MHN Evaluation
Research type
Research Study
Full title
Impact and Implementation Evaluation of the Wakefield Mental Health Navigator Scheme
IRAS ID
310730
Contact name
Sarah Blower
Contact email
Sponsor organisation
University of York
Duration of Study in the UK
1 years, 6 months, 31 days
Research summary
Research Summary
Poor mental health can make it harder to cope with housing problems. Being homeless or experiencing housing instability can also make mental health worse. Despite the interconnected relationship between mental health and housing, housing officers often have very few resources to support tenants with mental health difficulties. Likewise, mental health pracitioners have few resources to support patients with housing difficulties. This study evaluates an innovative service called the 'The Mental Health Navigators' (MHN) scheme. The scheme was set up to support tenants living in social housing who are at risk of losing their homes due to mental ill health. Tenants are supported by NHS employed mental health specialists embedded within a wellbeing team in the housing provider's organisation. The navigators provide support around mental health and help tenants access services and support that is tailored to their needs and available in their area. The scheme aims to improve mental health and support tenants to stay in their homes. Our study will explore the impact of the scheme on these outcomes, as well investigating factors that influence the delivery of the scheme and it's economic impact. To explore impact on outcomes, we will analyse existing monitoring data and seek consent from 30-50 service users (tenants) to extract and analyse data from their casefiles. To explore implementation we will conduct research interviews with groups of service users, navigators and other stakeholders. We also plan to synthesise learning into an 'implementation toolkit' that could be used by other organisations interested in rolling out a similar scheme in their area. The study will be conducted in Wakefield. It will commence as soon as approvals are obtained and is scheduled to end in September 2023.Summary of results
Study title: Impact and Implementation Evaluation of the Wakefield Mental Health Navigator Scheme
Who carried out the research?
The universities of York, Manchester and Newcastle received funding from the National Institute for Health and Care Research (NIHR) National Priority Area Research Programme 2020-23 (Health and Care Inequalities) to evaluate the Wakefield District Housing (WDH) Mental Health Navigator (MHN) scheme.Why was the research needed?
People with mental health problems are more likely to experience housing issues, and vice versa. Stable housing is crucial for mental well-being and recovery. The COVID-19 pandemic worsened housing insecurity for many, especially low-income renters. There's a need for better support to help people with mental health issues keep their homes.
The Wakefield "Mental Health Navigator" (MHN) scheme helps people with mental health problems navigate the complex system of housing and mental health support services. Navigators are trained professionals who guide individuals through the process of:
Identifying the right services they need.
Making referrals to those services.
Attending appointments with service providers. This is the first study to evaluate the impact of an MHN scheme specifically designed to address both mental health and housing instability.How did we do the research?
We conducted an evalaution which aimed to provide acomprehensive assessment of the Wakefield MHN scheme that could inform wider roll-out of the schemeto other organisations. We used routine administrative data gathered by WDH as well as from local and regional health and care providers to understand the impact of the scheme on the tenants and the wider care system. We also interviewed people involved in designing and delivering the MHN scheme in Wakefield as well as tenants themselves to find out their views and experiences. Throughout the study, we also worked with a range ofpublic stakeholders, including people with lived experienceof poor mental health, to guide our study and help us makesense of the findings.A summary of our key research questions and findings are presented below.
Which tenants received support and how did they benefit?
Over eight years, the scheme received 2,024 referrals for tenants who needed help. This shows a high and consistent demand for the service, even during the pandemic. Despite the high demand, people typically waited only about a month to see a navigator.
Most referrals were due to concerns about the tenant's emotional well-being (94% of cases). Other common reasons included housing issues (19%) and general health problems (15%).
This shows the scheme is focusing on people who need help with their mental health, which is its main goal.
About half of the people referred (48%) engaged with the scheme and worked with the navigators. One-third (28%) did not engage with the service. For the remaining people (24%), it's unclear if they used the service or not based on the available information. On average, people who engaged with the scheme worked with the navigators for about two months.What was the impact of the scheme on key outcomes of interest?
