Thrive LDN’s progress towards happier, healthier lives

Foreword from the Mayor of London

I’m determined to help make London a city where conversations about mental health are normalised and there is no stigma about seeking support. For many of us, this last year has been the most challenging of our lives, taking a heavy toll on our mental health and wellbeing.

There is no doubt that public conversations around such topics have come a long way in recent years but there is still so much further to go. One of the things I’ve been keen to do over the past year is set an example by speaking openly and honestly about how I’m doing because we shouldn’t feel we have to keep our feelings bottled.

As we reflect on the previous year, we should all be encouraging each other to talk and act more when it comes to mental wellbeing. This has never been more important for us as Londoners and for our city as a whole.

When I launched Thrive LDN, alongside health and care partners in 2017, we began an open dialogue with Londoners – to encourage everyone to think, talk and act more when it comes to mental wellbeing. Since then, there has been real progress, demonstrating that we can achieve great things when we work together.

I’m so grateful to the boroughs, organisations and communities cited within this document, and for your continued commitment to supporting the wellbeing and resilience of all Londoners.

You should be incredibly proud of what has been achieved. You are putting plans into action and, together, we are building a city where every Londoner feels supported not only to speak openly and honestly, but to thrive.

As we lay the foundations for our recovery from this pandemic, we must be mindful of the devastating mental health consequences of wider inequalities, whether they are as a result of problem debt, rising unemployment or structural inequalities. As Mayor, I will continue to ensure that mental health is considered across all our recovery plans. Nobody’s mental health and wellbeing should suffer because of who they are or where they live.

What the work within this report shows is that there’s tremendous courage and hope across London. Even in times of adversity and hardship, we’ve seen amazing selflessness and acts of kindness within our communities. Those who’ve been hardest hit by the pandemic have spoken about the positive significance of family and support structures, as well as the support offered by the wider community; from sports clubs to faith groups.

We must now build on the activities and initiatives detailed in this document so we can work towards fashioning a city where we have the right support available for everyone. As awareness of mental health – and how social inequalities can impact on it – continues to grow,

we need to harness the power of collaboration and togetherness to ensure innovative approaches can be shared, sustained

and continued. This report demonstrates that Londoners have their own solutions and know what is best for their communities. We must now continue to develop these ideas and approaches because doing so will help achieve our goal of making sure that all Londoners who need help and support are able to access it.

Sadiq Khan
Mayor of London

Foreword from Queenie Chizea

Young Londoners face a host of challenges and maintaining good mental health is one of the biggest, especially with the

COVID-19 pandemic igniting and heightening isolation, fear, family loss and separation amongst many other issues. Young people have been cut off from friends, extended family, familiar places, and daily activities. All of this has taken a toll on the average young Londoner – even though the lockdown measures were to protect their physical health.

On World Mental Health Day (WMHD) in October 2020, we saw a global community come together to highlight the importance of mental health now more than ever before, and it was great to witness Thrive LDN be a part of this global conversation.

The 2020 World Mental Health Day Festival hosted by Thrive LDN and City Hall’s Peer Outreach Team was not just a memorable one but an important one. I had the opportunity to co-lead during the planning and strategizing for the event, working closely with the Thrive

LDN team in order to deliver this online festival. Spanning over a couple months during the first lockdown, we discussed and met virtually on a weekly and at time bi-weekly occasion, bringing together speakers, mental health professionals, performers and, most importantly, the amazing young people to experience an exciting conversation like no other across the Thrive LDN website, YouTube and Zoom. I enjoyed the time spent planning and leading up to the day of the event that brought people from around the world together.

It is essential as a wider London community, that we work collaboratively on behalf of young people to deliver and co-produce activities that will benefit them and find means to ‘cope’ during these unprecedented times. Including young people in the conversation and production of activities will help to inspire as well as motivate young Londoners to keep active, dreaming and living positively during times such as the one we are living in. This will benefit the promotion of positive mental health habits, improving the feeling of isolation (even if social connection is hard or not as possible), and giving young people a way out and something positive to look forward to beyond the pandemic.

As we begin to see a glimpse of a safer, healthier and more positive future – I have had meaningful reflections and conversations with myself as to how I can personally recover from this pandemic and inspire others to do the same. The most positive aspect of this season is having positive people around myself, which I am certain many can relate to. Therefore, being able to support others in situations which may not be as positive as they’d wish it to be. The WMHD event highlighted this for many and the success of not being in a physical space but equally having a huge impact in which we can look back and reflect on how we persevered through the pandemic.

Queenie Chizea
Young Londoner and Project Manager within the Peer Outreach Team at City Hall

Executive summary

Thrive LDN is a citywide movement to ensure all Londoners have an equal opportunity for good mental health and wellbeing. We are supported by the Mayor of London and the London Health Board. At its core, Thrive LDN is a participation-driven partnership that engages with and responds to the needs and insights of Londoners. Since conception, insights and feedback from Londoners have been at the forefront of everything we do.

When reflecting upon the previous twelve months, Londoners’ needs and insights have been firmly rooted in the ongoing response to the coronavirus (COVID-19) pandemic. We publish this progress report a year on from when we started supporting partners to coordinate the public mental health response to the pandemic. It details what we have done and learned, as well as our plans for the year ahead.

We begin this report with lessons from one of the most challenging years of Londoners’ lives. The pandemic is continuing to affect our social, economic and family lives dramatically – both now and in the longer term. There is substantial evidence that the pandemic has simultaneously widened pre-existing inequalities whilst creating new ones. The economic hardship and mental health issues arising from the pandemic are disproportionately affecting Londoners with lived experiences of marginalisation and disadvantage.

Here, we outline how Thrive LDN approached supporting partners to coordinate the public mental health response to the pandemic and how we considered processes, actions, partnerships, and their outcomes at an individual, community, and system-wide level.

Section 1 also tells the story of how through adaption, innovation and collaboration, Thrive LDN has been supporting public mental health in London.

