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Evaluation of the Mental Health Navigator Scheme.

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This project is delivered by the NIHR ARC National Priority Consortium for Health and Care Inequalities.

Find out more about the NIHR ARC National Priority Consortium for Health and Care Inequalities – which is led by ARC North East and North Cumbria.

Project title: Evaluation of the Mental Health Navigator Scheme.

Duration (start and end dates): 1 September 2021 –31 August 2023

Funding total: £299,563

Funded by NIHR ARC Health and Care Inequalities National Priority Consortium. Led by ARC Yorkshire and Humber, collaborating with ARC North East and North Cumbria and ARC Greater Manchester.

What does the project aim to achieve?

In 2015 Wakefield District Housing (WDH) and Wakefield CCG implemented a Mental Health Navigator (MHN) scheme to support people with mental health problems to maintain tenancies and prevent secondary mental health care referrals.

Navigators, employed by the mental health trust (SWYFT), work with WDH to provide practical support and early intervention to tenants experiencing problems.

An early, small scale evaluation found the service highly valued by WDH staff who reported a positive impact on supported tenants including improvements to their working relationship. There was a reduction in rent arrears, and a 25% drop in evictions.

Supported tenants valued the service and reported a variety of global improvements, from improved functioning and integration to engagement with health and mental health services. Further outcomes and process evaluation is needed in order to inform implementation of the scheme in other sites and settings.

This project will conduct robust, theory informed, evaluation of the existing site (Wakefield), whilst exploring potential barriers and facilitators to adoption in novel settings, using that evidence to inform an implementation toolkit to support roll-out in other sites regionally and nationally.

It will conduct an evaluation that informs implementation with three key objectives: 1) assess the effectiveness and cost-effectiveness of the scheme; 2) explore existing and future service user, provider and stakeholder views of the acceptability and feasibility of the initiative; and 3) synthesise findings and ‘lessons learned’ to develop an implementation toolkit.

The evaluation approach is underpinned by principles of co-production and community engagement.

Who is it relevant to or who could it impact?

Mental health problems disproportionately affect people living in deprived circumstances and can cause significant impairment. Maintaining a tenancy during mental health challenges is difficult but few people with even severe mental illness live in supported housing; most rent their home.

Housing support officers have few resources to deal with mental health-related tenancy problems.

This project aims to develop a toolkit for implementing the Mental Health Navigators scheme in other sites regionally and nationally.

Anticipated roll-out could be embedded in social housing, as in WDH, in council housing services, or in the private rented sector, and setting diversity will be sought to provide guidance in relation to a range of implementation scenarios.

The intervention, if implemented elsewhere with joint commissioning through health and social care, could be extended to vulnerable council and private rental tenants, and owner-occupiers with mortgages – who are all at risk of homelessness from social fracturing as a result of mental health problems.

Why is this project important?

Housing loss has severe social and health consequences and people with mental health problems are vastly over-represented as homeless. The scheme, as implemented at WDH, is a high-volume, low resource, targeted intervention to reduce further health and social inequalities in a vulnerable population.

The project aims to quantify further key outcomes (e.g. debt management, service use) and understand mechanisms of action to successful crisis resolution to inform further implementation. Pandemic-related income and mental health pressures will soon result in a large number of tenancy breakdowns, and this scheme has the potential to reduce further inequalities.

Lead contact for the project: Dr Sarah Blower (sarah.blower@york.ac.uk)

Co-Investigators

Dr Sarah Blower, Research Fellow (Assistant Professor), Department of Health Sciences, University of York

Dr. Amy O’Donnell Senior Research Associate, Population Health Sciences Institute, Newcastle University, ARC NENC

Dr. Sheena Ramsay Clinical Senior Lecturer and Honorary Consultant in Public Health, Population Health Sciences Institute, Newcastle University, ARC NENC

Dr. Luke Munford Lecturer in Health Economics, University of Manchester, ARC GM
Professor Gerry Richardson, Centre for Health Economics, University of York, ARC YH

Professor Laura Bojke, Centre for Health Economics, University of York, ARC YH

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