Total tenant scores on the DIALOG scale were higher at the end of the intervention (indicating a better quality of life), as were scores for each individual item on the scale. There was a statistically significant improvement in scores for mental health, job situation, leisure activities, personal safety, medications and meetings, which may indicate that the MHN scheme worked particularly well for these areas.
The difference was not significant
for physical health, accommodation, relationships and practical help, suggesting that the scheme may have worked less well for these areas.What did key stakeholders think about the scheme?
Tenants appreciated:
-Increased awareness: The scheme helped them understand what mental health support is available.
-Boosted confidence: Navigators gave them the confidence to reach out for help.
-Home visits: These built trust and allowed for open conversations.
WDH staff valued:
-Reduced housing risks: The scheme helps prevent issues like rent arrears and anti-social behavior.
-Reduced need for acute services: It acts as a preventative service, reducing the need for emergency care.
-Improved tenant access: It helps connect tenants with healthcare services, even if they don't usually engage with the system.
Local NHS staff recognized:
-Reduced demand: The scheme helps alleviate the burden on mental health services.
-Better understanding of local needs: The scheme provides valuable insights into the mental health needs of local tenants.In essence, all stakeholders viewed the Mental Health Navigator scheme as a valuable resource that improves the lives of tenants, reduces housing risks, and enhances the overall well-being of the community.
Where can I learn more about the study?
An infographic providing a lay summary of the results is available at the following weblink:
https://eur03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fclick.pstmrk.it%2F3ts%2Fwww.york.ac.uk%252Fhealthsciences%252Fresearch%252Fpublic-health%252Farchive%252Fmental-health-navigator%252F%2523tab-5%2FNBTI%2FTOe5AQ%2FAQ%2F9c9f8132-55e7-4323-ba60-9efb98f8290e%2F1%2FhXhdHiBq1g%23tab-5&data=05%7C02%7CWales.REC5%40Wales.nhs.uk%7C20c6f8a1d72e443eaee508dd185641d4%7Cbb5628b8e3284082a856433c9edc8fae%7C0%7C0%7C638693480974816270%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=LCsZozieMOO1b41ETLlWZ2Ai56AXwJ2ldcEKBZYfdpk%3D&reserved=0A series of videos describing the findings of our research and providing more information about the scheme is available here:
https://eur03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fclick.pstmrk.it%2F3ts%2Fwww.york.ac.uk%252Fhealthsciences%252Fresearch%252Fpublic-health%252Farchive%252Fmental-health-navigator%252F%2523tab-6%2FNBTI%2FTOe5AQ%2FAQ%2F9c9f8132-55e7-4323-ba60-9efb98f8290e%2F2%2Fpz4JAd3nYO%23tab-6&data=05%7C02%7CWales.REC5%40Wales.nhs.uk%7C20c6f8a1d72e443eaee508dd185641d4%7Cbb5628b8e3284082a856433c9edc8fae%7C0%7C0%7C638693480974836472%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=z8YEq8wyJb2Gg98K4QdFAafp%2BXn1d%2FzZGWzI8xun1fw%3D&reserved=0A toolkit for those thinking of developing their own navigator scheme is available here:
https://eur03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fclick.pstmrk.it%2F3ts%2Fwww.york.ac.uk%252Fhealthsciences%252Fresearch%252Fpublic-health%252Farchive%252Fmental-health-navigator%252F%2523tab-4%2FNBTI%2FTOe5AQ%2FAQ%2F9c9f8132-55e7-4323-ba60-9efb98f8290e%2F3%2Ff_okac2C2N%23tab-4&data=05%7C02%7CWales.REC5%40Wales.nhs.uk%7C20c6f8a1d72e443eaee508dd185641d4%7Cbb5628b8e3284082a856433c9edc8fae%7C0%7C0%7C638693480974848715%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=F95JRnY08ocFn8B%2FBlChdBhRft00ovy6DXE%2Fq2Z1b3o%3D&reserved=0REC name
Wales REC 5
REC reference
22/WA/0232
Date of REC Opinion
19 Aug 2022
REC opinion
Favourable Opinion