Section 2 details outcomes and benefits from Thrive LDN activities between April 2020 and March 2021. During this time, more than 685,000 people have taken part in projects, events, and activities on which Thrive LDN has led or collaborated on. At a time when it has never been more important, and when public trust in the health and social care system has been tested, close to half a million (485,000) more Londoners have engaged with Thrive LDN and partners in 2020/21, representing at least a threefold increase year on year.

Some of our highlights from 2020/21 include:

• Supporting the Strategic Coordination Group and associated sub-groups to embed wellbeing into pandemic response structures.
• Establishing a public mental health research and community insights team, to provide up-to-date evidence on mental health and wellbeing in the capital.
• Expanding our communications function to develop and distribute regular public mental health communications toolkits so that key messages can be widely shared.
• Working with 200 different community groups and organisations and listening to the voices of over 10,000 Londoners to understand more about the experiences of 20 disproportionately at-risk groups.
• More than 3,000 people have engaged with World Mental Health Day festival content.
• Over 700 parents in London took part in online resilience building workshops.
• Awarding grants to 24 community and grassroots projects across London to help support the mental health and wellbeing of those who are experiencing higher levels of unfair treatment and discrimination.
• Launched in February 2021, our emotional resilience training video has had more than 235 hours’ worth of total viewing time so far.
• The Coping Well During Covid webinar series has received more than 19,000 unique visits.
• In partnership with Doctors of the World, producing wellbeing guidance in 36 languages to support migrant communities during COVID-19.
• Distributing 225,000 wellbeing cards across London to those less digitally enabled or struggling with personal debt.
• In partnership with the Mayor of London, enabling Debt Free London’s free, impartial debt advice service to operate 24/7 during January to the end of March 2021.
• Sudden bereavement support has been accessed more than 3,250 times.
• 215,000 Londoners have now completed free, online suicide awareness training.

The final section outlines activities Thrive LDN has undertaken to understand our approach to recovery. This includes reflecting on our learning from the pandemic and the work of others to understand what we can learn from the experience of recovery from other disasters, undertaking evidence reviews across various areas, including the impact of Brexit on migrant communities in London and the UK, and undertaking a public health scenario planning exercise to consider the broad variance in potential outcomes in terms of COVID- 19 response and recovery efforts.

What is clear is that the legacy of COVID-19 will have a serious impact on inequalities and mental health across London in the long-term. We need to continue to build the case for public mental health, prevention, and wider action to advance equality. To protect public mental health and build resilience, we need to step-up the support available to the scale required by all Londoners, whilst engaging with specific groups where interventions could be maximised, personalised, and culturally competent.

What is less certain is what connects the situation we find ourselves in now with the long- term. The disparities in the risks and outcomes for COVID-19 are replicated in disparities in risks and outcomes of poor mental health. There is not a simple or straightforward route to recovery from COVID-19 that will be inclusive and considerate of all Londoners’ experiences and needs. As we emerge out of this crisis, we need to learn from the pandemic response and move forward in a way that meets Londoners where they are at, recognises multiple stories and experiences, and achieves diverse impact to ensure recovery works for all.

The report closes with details on the activities Thrive LDN will focus on in the short, medium, and long term. This includes how we will continue to work with Londoners, London’s communities, and London’s health and social care system in the short to medium term to lay the foundations for recovery, and how in the long-term, we will continue to co-develop projects and activities with Londoners in response to insights shared, scaling and deepening our participatory approach further to address the marginalisation and powerlessness caused by entrenched health inequalities.

You can get involved and join the conversation now:

• Across all social media channels using: #ThriveLDN or @ThriveLDN.
• Send us an email to info@thriveldn.co.uk.

An unprecedented year for Londoners’ mental health

Thrive LDN is a citywide movement to ensure all Londoners have an equal opportunity for good mental health and wellbeing. We are supported by the Mayor of London and the London Health Board partners. In January 2020, we published a report of interim findings and future plans.¹ Since March 2020, Thrive LDN has been coordinating the public mental health response to and recovery from the coronavirus (COVID-19) pandemic in London on behalf of the Strategic Coordination Group, Public Health England London, and wider partners.

Before the pandemic, poor mental health was already a significant challenge for London, with the prevalence of poor mental health often disproportionately higher in communities facing other entrenched inequalities. There is substantial evidence that the pandemic has simultaneously widened pre-existing inequalities whilst creating new ones.² Whilst it is too soon to determine the full impact of the pandemic on the mental health of Londoners, it is clear the effects are multifaceted.

How the pandemic has impacted Londoners’ mental health 3

• During the pandemic, people have found a wide range of ways to deal with increased stress; these most often included going for a walk, spending time in green spaces, and staying connected with others.⁴
• Rates of life satisfaction and happiness have continued to drop since September with the introduction of stricter restrictions that aim to control the spread of the virus.⁵
• Black men experienced a far greater deterioration in their mental health during the first national lockdown compared to subsequent ⁶
• Parents and carers have experienced increased stress and ⁷
• Younger transgender and gender diverse Londoners have experienced high levels of stress and depressive ⁸
• People with a diagnosed mental health condition have been three times more likely to have suicidal thoughts, self-harm, or attempt suicide than those without a mental health ⁹
• Disabled people have also been more likely to be lonely, worried about the pandemic, and anxious.¹⁰
• UK household financial wellbeing declined faster at the end of 2020 than at any time during the five years before the COVID-19 ¹¹

We publish this report a year on from when we started supporting partners to coordinate the public mental health response to the pandemic. It details what we have done and learned, as well as our plans for the year ahead.

We believe Thrive LDN has continued to demonstrate the benefits and scalability of our social movement approach. Throughout the pandemic, we have prioritised those worst affected or most vulnerable by taking action to minimise the impact on Londoners’ mental health and wellbeing in the short, medium, and long-term. All of which moves us closer to our ultimate goal of giving every Londoner an equal opportunity to good mental health and wellbeing.

There is much more to do. The year ahead is going to be a challenging one for many of our partners and many Londoners. Firstly, we need to remind people that it’s OK if you don’t feel OK – support is available.¹² Second, Thrive LDN’s priority remains to support the mental health and wellbeing of Londoners and the work of our partners as we move forward.

