Scottish Government

Building Community Well-Being
An Exploration of Themes and Issues
Project Summary Report to the Scottish Executive

April 2003

Prepared for the Scottish Executive by Scottish Development Centre for Mental Health,in association with Scottish Council Foundation and OPM

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Foreword

This report is based on real practical work in real communities. It is concerned with the well-being and mental health of our communities, what this means to communities themselves, and what people working and living in communities feel has the biggest influences on their well-being and mental health.

The findings are important.

• Communities want to be part of the process of taking action - agencies delivering public services need to listen and consult, but for communities themselves active engagement and making a positive contribution are what really matters.
• The importance of children and young people and their place in building healthy communities for the future cannot be over-emphasised. Children will shape the communities of the future.
• There is already practical action in many places. What works well should be replicated more widely.
• Local government has important new powers to promote well-being. We are confident that these, combined with the efforts of Community Planning Partners and with action to build strong safe communities and improve health in the widest sense, will make a significant difference over the next few years.
• Building Community Well-Being is a challenge for us all. Taking a collective approach across government and across local agencies, with communities and with local people is the way forward.

The challenge is to mainstream improving mental health and well-being in our work in community regeneration, supporting people in our communities, improving social inclusion and health, and delivering improved public services.

The National Programme for Improving Mental Health and Well-Being, together with Ministers who are promoting health improvement, community regeneration and social inclusion, welcome this work and look forward to the improvements it helps generate.

Introduction

Building a Scotland where everyone can contribute to, and benefit from, the communities of which they are part is a goal shared by local and national government, by the public and private sector and by community and voluntary groups. As part of its National Programme for Improving Mental Health and Well-being, the Scottish Executive commissioned a project to explore what is meant by 'well-being', both with members of community groups and people working in health and community services and to identify how capacity to promote and sustain the well-being of communities can be developed and increased. ¹

The project was initiated by the Health Department of the Scottish Executive, but its application is potentially much wider. The issues emerging are closely related to themes of social inclusion and community development, and the findings are likely to be of particular interest and relevance to local authorities and their partner agencies as they take forward the agenda for community planning and the promotion of well-being set out in the Local Government in Scotland Act 2003. ² This report summarises the implications of the project's findings for public services and for the community and voluntary sector and is targeted at policy makers, service managers and community organisations: those whose roles and activities have a bearing on the well-being of communities.

The project team worked in four very different areas of Scotland: a 'new' town, an inner city area, a rural community and a New Community School cluster. ³ It gathered information by interviewing individuals, holding small group discussions and organising larger events. The nature of the project was exploratory and the process was one of inquiry rather than of formal research. This summary highlights key themes and distils from them a series of pointers relating to working practice, organisational behaviour and government action.

¹ The project was undertaken by the Scottish Development Centre for Mental Health, Scottish Council Foundation and OPM.
² The Act enables local authorities to do anything they consider is likely to promote or improve the well-being of the areas and/or the people in it.
³ Livingston, West Lothian; East End of Glasgow; Badenoch and Strathspey in Highland; East Renfrewshire.

What influences well-being?

For communities, well-being was perceived to be about 'thriving, not just surviving', being hopeful, healthy and sustainable. Among the many influences on well-being, three key factors stood out:

• Positive affirmation of worth: feeling valued by others and enjoying positive, participative relationships in which your views are listened to and respected. This applies chiefly to family and social interactions but participants also emphasised its relevance to more formal relationships, for example with employers, service providers and public authorities
• Access to a local infrastructure of amenities, services and opportunities: the local availability of adequate housing, paid work, public services, shops, parks, transport links, opportunities for learning and leisure, and sources of information and advice
• Safety and security: both personal safety, particularly in respect of crime, and financial security to support daily living and the ability to plan for the future

It was evident from the discussions that the well-being of individuals and the well-being of communities are interdependent. It is not enough that basic services and amenities exist; they must also be responsive to the people who use them and must treat them with respect. The more people feel valued within their community, the more likely it is that the community itself will develop the capacity to thrive.

Action to promote well-being then, must recognise wider structural factors as well as the development of individual coping resources. Relevant agencies must also recognise that their impact on well-being will be affected by the approach they take as well as by the success or failure of their longer-term or wider objectives.

Well-being, social inclusion and community planning: key issues

The project sought the views of participants about the areas where action and change are required in order to improve well-being. A number of issues relevant to social inclusion, community development and community planning emerged from the wide range of concerns raised and these are set out below. In each case, the relevance of the issue to the key factors for well-being is explored; specific problems identified; and appropriate strategies or approaches described.

