Written evidence submitted by Jiayi Jin (Assistant Professor of Architecture and Urban Studies at Northumbria University) (CMH0076)

Healthy Urban Neighbourhoods: Restoring Mental Health of Diverse Individuals with Data-driven Policy Advice

Dr Jiayi Jin, Department of Architecture of Built Environment, Northumbria University

My research explores the spatial elements that support mental well-being in urban environments and the accessibility of these spaces for diverse populations. I began by examining theories on urban design and mental health, recognising the importance of understanding how different groups perceive and experience urban spaces. Given that these experiences are deeply personal and shaped by varying needs and values, qualitative research was conducted to investigate both positive and negative aspects, using workshops to engage targeted groups in these discussions. The findings indicate that the pathways towards mental health are complex, multivariate and interconnected. In order to address this challenge, policymakers should take an integral evidence-based approach. These inquiries are examined through the recently completed British Academy-funded project “Navigating Eco-Social Vulnerabilities (NESV): Uncovering Knowledge and Practical Gaps Across the UK, the Netherlands, and Norway” and “Participatory Neighbourhood Planning for the ‘Brown to Green’ Transition in Tyneside” (funded by AHRC).

How can community mental health services work with social care, the third sector and local government to better address service users’ health and wider social needs that are wider determinants of mental health outcomes?

Effective collaboration between community mental health services, social care, the third sector (charities, NGOs, and voluntary organisations), and local government requires a coordinated, multi-agency approach. However, mental health information systems often lag behind those in healthcare, and policymakers frequently lack a thorough understanding of the wider determinants of mental health. A key action point highlighted in policy trend analysis is the need to reduce health inequalities. Disparities in access to resources are major contributors to health deterioration, and these inequality gaps continue to grow in many regions.

Figure 1: Multi-Actor Analysis for Enhancing Mental Health

To address environmental inequalities, it is essential to reduce the prevalence of ‘problem neighbourhoods’ and minimise general stressors in urban areas. This would provide individuals with more space for resilience in the face of mental health challenges. Simply providing resources for healthy living is insufficient; people should also be educated and encouraged to make healthier choices. Beyond the urban environment, mental health disorders can also be influenced by major life events or genetic factors. Therefore, it is vital to have a robust mental health system in place at the community level to treat individuals experiencing mental health issues.

Central to these improvements is research and continuous monitoring, which equips policymakers with the information needed to weigh their options and make informed decisions. A key aspect of this collaboration is integrating services in a way that ensures individuals can access a comprehensive range of support. Co-location of services—such as bringing mental health professionals, social workers, and third-sector organisations into shared spaces like community hubs—can improve communication and accessibility. Additionally, establishing multi-disciplinary teams that include a diverse range of professionals ensures that all aspects of a person’s needs are met in a holistic manner. A unified referral system can also streamline the process, making it easier for service users to navigate various services without encountering unnecessary barriers.

Another critical strategy is joint commissioning and funding. By pooling resources, local authorities, NHS mental health trusts, and third-sector organisations can maximise the impact of initiatives that address both mental health and social needs. Outcome-based commissioning, which aligns funding with shared goals such as reducing hospital admissions or improving social inclusion, can further support these efforts. Additionally, grant schemes for grassroots organisations can provide crucial financial backing to smaller community organisations, enabling them to offer tailored and culturally specific mental health support.

Data sharing and digital integration are also essential components of successful collaboration. Secure information-sharing agreements allow for the efficient exchange of relevant data across services while respecting privacy laws. This can be enhanced with digital platforms that facilitate case management, enabling professionals from different sectors to coordinate care in real time. Leveraging tools like AI and data analytics can help identify emerging trends, such as mental health crises, homelessness, or unemployment, and target interventions more effectively.

Cross-sector training and capacity building are crucial for ensuring professionals from various sectors can work together effectively. Joint training programmes focused on trauma-informed care, mental health first aid, and the social determinants of health can foster shared understanding and enhance collaboration. Additionally, creating peer learning networks that facilitate the exchange of knowledge between statutory services and grassroots organisations strengthens these partnerships. These initiatives empower both organisations and individuals to offer more comprehensive and effective support to those experiencing mental health challenges.

Local governments play a significant role in shaping the city’s design and can therefore influence the physical environment in ways that impact mental health. They also have the power to affect the economic, social, and lifestyle factors that contribute to well-being. For example, economic inequality can be addressed by increasing social welfare or providing subsidies, while the social environment can be improved by building spaces that encourage social interaction and connection. Additionally, lifestyle choices can be influenced through education and targeted public health campaigns. The local government is a key factor in fostering a healthy environment, as it can directly influence public health and care services. As the model shows, factors such as education, physical activity, social support, the built environment, economic conditions, and safety are all interconnected with mental health outcomes. This suggests that urban mental health is influenced by a wide range of local authority clusters, not just health services alone.

Finally, community-led and participatory approaches are essential for ensuring that services meet the needs of service users. Involving people with lived experience of mental health challenges in the co-design of policies and services ensures that care is both relevant and effective. Additionally, establishing local mental health forums where service users, carers, and organisations collaborate can help shape services that are responsive to community needs. Leveraging the strengths of the community, such as peer support networks and local businesses, can further enhance mental health resilience and promote well-being in the broader social context.

