build and maintain relationships and connections while bringing life to what we value and motivating us to take action.
Since our initial work in Lambeth, South London, we’ve used stories as our foundation - as a means to both understand the existing challenges in the system and to create a new desired way of working.
In 2010, Denis O’Rourke, a trailblazing Commissioner in Lambeth’s CCG, developed Vital Link to support and train people with lived experience to gather stories from other people using Lambeth’s services and their carers.
For our part, Innovation Unit trained people to collect and then tell stories from acute mental health hospitals. These stories united people with lived experience and practitioners around the shared values they held for what good support should be and revealed the gap between these aspirations and the reality of provision. Stories from the acute wards, along with stories from other services, became an engine for the transformation of community-based support that Lambeth would go on to pioneer.
Such power of stories has long-been evidenced as a potent means to transform complex systems. Marshall Ganz, Senior Lecturer in Leadership, Organising and Civil Society at the Kennedy School of Government, Harvard, describes how stories connect our values to our actions. Over the past four years in Living Well, our application of Ganz’s theory has revealed three learnings:
Stories connect people’s roles to their purpose People working in mental health systems often have an identity that is defined by the technical role or function they play in the service or system. Such identities can deepen a sense of detachment from the real purpose and sense of responsibility for outcomes for people. As Wendy, Chief Executive of Health in Mind Edinburgh in our second storybook book Working for Something Better described: “There were days when we came away thinking - this machine is too big it will never change. I can’t hold the responsibility of making this difference.” Living Well has created spaces, like our national community of practice, for people to talk about why they are here, what motivates them and what they care about. These spaces enable the opportunity for people to begin to reconnect with their own personal story - or their ‘calling’ - for why they are working to support people’s mental health. Marshall Ganz describes this as a story of self, and it is by exploring this story that he says we can each “understand the values that move us to act”.
Stories connect people with one another The ‘machine’ of mental health systems that Wendy described can feel very disconnected and alienating. Teams and those in them can feel isolated in the system. As Linda, Strategic Manager for Mental Health and Wellbeing, Edinburgh shared in Working for Something Better: “How do you connect with someone when that is just so far beyond your experience of where you’re coming from?”. When we share stories about our own motivations and cares with others, we reveal the values that underpin them. When we feel we hold shared values with others we can feel a powerful sense of ‘us’ - as a collective or community. In our blog about building shared purpose, we explored how creating this sense of community requires developing and communicating what Ganz calls a “story of us”. This is the way we can create a stronger shared identity and purpose in a system that moves beyond the siloed and disconnected teams, services, functions, agencies, etc. As Judd, Commissioner in Salford, said in Working for Something Better: “Being in a room where everyone was speaking the same language, and everyone’s getting it, and I guess coming away, chatting with some of the people with lived experience who came with us and them saying, ‘God, you know, we’re doing some really good stuff here.’”
Stories build movements that motivate people to act By acknowledging our stories of self, we can create and foster a story of us. However, Ganz argues it is only by acknowledging and communicating both the possibility for better if we act, alongside the risks if we fail to act, that we motivate people to take action. Ganz describes this as the “story of now”. It is by developing this story in conjunction with stories of self and stories of us, that Living Well’s pioneering sites have been building movements for change across mental health systems.
At the heart of our learning in Living Well, is that when we start to tell a new story, transformative change feels very urgent, very difficult, but quite possible. Our support for sites has taken them on a journey to understand and value the power of stories in the transformation of their systems.
By fostering this culture of storytelling - and by guiding our sites in how to establish this culture through new practices, processes and policies in the system - we help ensure that our sites can continue to inspire, mobilise and maintain people in an ongoing process of transformative change.
If you’d like to talk to us about Living Well, including developing a programme in your area, then please email email@example.com and we’d be delighted to start a conversation.
Living Well UK Programme is funded by The National Lottery Community Fund, the largest funder of community activity in the UK.