Social care interventions that promote social participation and well-being: a mixed methods study

Introduction

Supportive relationships are important for people experiencing mental health problems. They can both enhance mental well-being and provide access to social resources which, in turn, can support recovery. As mental health problems often impact on an individual’s social relationships – because of stigma or the effect of the mental health problem on the individual, for example – it is important for health and social care workers to support people to maintain and develop their social connections. However, there are no practice guidelines to assist workers with this.

Objectives

Understanding practice contexts and harnessing the expertise of workers and service users is essential to the development of complex social interventions. Therefore, it was important in this study to understand how health and social care workers helped people to develop and maintain social relationships to provide the basis for practice guidance. In particular, this study aimed to investigate how workers:

• developed effective working relationships with service users;
• created new opportunities for social engagement;
• discussed service users’ concerns about creating and maintaining social relationships;
• discussed with service users about developing social relationships with resourceful people, (and their understanding of ‘resourcefulness’ in this context);
• supported service users to develop and maintain their social connections.

Methods

This study explored good practice in six health and social care agencies. Conducted between September 2010 and November 2012, it focused on workers who were skilled at assisting people to develop and maintain relationships, and had a particular interest in the experience of people with a diagnosis of psychosis. A researcher used observations, interviews and focus groups to explore practice in NHS mental health teams, a housing support agency and third sector agencies. The findings were summarised in a model – the Connecting People Intervention – which articulated all the components and processes which are likely to be involved in supporting people to develop and maintain new social relationships.

Guidance was developed from the study’s findings to explain to workers how the model works in practice. The model and practice guidance were refined by study participants and the study’s advisory group through focus groups and a consultation.

The effectiveness of the Connecting People Intervention has been evaluated in a large pilot study in sites across England in other NIHR SSCR-funded studies.

Findings

• The process of developing and maintaining relationships is not linear and cannot be ‘engineered’ by workers
• A co-productive approach whereby workers and individuals develop goals and interventions together is more likely to be effective
• Agencies need to be outward-facing and engage with both local communities and communities of interest to enhance their service users’ connections and social relationships.

Resources

Journal paper

Webber M (2014) From ethnography to randomized controlled trial: An innovative approach to developing complex social interventions, Journal of Evidence-Based Social Work, 11, 1-2, 173–182.

Practice outputs

Practice guidance

Interactive model

Further information can be obtained from project website at www.connectingpeoplestudy.net.