Thrive Together

Executive Summary

Thrive LDN is a citywide movement to ensure all Londoners have an equal opportunity to good mental health and wellbeing. We are supported by the Mayor of London and London Health Board partners.

Since March 2020, we have also been coordinating the public mental health response to the coronavirus pandemic on behalf of Public Health England London and wider partners, with the aim of ensuring London’s diverse communities have the strength and resilience to cope with and overcome unprecedented

As part of our coordination role, we are producing regular working papers on what we do and do not know about the impact of the coronavirus pandemic on Londoners’ mental health and wellbeing. This work has highlighted that there is a lack of representative and granular information available on the experiences and needs of disadvantaged communities in London, leading to a significant barrier to understanding the action required to create positive

In direct response to this, Thrive LDN, supported by funding from the Leaders’ Group, undertook our largest and most ambitious community engagement project to date – working with 200 different community groups and organisations to listen to the voices of over 10,000 Londoners to understand more about the experiences of 20 disproportionately at-risk groups.

We are keen to stress that this work is ongoing, and the findings and suggested actions presented here are a rough cut at this present time, shared due to the urgency of the current situation and to avoid delaying meaningful action. It is important to note that further work is planned to share our findings back with the groups and communities who have participated to ensure they are involved in the interpretation of findings and implementation of actions.

We would also like to express a massive thank you to the many individuals, groups, teams and communities that have directly and indirectly contributed to this work – London’s health and care system (NHS, public health and local government) at regional, sub-regional and local levels, voluntary organisations, educational institutions, faith leaders, doctors and nurses, community and grassroots groups, and Londoners themselves. We have learnt a lot and are committed to working with you all, and many more, in the future as we progress this work

Overall findings from the analysis indicate that, for many communities across London, the coronavirus pandemic is seen as the latest crisis event in a crisis trend – a steadily worsening series of situations disadvantaged communities across London face. This is against a backdrop of vital conditions for wellbeing and resilience being eroded of time and a fear for what is to come – be that a worsening pandemic, winter challenges, uncertainty over income and employment or Brexit. There is a 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.

The findings also illustrate a general sense of loss across all aspects of many Londoners’ lives: loss of loved ones, employment, relationships, homes, education and wider opportunities. However, there is also a definite theme of hope. Communities disproportionately affected by the coronavirus pandemic, who already experienced poorer social, economic and health outcomes, identified the significance of family and support structures, and the support offered by wider community and faith groups. Early findings show a clear relationship between resilience and coping with uncertainty, and the power of relationships, collectivising, and social networks. There is a clear need to examine these assets further and how they can be reinforced to protect Londoners’ mental health and build strength and resilience in the
long-term.

Having analysed the responses, findings and submissions, Thrive LDN has begun testing some potential solutions and interventions with our partners and contributors. We acknowledge that there is no one size fits all, but we have found that many of the communities have the solutions and answers to what they need to look after themselves and one another; they just want more support on how to access, promote and localise these.

Engage with and learn from how community support services proactively responded to the coronavirus pandemic and identify where different approaches were used in comparison to mainstream services to ensure innovative approaches can be shared, sustained and continued support is appropriate or sufficient.

Thrive LDN strives to work with communities and will continue to iterate, listen and develop ways of supporting Londoners, however, these are extraordinary times, and, as the winter months loom, we have developed some initial suggested actions for our partners to consider and outlined some actions Thrive LDN will take.

Strengthen community

• Engage with and learn from how community support services proactively responded to the coronavirus pandemic and identify where different approaches were used in comparison to mainstream services to ensure innovative approaches can be shared, sustained and continued support is appropriate or sufficient for everyone.
• Develop and implement universal and selective place-based and settings-based resilience and/or bereavement support and promotion programmes.
• Utilise neighbourhood and community assets to improve social cohesion and develop more safe places for social connection and interaction via. community and peer support.
• Ensure trauma-informed practice is widely adopted across London’s public services and business sector.

Address discrimination

• Engage with and listen to communities with lived experiences of inequality and discrimination and invite them to join the conversation around decisions which affect their mental health and wellbeing.
• Work with grassroots groups to proactively co-develop narrative change campaigns that amplify the experiences and voices of those who experience discrimination, weaken damaging stories and strengthen alternative ones.
• Consider potential barriers to accessing mental health services and support for those who experience inequality and discrimination and mitigating measures, such as varied communications methods, simplifying referral pathways and enhanced outreach.
• Ensure that COVID-19 transition and recovery strategies actively look to reduce inequalities and discrimination.

