Investigating the contribution of the voluntary sector to mental health crisis care in England (2016)

The Health Services Management Centre (HSMC), in partnership with the Third Sector Research Centre (TSRC) at the University of Birmingham, Suresearch and the Open University Business School, has won an award from the National Institute for Health Research Health Services and Delivery Research (HS&DR) Programme to investigate the role of the voluntary sector in mental health crisis care in England.

Led by Dr Karen Newbigging, this study will provide a national overview of the range of crisis support offered by the voluntary sector; explore stakeholder views of the relative strengths and weaknesses of different types of voluntary sector crisis services and make recommendations as to what needs to happen for the NHS and Local Authorities to improve how they work with voluntary sector crisis services to ensure that people in a mental health crisis can get the right help at the right time.

Dr Karen Newbigging on mental health research

Overview of the study

Background

Research and national reports have shown that access to the right kind of support at the right time for people in a mental health crisis can be a problem. Some people, also, avoid seeking help because of fears related to hospital admission or poor treatment, which can result in involuntary detention under the Mental Health Act. As a result, the voluntary sector, also referred to as the third sector, provides support for people in a mental health crisis. This ranges from helplines, peer support, befriending or crisis houses, which provide an alternative to inpatient admission and community support.

Voluntary sector support is highly valued because it is informal, focuses on social context and builds relationships with the person in crisis. How widely available these different types of crisis support are, what they provide and how they fit with the crisis services offered by the NHS or Local Authority is not well understood. A literature review for this proposal found that the majority of research has focused on statutory service provision and there is a clear lack of evidence in understanding what they diverse range of voluntary sector organisations (VSOs) can offer and how this might be used to best effect in mental health crisis care.

Aims and methods

The ams of this study are to:

  • Investigate the range of crisis support offered by VSOs in England.
  • Explore stakeholder views of the relative strengths and weaknesses of different types of voluntary sector services.
  • Recommend what needs to happen for NHS and Local Authority crisis services to work with voluntary sector services better.

This is a multi-method study involving four work packages (WPs). WP1 scopes the contribution of VSOs to mental health crisis care through a national survey of VSOs supplemented by interviews with national stakeholders. This will be underpinned by an analysis of available data on VSOs to identify the different types of VSOs providing support and care to people experiencing a mental health crisis. WP2 involves detailed mapping of the VSO provision, including capturing small scale community based initiatives within two regions to develop a taxonomy of crisis care, which will provide a sampling frame to select two case studies per region to investigate the contribution of VSO provision to crisis care at both a system (WP3) and individual level (WP4). These case studies will be selected to reflect the diversity of the population and geography, which might impede access to support in a crisis. In these case study sites, WP3 will focus on mapping the crisis care system at a local level. Data on activities, interventions and stakeholder perceptions of effectiveness of the voluntary sector contribution to the crisis care pathway will be collected through documentary analysis, a key informant questionnaire, interviews with key stakeholders and focus groups with mental health service users and carers. WP4 will map the crisis care trajectories of 10 service users in each site, from interviews with mental health service users, carers and statutory providers.

Analysis

Results from the national mapping of VSOs will be classified to develop a typology. Data from qualitative interviews will be thematically analysed to address the research questions and triangulated with the mapping data to identify the VSO contribution to an integrated crisis response. Our results will be used to produce guidance on how the NHS can work effectively with VSOs to improve mental health crisis care in England. This will benefit people experiencing a mental health crisis, their families and carers.

Ethical approval

This study will require ethical approval from the Health Research Authority.

Research Timescale

This is a two year project commencing 1st November 2016.

Research Team

The research team is an experienced team bringing together methodological expertise with contextual and theoretical knowledge of the voluntary sector and of mental health. The team members are:

  • Dr Karen Newbigging, Health Services Management Centre, University of Birmingham (Chief Investigator)
  • Alex Davis, Suresearch member and carer
  • Dr Jenny Harlock, Health Services Management Centre, University of Birmingham
  • Professor John Mohan, Third Sector Research Centre, University of Birmingham
  • Dr James Rees, Open University Business School

People with lived experience of mental health issues will be extensively involved in the conduct of research and three service users are being recruited to the team as co-researchers, supported by Suresearch, a Midlands network of people who use their experience of mental health issues and services in education and research. There will also be a reference group of service users acting as critical friends to the project.

Research governance


Research governance will be provided by a Study Steering Group (SSG) to ensure that the project conforms to standards of good practice, as laid out in the Department of Health’s Research Governance Framework for Health and Social Care.  The SSG will also provide expert advice to the research team and membership will, therefore, reflect different interests in ensuring access to high quality crisis care. The Study Steering Group will meet four times during the course of the project and there will also be virtual meetings and correspondence as needed.

Further information


Further information is available from Dr Karen Newbigging k.v.newbigging@bham.ac.uk and 07974-929367.

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