We need to continue to build the case for public mental health, prevention, and action to advance equality. To protect public mental health and build resilience, we will need to step- up the support available to the scale required by all Londoners, whilst engaging with specific groups where interventions could be maximised, personalised, and culturally

competent. Furthermore, evidence shows that participatory approaches directly address the marginalisation and powerlessness caused by entrenched health inequalities.¹³ Therefore, through Thrive LDN and our network, we are also able to take wider action to advance equality at the same time.

Driving outcomes

Thrive LDN operates under the hypothesis that by changing the population outcomes around the social determinants and reducing inequalities, it will improve Londoners’ opportunity for good mental health and wellbeing. Our theory of change¹⁴ operates across a networked system, where all activities are interrelated, developed and delivered in collaboration with Londoners and partners. However, to move closer to Thrive LDN’s ultimate goal of every Londoner having an equal opportunity to good mental health and wellbeing, it is necessary to consider processes, actions, partnerships, and their outcomes at an individual, community, and system-wide level.

Londoners

In order to effectively advance social change, it is necessary to constantly engage and work with individual Londoners. Between April 2020 and March 2021, more than 685,000 people have taken part in projects, events, and activities on which Thrive LDN has led or collaborated on. At a time when it has never been more important, close to half a million (485,000) more Londoners have engaged with Thrive LDN and partners in 2020/21, representing at least a threefold increase year on year.

London’s communities

We are privileged to be part of the most diverse and multicultural city in the world, with vibrant communities of people who join together by common interests, backgrounds, or experiences. These communities play a vital role in Londoners’ health and wellbeing. In the past year, Thrive LDN has engaged with over 200 community groups and organisations and listened to over 10,000 Londoners to understand more about the experiences of 20 disproportionately at-risk communities.¹⁵ COVID-19 has shown the differential experiences of communities across London and highlighted the inequalities which have been exacerbated by the pandemic.

London’s health and social care system

Resilience is defined as the ability to prepare for, manage and learn from shocks.¹⁶ It is key to the health and social care system’s ability to deal with catastrophic events, such as the economic crisis and the coronavirus pandemic. Thrive LDN acts only to enhance and build on the wider work happening across the health and social care system, regionally, sub- regionally, and locally. Over the past twelve months, we have sought ways to ensure a collaborative and integrated approach across the health and social care systems’ response, including:

• Supporting the Strategic Coordination Group and associated sub-groups to embed wellbeing into pandemic response structures
• Establishing a public mental health research and community insights team, to provide up-to-date evidence on mental health and wellbeing in the capital
• Expanding our communications function to develop and distribute regular public mental health communications toolkits so that key messages can be widely shared.

COVID-19 response

Thrive LDN was ideally placed to lead the coordination of the public mental health response to and recovery from COVID-19. We utilised our existing resources and networks to create, scale, and step-up various activities to meet the evolving mental health needs of Londoners during the pandemic. Our agile approach enabled us to balance the need to be responsive to the latest situation against anticipating what might be on the horizon.

COVID-19 has necessitated systems change and a shift in power across London. The objective of all activities, outputs, and outcomes across Thrive LDN’s theory of change¹⁷ relates to change in infrastructure, policy, behaviour, and perception, putting democracy at the centre of activity.

All mobilised activity has been informed by insights and developed in partnership with Londoners and, where possible, continues to develop sustainably through regional and local

networks and leadership. Through adaption, innovation and collaboration, Thrive LDN has elevated and expanded the reach of Londoners and their communities, alongside the capacity of the wider health and social care system, to support public mental health in London.

Adaption

At the onset of the pandemic and introduction of safety measures to control the spread of the virus, like many other programmes across the health and social care system, we reviewed our activities and adapted delivery where necessary. We were able to find efficiencies, whilst not sacrificing key priorities, benefits, or entitlements for Londoners. For example, Youth Mental Health First Aid Training was temporarily paused before moving online, with over 750 education staff trained during the pandemic.

Innovation

Coordinating the public mental health response to and recovery from COVID-19 has enabled an innovative approach to share and promote agreed citywide public health messaging and resources from wide-ranging partners.¹⁸ The public mental health communications toolkit is distributed to more than 400 communications, policy and health leads across London to adapt for their communications with the public and has been uniquely accessed more than 4,650 times since publication.

Responding to the need to have a pragmatic view of research and intelligence relating to the impact of COVID-19 on Londoners’ mental health and wellbeing, Thrive LDN established a research and community insights function, with a dedicated team to examine the effects of the pandemic on Londoners. This new function informs real-time action to offset and prevent negative effects of the pandemic and regularly publishes working papers and briefings summarising findings and suggested actions for partner organisations.¹⁹

Collaboration

The swift and heroic efforts of the voluntary and community sector during the first national lockdown led to innovation and transformation at a scale and speed never seen before.

Local community groups and grassroots organisations have played a critical role across all Thrive LDN and partners’ COVID-19 activity. Our priority has been engaging and listening to their experiences, building the resilience of a wider support system, and working together to drive change.

Some of our learning was gained through collaboration with the GLA London Community Response Survey which has been capturing feedback from a cohort of more than 360 frontline civil society organisations since April 2020 on the challenges and support needed by Londoners.²⁰ In another example, Thrive LDN convened an economic support group to help improve the accessibility and inclusivity of mental health and suicide prevention support, particularly against a backdrop of the growing number of Londoners facing problem debt and financial difficulty.

Our activities during 2020/21

During 2020/21, more than 685,000 people have taken part in projects, events and activities which Thrive LDN has led or collaborated on.