Digital inclusion

• Bring together the business sector, telecommunications companies and people with lived experience of digital exclusion to innovate and pilot solutions to providing free or cheap Wi-Fi for digitally excluded communities. This could be through collective switching, housing associations providing free or cheap Wi-Fi or through data sharing partnerships between neighbours.
• Provide digital skills training in the home or within housing estates.
• Londoners with internet access are better equipped to find tools, resources and support for their mental health and wellbeing. For those digitally excluded, ensure Social Prescribers signpost to mental health tools, resources and support, or even prescribe devices to patients so they are better able to self-manage their mental health and wellbeing.
• Young people are interested in attending online workshops, run by mental health professionals, which teach them how to manage their mental health and wellbeing. They are also interested in being part of online but professionally moderated communities to get support with their mental health. Health and care partners could play a role in creating or facilitating these workshops and forums.

Balance uncertainty for the future

• Work with partners to deliver targeted community engagement and activities focusing on the principles of emotional resilience – a process of negotiating, managing and adapting to significant sources of stress or trauma – bespoke to the needs and experiences of local, cultural or community groups.
• Working in partnership with community networks, deliver free training and resources to community leaders, faith leaders and volunteers in interventions such as psychological first aid, bereavement support, suicide prevention and trauma-informed values and principles, so that they are better equipped to support individuals to overcome adversity and uncertainty.
• Deliver regional and local campaigns that acknowledge the real concerns people face and feelings of uncertainty, normalise feeling stressed and mitigate stigma (for example, “it’s OK not to be OK”), and promote tools and resources to support individuals and communities to build their strength and resilience.

Financial security

• Ensure economic recovery efforts focus on creating sustainable and inclusive employment opportunities and support vulnerable people into employment.
• Continue investment in apprenticeships at a regional and local level, particularly for 18-24 year olds.
• Undertake targeted outreach to people who are unemployed, struggling with debt or at risk of eviction and ensure accessible mental health, psychological and suicide prevention support is available.
• Take action to end fuel poverty and thereby improve Londoners’ health and quality of life, by working in partnership with the voluntary and community sector and regional and local policy makers so fewer people will have to choose between heating and eating.

Value family and support structures

•  Give parents, particularly those from under-privileged backgrounds, the skills and support they need to give their children the best start through peer- parenting groups.
• Develop policies that improve access to affordable childcare, particularly for single parents.
• Engage with and listen to multi-generational families and their communities to understand more about the issues and assets of multi-generational living.
• Provide young LGBTQ+ Londoners, particularly young LGBTQ+ Londoners of colour, with the tools and resources they need to maintain and grow support networks and safe spaces to connect and succeed in London.

Improve access to information, advice and support

• Communicate clear and consistent public mental health messages that promote practical things people can do to support their own mental health and wellbeing and build resilience, encourage help-seeking behaviour and signpost people to a diverse variety of support.
• In coproduction with marginalised communities, develop and implement more culturally competent public mental health education and prevention campaigns, and public mental health programmes.
• Work across sectors and with local communities to understand any localised increase in demand for mental health support and to develop and implement integrated placed-based models on a neighbourhood or Primary Care Network area.

Commit to delivering change for Black, Asian and minority ethnic communities

• Implement the recommendations in Public Health England’s descriptive review of data on disparities in the risk and outcomes from COVID-19 and the accompanying report sharing insights from stakeholder engagement.
• Create channels for affected Black, Asian and minority ethnic communities to inform regional policy and service delivery.
• Support Black, Asian and minority ethnic-led organisations to respond to the needs of communities and provide the tools and resources needed to ensure to collaborate and grow networks.
• Undertake more locally-led partnership engagement activities to improve understanding, build trust and develop solutions that are meaningful and impactful for Black, Asian and minority ethnic communities.

Thrive LDN's response

Building participatory processes and infrastructure

Participatory approaches directly address the marginalisation and powerlessness caused by entrenched health inequalities. Rooted in sharing our findings and suggested actions back with the groups and communities who have participated, Thrive LDN is co-designing additional participatory processes, infrastructure and action research projects to ensure participants are leading and involved in the interpretation of findings and meaningful implementation of actions.

Right to Thrive expansion

Right to Thrive is our 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. We are currently expanding our Right to Thrive programme to offer additional support and development opportunities to grassroots groups and take further action to advance equality and ensure more equal access to opportunities. This will include a development programme and peer network for community leaders supporting disadvantaged groups, further work to co-produce tools and resources, and further narrative change campaigns to amplify the voices of grassroots groups.

Resilience promotion

Thrive LDN is co-designing an emotional resilience and resilience promotion programme to support Londoners to cope better with uncertainty and overcome future unprecedented events. Furthermore, working in partnership with community networks, we are delivering more free training and resources to community leaders, faith leaders and volunteers so that they are better equipped to support individuals they work with.