Social capital and community capacity

Social capital is the advantage that an individual or community gains by being part of a social network: the connections of trust, understanding and shared values that bind people together and enable them to co-operate for mutual benefit. In this project, it was clear that positive relationships and connections are crucial to individual well-being and essential to the capacity of communities to thrive. But connections can be inhibited or disrupted by a range of factors:

• extended families become separated as young people have to move away from their home communities in search of job opportunities and/or affordable housing
• communities can lack a 'heart' or focal point where local people interact. Even where there is such a facility, it is not always accessible to the whole community, meaning that connections between generations or different ethnic groups are hard to forge
• unemployment can bring financial hardship, prevent access to important 'social' aspects of paid work, notably interaction between colleagues and the sense of worth that derives from fulfilling a valued role in the community. Insecure employment can detract from the benefits of being in paid work, generating uncertainty about the future

Initiatives to combat the social exclusion of individuals should aim simultaneously to build the social capital of a community, thus promoting the well-being of both. Examples include credit unions, which offer a community-owned method of debt management, and volunteering, which encourages interaction with others in pursuit of a social objective.

Tackling inequalities: closing the gap

The need to address inequalities and the stigma attached to 'difference' was a recurrent motif throughout the project. One of the chief critiques of the 'social capital' approach to community development is that although communities with high social capital experience decreases in crime, higher quality amenities and an overall improvement in well-being, they can also become wary of or even hostile to diversity and 'in-comers'.

Actions to promote social capital and well-being must therefore include rigorous attention to the promotion of equal opportunities and the combating of discrimination through measures such as:

• job retention support for those experiencing ill health, in particular mental ill health
• access for local people to affordable housing, enabling people to maintain family and community connections
• inclusive health and support services as opposed to the compartmentalising of 'client' groups
• the development of facilities and focal points which are accessible to the whole community

Public services: access, quality and public involvement

Access to a range of public services was, for project participants, one of the essential preconditions for well-being. In many Scottish communities however, there are few public services available locally. Where services do exist, rationing mechanisms are employed, from the formal (waiting lists) to the informal ('fobbing off'). Service boundaries do not always correspond to the 'natural' affinities that people have with a particular place. Consequently people may not identify with 'community' services.

The quality of service received and the degree to which the service user is consulted and involved have a significant bearing on well-being, particularly (although not exclusively) in relation to health and support services. Specific difficulties arise as a result of the ways in which services are organised and delivered:

• services tend to compartmentalise people into age or 'client'-related groups
• access to services for people from minority ethnic communities can be inhibited by language barriers or the absence of culturally appropriate approaches. Similar issues arise for other marginalised or disadvantaged groups
• 'traditional' services do little to promote self help or develop individual coping skills
• many services are still only available during 'office hours'
• an atmosphere of 'them and us' can develop between service providers and service users

Addressing these issues may once again be facilitated by looking at how the needs of individuals can be met in ways that also build capacity in the community. For example, 'mainstreaming' services instead of keeping them 'client-group' specific can help combat discrimination and promote connections between diverse groups. Offering flexible hours to service users can also serve to accommodate staff needs in relation to balancing work and family responsibilities; and recruiting public service staff from among the local population brings a range of economic and social capital benefits.

Staff attitudes and behaviours are very important in relation to service users' sense of self-worth and consequently to their perception of quality. In particular, service users are likely to develop more confidence in a service if they are kept fully informed and consulted about their own use of the service and involved in the planning of the service more generally through community consultation and participation initiatives.

Managing transitions

There are a series of pressure points in people's lives where additional or specialist support may be required to maintain well-being. These occur at times of transition: out of school and into work or training; into (or back into) work after unemployment or illness; changes in personal circumstances, such as becoming ill or becoming a parent (or carer). During these times, the factors identified for well-being - positive affirmation of worth, access to services, and security - can become simultaneously more important and more elusive. Some service interventions exacerbate difficulties here, undermining individual capacity to cope. Measures to support individuals at times of transition can have attendant benefits for social capital and community well-being. Examples include job retention schemes for those experiencing health problems, and skills development and training programmes, such as apprenticeship schemes, for young people leaving school.