• We have engaged with over 200 different community groups and organisations. And we listened to the voices of over 10,000 Londoners, to understand more about the experiences of 20 disproportionately at-risk groups
• We awarded £170,000 to 24 grassroots and community projects
• More than 3,000 people engaged with World Mental Health Day Festival content
• 215,000 Londoners have now completed online suicide prevention training
• 225,000 wellbeing cards distributed across London to those less digitally enabled or struggling with personal debt.
• Thrive LDN’s Act On podcasts, co-developed with Londoners to discuss issues that impact their mental health, have been
  downloaded more than 1,500 times.
• Sudden bereavement resource accessed more than 3,000 times online. Additionally, 7,000 hard copies sent to 30 London hospitals to support NHS bereavement teams.
• Psychological first aid resource accessed more than 1,300 times.
• Over 700 parents in London took part in online resilience building workshops.
• 750 more education staff trained in Youth Mental Health First Aid.
• 640 education staff across 31 London boroughs have now been fully trained in suicide prevention education.
• In partnership with Doctors of the World, we produced wellbeing guidance in 36 languages to support migrant communities during COVID-19.
• More than 7,000 mental health and wellbeing booklets in 15 languages have been distributed to 6,200 asylum seekers in London.
• Developed a mental health poster campaign for the Transport for London network, covering underground and overground services, including bus shelter poster sites.
• In February 2021, Thrive LDN launched a training video on building emotional resilience which has already had more than 235 hours’ worth of viewing time.

Community engagement and participation

At its core, Thrive LDN is a participation-driven partnership that engages with and responds to the needs and insights of Londoners. Between April 2020 and March 2021, more than 685,000 people have taken part in projects, events, and activities which Thrive LDN has led or collaborated on. This builds on the 2019/20 activity and represents at least a threefold increase in participation. Whilst the level of participation varies across this cohort, from enabling young people to be in control of the World Mental Health Day festival to providing information on health and wellbeing to shielding Londoners, the volume and quality of engagement suggest an elevated level of public trust during a time when suspicion and fear regarding traditional power structures have been compounded.

Thrive Together

There is growing evidence that the pandemic has widened pre-existing inequalities, whilst creating new ones.²¹ However, there has been a lack of representativeness and detail on the lived experiences and needs of disadvantaged communities in London. To address this, Thrive LDN engaged with 200 different community groups and organisations, encompassing all protected characteristics, and listened to the voices of more than 10,000 Londoners to capture the experiences of Londoners during the pandemic.

Our report, Thrive Together,²² summarised research, insights, and stories of Londoners’ lived experience. We found that for many communities, the coronavirus pandemic is the latest crisis event in a crisis trend – a steadily worsening series of situations they face. Those entering the pandemic in disadvantaged circumstances have seen the greatest risk to their physical and mental wellbeing, including their ability to withstand the negative financial effect experienced by many. We have explored the key themes from the community insights further, specifically on racism, discrimination, the digital divide, and community and social networks.

“We don’t always know how, but we know we’ll be OK together.”

“I think Pandemic or not, surveys help a lot to let people know that are never alone and there are people who can understand and listen.”

Pandemic Stories

Thrive LDN has been working with Toynbee Hall on Pandemic Stories,²³ a participatory action research project. Beginning in June 2020, Toynbee Hall has worked in collaboration with Londoners who have been disproportionately affected by the COVID-19 crisis as part of the Pandemic Stories project.

17 peer researchers aged between 20 – 70 years old, speaking 13 languages between them, conducted participatory action research to investigate the impact of the crisis and co-design effective solutions to improve financial resilience and wellbeing. Toynbee Hall held regular analysis sessions with the peer researchers to understand the findings and explore possible solutions. The researchers shared these in turn with interviewees and their input was used to further refine and identify solutions.

“It’s really hard for one person to be heard properly right and if the community got together, if they all expressed the same concerns and the same worries, I think they’re most likely to be heard, the change is most likely to happen.”

Young Londoners

Evidence and insights captured show the impact of the pandemic on children and young people is multi-faceted and likely to have long-term effects. In 2020, Thrive LDN’s Young Londoners’ programme expanded, intending to positively impact the future and lifelong health and wellbeing of young people from early years to early adulthood.

The Peer Outreach Network

The Mayor of London’s Peer Outreach Network is a key partner in Thrive LDN’s engagement and participation with young people. This partnership has been in place since 2017 and has been developed further over time with the team of 25 young people supporting and influencing Thrive LDN’s initiatives for young people.

The outcome of this partnership is the continued engagement of a diverse team of young people, who through their voices and networks are able to share valuable insights about the complex lives of young people in London. This informs key issues relating to the challenges for young Londoners and what young people would like to see as solutions for positive change in their own mental health and wellbeing and that of others.

World Mental Health Day

The online festival brought together more than 1,000 people on the day and a further 2,000+ people have engaged with WMHD festival content since.

For the third consecutive year, Thrive LDN and the Mayor of London’s Peer Outreach Team hosted a young Londoner-led festival to mark World Mental Health Day (WMHD) on 10 October 2020. This year the development of the festival programme was led by young Londoners Kamahl Miller and Queenie Chizea and focused on sharing experiences of COVID-19 and the Black Lives Matter movement to build resilience and promote positive wellbeing.

WMHD was an important outlet of collaboration for young creators in London during a period where work in creative industries had been severely impacted by the pandemic. The festival established a sense of community, positivity, and resilience that directly combatted feelings of isolation, uncertainty, and hopelessness in the face of the COVID-19 crisis.

In partnership with Toynbee Hall and the Mayor of London’s Peer Outreach Team, we are now co-designing workshops with young people which will be delivered in the lead up to World Mental Health Day 2021.

“As an artist, I was able to build my portfolio, it was a great experience. Thanks for giving me my first proper performance.”

“I felt like our voice was being heard.”

Act-On Podcast Series

Act-On is a podcast series initially developed in 2019 by young Londoners to share and discuss topics and issues which have the greatest impact on their mental health and wellbeing, including identity, inequality, and bereavement. A total of 23 episodes of the Act-On podcast have been recorded and released throughout 2020.

The Act-On podcast has been downloaded more than 1,500 times, with a combined total of 64 speakers taking part in issues important to them.

Youth Mental Health First Aid

The Youth Mental Health First Aid (MHFA) programme is in its third year of delivery and is the longest running project within the Young Londoners programme. Training has now been offered to all state-funded schools within London and is enabling education staff to develop the knowledge, skills, and confidence to support young people with their mental health. The programme has been extended to support the youth sector, those who work in voluntary and community organisations, and higher education institutions in London. The programme includes an independent evaluation, which will produce findings in 2022 on the full impact of this work.

Over 2,000 education staff are now Youth Mental Health First Aiders in London.

Resilient Futures Bounce Forward

Recognising the unequal impact on the mental health and wellbeing of older young people during the pandemic, Thrive LDN, in partnership with Bounce Forward, commissioned a project to strengthen the resilience of young people aged 18-24, giving them the skills and strategies to deal well with setbacks, fail well and thrive. The project aspires for participants to become local champions for resilience. The outcomes of this project will be shared in an impact report once completed in the spring of 2021.

Higher and Further Education Mental Health Needs Assessments

Together with The University of London, London Higher, and the Association of Directors of Public Health (ADPH) London, Thrive LDN commissioned Fiveways and Mind to conduct a mental health needs assessment to improve our understanding of the mental health needs of students in London. Clear recommendations have been produced to support student mental health for universities, NHS services, and the wider public mental health sector that supports student health, which will form a core part of our Young Londoners’ programme in 2021/22.

In partnership with Greater London Authority, further research is underway to understand student mental health needs in further education settings. Findings are due to be published in summer 2021.

Supporting London’s families and parents

Evidence and insights collected have shown that the pandemic, lockdown, and related crises are affecting families with children, particularly single parents. In early 2021, Thrive LDN supported the delivery of parenting programmes to help offer support to parents and families in London.

MIND TV

In partnership with MIND West London, a series of short videos have been created to address some of the challenges young people, staff, and parents may face in light of the pandemic. They are supported by Youth Mental Health First Aid (YMHFA) Instructors who offer practical and positive solutions for overcoming these challenges. The resource has been shared with and by schools, colleges, and wider partners.

Raise Resilience workshops for parents

In partnership with Bounce Forward, an organisation that works to develop the resilience of parents and young people, we held four series of six one-hour sessions focused on parental wellbeing. Participating parents were offered a set of practical tools and skills to support them during the pandemic and into the future. Over 700 parents in London took part in the online workshops.

“I loved this course so much. Despite it being virtual it felt really engaging and Luci was an excellent trainer. It was very interesting and have loved the discussion of ideas, problems, tips and recommendations. Thank you so much!”

“Massive thanks to Luci who was attentive and validating throughout, and Elisha for the behind-the-scenes admin, and of course Thrive LDN.”

Empowering Parents Empowering Communities (EPEC)

In March 2021, Thrive LDN and the Empowering Parents Empowering Communities (EPEC) programme at South London and Maudsley NHS Foundation Trust (SLAM) launched a series of online workshops and Facebook Live events to help support parents of children aged 2-11. For these London sessions, SLAM has developed two series of three workshops designed to help parents better understand their children’s behaviour and feelings, support their emotional wellbeing, and find fun and play in stressful times. The outcomes of this project will be shared in an impact report once completed in the summer of 2021.

Right to Thrive

Right to Thrive is Thrive LDN’s ongoing commitment to celebrate and protect diversity in London, especially for those at higher risk of unfair treatment based on their identity, beliefs, or social class, and in some cases a combination of these. Right to Thrive projects, partnerships and activities aim to support those communities and groups most likely to experience poor mental health, to amplify their voices, and to share power and leadership.

Right to Thrive partner: Jacksons Lane’s Feeling Good project

Feeling Good is Jacksons Lane’s project to bring the arts to older adults across North London, based on companionship, creativity, and communication. Thrive LDN has supported the project, which in part is helping to matchmake isolated and vulnerable older adults with a volunteer. There are now nearly 70 volunteers paired up in intergenerational companionships

Right to Thrive grants scheme

Since April 2020, Thrive LDN has awarded grants to 24 community and grassroots projects across London to help support the mental health and wellbeing of those who are experiencing higher levels of unfair treatment and discrimination, including projects for Deaf LGBTQ+ Londoners, Asian LGBTQ+ Londoners, marginalised people with lived experience of poor mental health, young people from the gypsy/traveller communities, refugees and asylum seekers, Black men, and transgender people.

Right to Thrive partner: Kanlungan

Kanlungan – Filipino for haven or sanctuary – is a registered charity bringing together several community-based organisations in the UK. Kanlungan is using a Right to Thrive grant from Thrive LDN to develop and improve the positive coping skills, resilience, and wellbeing of migrant women and LGBTQ+ people in precarious job conditions. It aims to build the confidence and capacity of migrant communities to deal with stressors.

“Many of the migrant communities are actually the frontliners during the lockdown,” Kanlungan’s Andrea Martinez explains. “Many of them have suffered from anxiety, even trauma, and isolation. Some have lost their loved ones, others have actually suffered through their mental health problems.”

“So we still need organisations and people to help us through these problems. Thriving does not mean merely coping with our everyday stressors, it means our ability to bounce back, our ability to survive and our ability to prosper from whatever adversities come our way.”

Capacity building and participatory leadership

The Right to Thrive initiative has adapted and expanded due to the emerging needs of those disproportionally impacted by the pandemic. The initiative includes a greater range of resources and support for community and grassroots groups, including a peer-to-peer support workshop, four development workshops, and offering Thrive LDN’s training offers for free to community and grassroots groups.

Right to Thrive partner: Latinx Collective

The Latinx Collective project aims to understand the experiences of Latinx communities in London and co-produce projects that will encourage engagement and partnerships. It has provided visibility to a community that has been historically marginalised and disadvantaged, and created partnerships with local grassroots groups and organisations that promote good mental health and wellbeing for Latinx communities and Londoners overall.