Listening to communities

Being listened to and having your views respected is a key factor in individual well-being: conversely, a lack of control over events and the inability to influence developments that affect you directly can bring serious consequences both for individual motivation for change and for community capacity for action. Yet there is a continuing sense within communities that 'things happen' without reference to them or to their priorities, and that agendas are set elsewhere. There is also a concern that where consultation does take place, it is the 'usual suspects' that come forward, with disadvantaged or marginalised groups being particularly excluded. Specific issues include:

• agencies fail to share good practice relating to consultation and involvement
• agencies conduct 'one-off' consultation exercises rather than entering into a dialogue
• too much concentration on structures to promote public involvement and not enough on the quality and impact of the steps that statutory agencies take to involve people
• a continuing emphasis on innovation at the margins rather than review of core working practices

Strengthening local communities and investing in their development creates greater capacity for representation and participation. Participation is more likely if established, credible organisations are used to drive forward change, rather than 'new' agencies and initiatives; similarly, community 'champions' are important to mobilise opinion and represent views.

Ultimately, motivation to participate is likely to be greater where planning and strategy is driven by local concerns. This, in turn, is more likely to happen where agencies work with each other and with communities themselves, abandoning the traditional 'power' relationships and pooling both their knowledge of community needs and their capacity to respond. This, effectively, is the essence of community planning.

Young people - perspectives and involvement

The well-being of young people was considered by project participants to be pivotal to communities' capacity to thrive. Specific difficulties to overcome include the following:

• the association in people's minds between young people and anti-social or criminal behaviour. Young people can respond to this by fulfilling worst expectations
• the lack of a focal point in communities for interaction, leads some young people to 'hang around' in public areas, reinforcing associations with trouble making
• fear of crime can mean that parents restrict the freedom and independence of young people
• the geographical or legal separation of families can mean that young people lack guides or mentors
• apathy and frustration resulting from exclusion from local decision making can be more acute in young people

There is a clear role for schools in developing confidence and self respect in young people, to nurture their aspirations for the future. But there is also a need to address some of these issues outside the school, on young people's own 'territory' and on their own terms.

Community facilities for young people and the promotion of peer support networks can help to boost the capacity and motivation of young people to become involved in community development.

Building capacity for well-being

This project aimed to consider the capacity needed to achieve improvements in individual and community well-being: not only the volume of services or the number of professionals required to meet need, but also the environments, skills, values, beliefs and behaviours that enable people and communities to thrive.

Drawing together the range of issues discussed above, a range of working practices and approaches, organisational features and national support strategies stand out as prerequisites to build local capacity to enhance well-being:

Working practices and approaches that promote well-being

• Intervening in ways that encourage and reinforce self help, peer support and skills development and promoting collective action
• taking people's concerns seriously, not 'fobbing them off'
• creating a sense that change is possible whilst being realistic about what can be achieved
• recognising the importance of social contact and connections
• adapting service responses to individual requirements and circumstances

Organisational features and attributes that facilitate well-being

• A non-hierarchical structure that assures a localised presence and decision-making capacity with transparent decision making and clear feedback loops to communities
• funding streams that enable longer-term investment and regard prevention and promotion work as equally deserving as 'crisis' intervention
• support at senior level for participative approaches (including peer review and community-led audit) signalling an interest in the views and aspirations of specific communities
• professional training that prepares workers to interact with individuals, families and communities in ways that promote confidence and underpin informal support networks
• willingness and ability to build strategic cross-sectoral and interagency alliances

Central government support

• Clarity and simplicity at policy level, so that agencies are clear about what really matters: the current agenda is perceived as being too complex and the pace too frenetic
• raising awareness of the importance of the promotion of well-being across all sectors and departments of the Executive ('mainstreaming' or 'cross-cutting')
• 'staying power' to wait for results following investment, coupled with a shift of emphasis from 'what works' to why, how and under what conditions
• a willingness to legislate where voluntary approaches and exhortations do not bring results, to build community well-being and enhance capacity to thrive

Those areas which took part in the project have used the experience to shape and develop local priorities to improve community well-being and to build awareness of the range of activity happening locally that contributes to improvement of well-being. More generally, the project generated ideas and learning that can inform continuing work at local and national level within communities across Scotland.

Improving community well-being needs be taken forward through local community planning, using local authority powers to advance well-being. It should also be taken up as part of the Health Improvement Challenge. Community well-being will remain a key component of the National Programme for Improving Mental Health and Well-being, working with and supporting further developments in local communities.

Further details about the project can be obtained from the Scottish Development Centre for Mental Health (sdc@sdcmh.org.uk).