“This project has broadened my insight of experiences among Latinx communities in London. It has helped me to connect further with Latinx individuals and communities who share experiences of invisibility, migration, and marginalisation. Connecting with others on shared commonality, and creating partnerships with groups and organisations, has been an empowering experience. Particularly in a time of crisis and disconnect. With the support of Thrive LDN, I have been able to explore and learn ways to promote good mental health and wellbeing. I look forward to future projects and outcomes that demonstrate the power of collective action.”

Working with faith and belief groups

Thrive LDN, the Faith Forum for London and Greater London Authority facilitated the Bring Your Light webinar in the summer of 2020 to bring together faith and belief groups, practitioners, voluntary and community organisations, and charities to have an online, citywide conversation on faith and resilience in light of COVID-19 and beyond.

We are currently working with faith and community partners to create a concise conversation starter to enable faith and community leaders to initiate conversations that support mental health and wellbeing with their members.

Resilience

Since March 2020, Londoners have been in an unprecedented situation. For many of us, losing our normal sources of support or experiencing reduced social connection has created unforeseen pressures on our mental health and wellbeing. Resilience is the ability of an individual, a community, or a system to withstand stress and challenges,²⁴ and in response to the pandemic, Thrive LDN and partners developed a new resilience programme to better equip individuals, communities, and systems to respond and adapt to the uncertainty caused by the pandemic.

Psychological First Aid Resource

Many people want to reach out a helping hand to those around them who are or have been affected by the coronavirus crisis. To support this, Thrive LDN produced general guidance on how best to provide humane, supportive, and practical help for distressed people. It provides an overview of psychosocial approaches with a series of considerations and questions to follow, ending in signposting to appropriate support.

The guidance has been accessed more than 1,300 times online and complements Public Health England’s Psychological First Aid training.

Building emotional resilience

In February 2021, Thrive LDN launched a campaign focused on building emotional resilience. Centred around a 20-minute training video hosted by Dr. Radha Modgil provides techniques and activities that can help Londoners to maintain good mental health during the pandemic. The video has more than 235 hours’ worth of total viewing time to date.

“Small changes can make a big difference for mental health and wellbeing.”

Coping Well During Covid – a webinar series for London

In partnership with London’s digital talking therapies team and the NHS in London, the Coping Well During Covid webinar series was established in the summer of 2020 to help viewers develop positive coping strategies that would allow them to manage their wellbeing during the pandemic. A concurrent series of webinars was developed to support the mental health and wellbeing of health and social care workers.

The webpages for both webinar series have received more than 19,000 unique visits and resulted in more than 4,000 views across the 26 webinars.

“It was excellent. Emily presented the information in an engaging, caring, fun, non-judgemental, open, and supportive manner. I had been a little apprehensive in advance but soon felt at ease because of the way the information was conveyed.”

“I found it really interesting but was particularly impressed by how practical it was – there’s a lot of resources out there that are a quite high level and not really helpful. This was great as it gave real practical changes we could make to help ourselves.”

Addressing specific challenges through targeted communications

Taking a person-centred approach, a targeted digital communications campaign was launched in February 2021 to help Londoners disproportionately affected by the coronavirus pandemic access relevant tools and resources to support their wellbeing. Bespoke content was created for Londoners with pre-existing mental health problems; ethnic minority communities, deaf Londoners, families with children and single parents, women, young Londoners, older Londoners, and LGBTQ+ Londoners.

The two-week London-wide digital campaign generated nearly 15,000 click-throughs to targeted wellbeing support and resources.

Community groups that had a particularly high engagement rate, between 4 and 6 times the sector average, were LGBTQ+, older Londoners, and those with pre- existing mental health issues.

Elsewhere this year we have:

• In partnership with Doctors of the World, produced wellbeing guidance in 36 languages to support migrant communities during COVID-19.
• Distributed more than 7,000 mental health and wellbeing booklets in 15 languages to asylum seekers in London.
• Developed a mental health poster campaign for the Transport for London network, covering underground and overground services, including bus shelter poster
• In partnership with The Royal Parks and Public Health England (London), supported the #WelcomeWinter campaign to encourage the safe use of London’s green spaces during the winter
• Distributed more than 225,000 wellbeing cards to support some of the most vulnerable Londoners during the coronavirus pandemic. Pocket-sized and packed with information, they offer tips on wellbeing, how to deal with stress and anxiety and where to get more help if you need it.

Financial resilience

The pandemic has caused economic hardship and eroded financial resilience for many in the capital. This is concerning given the clear links between debt and money worries and developing poor mental health. In partnership with Debt Free London, a targeted outreach programme has been developed to support those who are struggling financially to keep themselves well, despite any sudden and complex situation they may find themselves in.

To date, this has involved providing advice and support through both digital and non-digital routes of communication, supporting debt advisors to access mental health first aid training, and enabling Debt Free London’s free, impartial debt advice service to operate 24/7 during January, February, and March 2021, with support from the Mayor of London.

Furthermore, plans are in place to establish 15 video information kiosks across London in community venues to connect Londoners to expert debt advisors via video chat. These kiosks will facilitate digital inclusion, whilst utilising community assets, and represent the next step in a series of interventions aimed at making vital financial support services more accessible as we move into recovery from the pandemic.

Support after sudden bereavement during the COVID-19 pandemic

Many people and communities across London have suffered a bereavement as a result of COVID-19. To support individuals and communities experiencing grief and coming to terms with loss, an online resource was created with leading charity partners for those grieving the death of someone close or supporting someone going through sudden bereavement, including bereavement by suicide. In February 2021, Thrive LDN printed and dispatched several hundred copies of an abridged leaflet version of the resource to 30 London hospitals, to support the work of NHS bereavement teams.

The resource has been downloaded more than 3,000 times. It was developed in partnership with key bereavement charities, such as Support After Suicide Partnership and Child Bereavement UK.

Partnership resilience grant schemes

We have partnered with Sport Unites, the Mayor of London’s flagship community sports programme, on the Active Londoners Fund, which tackles inactivity by supporting individuals and organisations who use sport and other kinds of physical activity to improve the physical and mental health of Londoners. The Active Londoners Fund has awarded grants to 19 projects across London.

In addition, Thrive LDN is a partner to the Mayor of London’s Resilience Fund, which is a challenge fund which aims to incentivise innovators to address socially impactful issues facing London. We are supporting a bereavement services challenge, which is looking to work with innovators to develop solutions to improve bereavement support services for underrepresented communities. Applications are due to close on 1 April.

Suicide Prevention

In London, more than 12 people take their own life each week. Throughout 2020, Thrive LDN has continued to develop and support suicide awareness and prevention programmes of work. In the context of the pandemic, Thrive LDN and suicide prevention partners have recognised that some people will find the challenges of COVID-19 harder than others because of their health, where they live, or the impact on their financial situation.

The Suicide Prevention Group

The Thrive LDN Suicide Prevention group is a partnership made up of 36 organisations and 48 members including London’s first responder authorities, NHS bodies, Public Health England, organisations associated with London’s rivers and railways, local authorities, academics, third sector organisations, and those with lived experience. At the height of the pandemic, the group met more regularly with sub-groups formed to look specifically at issues, including myth-busting and financial and economic resilience.

#ZeroSuicideLDN campaign

The Suicide Prevention Group also has oversight of the #ZeroSuicideLDN campaign, launched by the Mayor of London in September 2019. Managed by Thrive LDN, the campaign set an initial goal of encouraging 100,000 Londoners to access the Zero Suicide Alliance’s free online suicide prevention training within twelve months.

Positively, there was a surge in participants during the pandemic which highlighted Londoners are looking out for each other. As of January 2021, more than 215,000 Londoners have completed the training, helping to play their part in saving lives and looking out for other Londoners.

Information Sharing Hub on suspected suicides

In 2020, Thrive LDN implemented an expansion of the information-sharing hub on suspected suicides in London. First piloted in 2019, the Hub incorporates intelligence provided by several different authorities and organisations across London on individual suspected suicides in the London region. This helps to increase public agencies’ understanding of suicide on a citywide basis and allows more rapid tackling of the issue of poor mental health and suicide.

Losing someone to suicide can be one of the most difficult and lonely experiences a person can have. The Hub has been further developed so that in cases of suicide, next of kin can be contacted within one week with the offer of a referral to specialist bereavement services.

The bereavement support function has already resulted in 204 referrals of next of kin to specialised bereavement support in the days following a death by suicide.

We are currently expanding the Hub to include information on attempted suicides and self- harm, which will begin being piloted in the summer of 2021.

Suicide prevention education

Research has indicated that young people are disproportionately at risk of the negative mental health impacts of the COVID-19 pandemic. Thrive LDN has partnered with PAPYRUS UK, an organisation that provides suicide prevention education tailored specifically towards preventing suicide amongst young people. The partnership offers training to staff in education settings across London to mitigate the risks of a young person that may be struggling with their mental health ending their own life.

To date, 31 London boroughs have booked education staff into the suicide prevention training and 640 people have been fully trained as part of the first tier of the rollout.

Our future activities: laying the foundations for recovery

Laying the foundations for recovery

We have undertaken several activities to understand our approach to recovery and the activities Thrive LDN will focus on in the short, medium, and long term:

• Reflected on our learning from the pandemic and the work of others to understand what we can learn from the experience of recovery from other disasters.
• Considered findings from Thrive Together and wider community engagement and participatory action research, such as Pandemic Stories.
• Considered findings from our working papers summarising the known impact of COVID-19 on Londoners’ mental health and wellbeing.
• Undertaken evidence reviews across various areas, including the impact of Brexit on migrant communities in London and the UK.
• Undertaken modelling work to understand possible future trends and forecasting.
• Considered findings from our work to support the Strategic Coordination Group and associated sub-groups to embed wellbeing into pandemic response structures.
• Undertaken a public health scenario planning exercise to consider the broad variance in potential outcomes in terms of COVID-19 response and recovery efforts.
• Reviewed and updated our theory of change to realign around long-term goals in infrastructure, policy, behaviour, and perception change.

What is clear is that the legacy of COVID-19 will have a serious impact on inequalities and mental health across London in the long-term. Insights from the King’s Fund research on COVID-19 recovery²⁵ highlights four key priorities that require focus – putting mental health and wellbeing at the forefront of recovery efforts; ensuring communities are not left behind; making collaboration work and prioritising workforce wellbeing. Also, the UK’s departure from the EU on 31 December 2020 is already having an impact on the mental health and wellbeing of Londoners, particularly for the one million EU Londoners directly affected.²⁶ There is a visible need for a framework of assistance and mental health support for vulnerable communities as well as the promotion of the EU Settlement Scheme.

We need to continue to build the case for public mental health, prevention, and wider action to advance equality. The pandemic will not affect all communities in London equally. It has exacerbated risk factors for many across the life course and, in all aspects, those who entered the coronavirus crisis at a disadvantage have been hardest hit. Recovery from the pandemic is also not the only challenge communities in London face, with discrimination, uncertainty over income and employment, and Brexit regularly cited in our community engagement and participatory action research. We need to understand more about the intersectional nature of issues communities face, the impact of cumulative stressors over time and the systemic action needed to address them. In order to protect public mental health and build resilience, we need to step up the support available to the scale required by all Londoners, whilst engaging with specific groups where interventions could be maximised, personalised, and culturally competent.

The long-term goal of Thrive LDN of ensuring all Londoners have an equal opportunity to good mental health and wellbeing has never been more urgent. To achieve this, we know we will need to continue to co-develop projects and activities with Londoners in response to insights shared (see: Thrive Together themes below). As well as:

• Democratise the production and dissemination of knowledge and improve the representativeness and inclusiveness of information and understanding.
• Continue to raise awareness around the impact of inequality on Londoners’ mental health and wellbeing and positively shift public perception around these issues.
• Scale and deepen our participatory approach further to address the marginalisation and powerlessness caused by entrenched health inequalities.
• Support the growth of cross-sector local and regional networks to develop and deliver activities.
• Support our partners to strengthen existing policy outcomes and enact mental health in all policies’ approach.

Furthermore, Thrive LDN is supported and enabled by a unique regional, sub-regional and local partnership across London’s political, health and social care, voluntary and community, academic, economic and business, cultural and educational sectors. This partnership is the firm foundation from which we can build sustained, collective action and we are currently reliant on the ongoing support and leadership of that partnership to continue to grow sustainably. We also need to widen, deepen and diversify our partnerships further to strengthen those firm foundations and become more sustainable over time.

For example, to accelerate the pace of change in tackling the underlying causes of inequalities in mental and physical health, Thrive LDN is extending an existing collaboration with King’s College London as part of a proposed Health and Social Equity Hub. This will involve meaningful collaboration across higher education, health and social care, and other public sector partners in the UK and internationally, linking co-developed activities to outcomes for improved mental health and wellbeing.

What is less certain is what connects the situation we find ourselves in now with the long- term. The disparities in the risks and outcomes for COVID-19 are replicated in disparities in risks and outcomes of poor mental health. There is not a simple or straightforward route to recovery from COVID-19 that will be inclusive and considerate of all Londoners’ experiences and needs. Intersectionality allows us to focus on where experiences of disadvantage and marginalisation have led to disproportionate outcomes for many London communities.

As we emerge out of this crisis, we need to learn from the pandemic response and move forward in a way that meets Londoners where they are at, recognises multiple stories and experiences, and achieves diverse impact to ensure recovery works for all. Thrive LDN will also need to continue to work in a collaborative and integrated approach across the wider health and social care system to ensure we consider how best we can support the challenges they will face and continue to support the delivery of regional, sub-regional and local priorities for advancing equality and good mental health.

In the immediacy, Thrive LDN will continue to be led by insights and be agile to situations as they emerge and evolve. However, based on what we understand now, we have defined some initial short-term (1-3 months), and medium-term (3-6 months) actions for the year ahead.

Londoners 

London’s communities

 London’s health and social care system

References

1 Thrive LDN (2020) London’s progress towards happier, healthier lives: https://thriveldn.co.uk/wp-content/uploads/2020/01/Thrive-LDN-Insights-2019-20-interim-report-January-2020-1.pdf

2 Blundell et al (2020) COVID-19 & Inequalities FISCAL STUDIES, vol. 41, no. 2, pp. 291–319 (2020) 0143-5671 https://onlinelibrary.wiley.com/doi/epdf/10.1111/1475-5890.12232

3 See: https://thriveldn.co.uk/resources/the-impact-of-covid-19-on-londoners-mental-health-and-wellbeing/

4 Mental Health Foundation (2020) Coronavirus: Mental Health in the Pandemic: https://www.mentalhealth.org.uk/our-work/research/coronavirus-mental-health-pandemic/

5 University College London (2021) Covid-19 Social Study: https://www.covidsocialstudy.org/results

6 Proto E, Quintana-Domeque C (2021) COVID-19 and mental health deterioration by ethnicity and gender in the UK. PLoS ONE 16(1): e0244419: https://doi.org/10.1371/journal.pone.0244419

7 Co-SPACE (2021) Changes in parents’ mental health symptoms and stressors from April to December 2020: http://cospaceoxford.org/wp-content/uploads/2021/01/Report_07_19JAN.pdf

8 University College London (2020) Queerantine Study: https://queerantinestudy.wixsite.com/mysite

9 University College London (2020) Covid-19 Social Study: https://www.covidsocialstudy.org/results

10 The Health Foundation (2021) The forgotten crisis: https://tinyurl.com/mkbpa4dx

11 Financial Conduct Authority (2021) Financial Lives 2020 Survey: the impact of coronavirus: https://www.fca.org.uk/publications/research/financial-lives-2020-survey-impact-coronavirus
12  For example, see: www.thriveldn.co.uk or www.good-thinking.uk

13 PHE (2015) A guide to community-centred approaches for health and wellbeing https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/402889/A_guide_to_community-centred_approaches_for_health_and_wellbeing__briefi___.pdf

14 Thrive LDN (2020) London’s progress towards happier, healthier lives: Thrive LDN Insights 2019/20 interim report: https://thriveldn.co.uk/wp-content/uploads/2020/01/Thrive-LDN-Insights-2019-20-interim-report-January-2020-1.pdf

15 Thrive LDN (2020) Thrive Together: https://thriveldn.co.uk/wp-content/uploads/2020/11/Thrive-Together-report.pdf

16 WHO (2020) Policy briefing 36: Strengthening health systems resilience https://apps.who.int/iris/bitstream/handle/10665/332441/Policy-brief%2036-1997-8073-eng.pdf

17 Thrive LDN (2020) London’s progress towards happier, healthier lives: Thrive LDN Insights 2019/20 interim report: https://thriveldn.co.uk/wp-content/uploads/2020/01/Thrive-LDN-Insights-2019-20-interim-report-January-2020-1.pdf

18 See: https://thriveldn.co.uk/toolkits/

19 See: https://thriveldn.co.uk/resources/the-impact-of-covid-19-on-londoners-mental-health-and-wellbeing/

20 See: https://data.london.gov.uk/dataset/london-community-response-survey

21 Blundell et al (2020) COVID-19 & Inequalities FISCAL STUDIES, vol. 41, no. 2, pp. 291–319 (2020) 0143-5671 https://onlinelibrary.wiley.com/doi/epdf/10.1111/1475-5890.12232

22 Thrive LDN (2020) Thrive Together: https://thriveldn.co.uk/wp-content/uploads/2020/11/Thrive-Together-report.pdf

23 Toynbee Hall (2021) Pandemic Stories: https://thriveldn.co.uk/pandemicstories/

24 Kings Fund (2021) Covid-19 recovery and resilience: what can health and care learn from other disasters? https://features.kingsfund.org.uk/2021/02/covid-19-recovery-resilience-health-care/

25 University College 2021 (2021) COVID-19 Social Study: https://www.covidsocialstudy.org/results