What blockers or enablers should policy interventions prioritise addressing to improve the integration of person-centred community mental health care?

In the UK, improving person-centred community mental health care requires addressing both the blockers and enablers within the current system. A major barrier is the fragmentation of services across health, social care, and voluntary sectors. The lack of coordination between these services often results in siloed care, which can hinder the delivery of comprehensive and person-centred support. Policies should prioritise the creation of integrated care models that facilitate collaboration between mental health services, general healthcare, social care and other community services. This would ensure that individuals receive holistic, coordinated care that addresses all aspects of their wellbeing.

For collaboration to be effective, integration is essential. Different sectors must be involved, with a shared willingness to collaborate. This need for integration arises because, as services become more differentiated, it becomes clear that no single actor can address the complexities of mental health on their own. In such a framework, all actors—whether from health, social care, or voluntary sectors—must have access to relevant information and engage in clear communication. Achieving this requires establishing transparency and trust among team members, which is vital for effective collaboration. A key element of successful collaboration is the development of multi-disciplinary, person-centred teams. When professionals such as health practitioners, social workers, housing officers, and community support staff work together, they are better able to respond to the complex, overlapping needs of service users. Policies should focus on creating these teams and ensure that all professionals are trained in collaborative practices and person-centred care. This approach allows for more responsive, flexible care that adapts to the evolving needs of individuals, providing a more personalised service.

Another barrier to the integration of person-centred care in the UK is the underfunding of mental health services. Despite recent improvements, mental health services continue to receive less funding than other parts of the healthcare system, limiting their capacity to deliver high-quality, integrated care. There has been a welcome increase in UK government commitments to mental health services in England in recent years, which has translated into an overall higher level of funding. However “whilst spend is increasing, it is not increasing at a fast enough rate; spending on mental health has increased at a slower rate than overall NHS expenditure, and the proportion of the NHS England budget spent on mental health has fallen since 2016/17” (British Medical Association, 2025). Policies should address this funding disparity by ensuring that mental health services are adequately funded and resourced to meet the demand. Furthermore, long-term investment in community mental health services would help create a sustainable framework for delivering person-centred care that is not just reactive but also preventive in nature.

Beyond funding, workforce capacity and training are major challenges in delivering person-centred mental health care. Many professionals in the mental health and social care sectors lack the specialised training needed to support individuals holistically, taking into account their unique circumstances. To address this, policy interventions should prioritise training programmes at the local level and equip professionals with the necessary skills and knowledge to deliver effective, compassionate care. Ensuring a well-trained workforce is essential for creating a system that truly meets the needs of those seeking mental health support.

The prevalence of mental health issues varies across neighbourhoods, highlighting a spatial dimension to mental health challenges. Local governments can leverage data modelling as a valuable tool to generate evidence-based insights into urban mental health systems. It can help identify mental health concerns, recognise population groups affected by similar determinants, and guide targeted interventions. Additionally, data modelling can operationalise theoretical frameworks introduced in academic research. However, addressing complex urban mental health challenges requires more than data modelling alone. A mixed-methods approach is essential to uncover cause-effect relationships between urban determinants and mental health, ensuring that findings are effectively translated into policy and practice.

Finally, empowering service users and communities plays a critical role in enabling person-centred care. Engaging individuals with lived experience of mental health challenges in the co-design of services ensures that care is both relevant and responsive to their needs. Policies should prioritise the involvement of service users in decision-making processes, encouraging a culture of co-production where individuals have a say in the care they receive. Additionally, supporting community-based organisations and peer support networks can enhance mental health resilience and offer a more holistic approach to care. By fostering this collaborative approach, policies can create a system where mental health care is well aligned with the needs of individuals and communities.

Table 1: This table provides a summary of the challenges (blockers) and corresponding enablers for advancing person-centred community mental health care.

What are the examples of good or innovative practice in community mental health services? And what needs to happen to scale up the adoption of these practices across the country?

In the UK, several community mental health services have pioneered innovative and effective approaches. Here are some notable examples:

1. Community-Based Peer Support Networks (e.g., Together UK, Peer Support Scotland): Community-based peer support networks provide a vital, grassroots approach to mental health support by connecting individuals with lived experience of mental health challenges. These networks foster mutual understanding, shared experiences, and emotional support, helping people navigate their mental health journey in a non-judgmental and empowering environment. Together UK is a national organisation that champions peer-led mental health support across England. It offers one-on-one and group-based peer support, focusing on recovery, self-advocacy, and personal empowerment. Through trained peer supporters—individuals with lived experience—Together UK provides practical guidance, emotional support, and signposting to additional resources. Peer Support Scotland operates with a similar philosophy, promoting peer-led initiatives across Scottish communities. Their programmes focus on informal and structured peer support, aiming to reduce isolation and enhance well-being through shared lived experiences. These examples contribute to a more holistic approach to mental health care that values lived experience as a key resource for recovery and resilience.
2. Network-based Approach (NHS Trusts in London, Kent, and other areas): Open Dialogue (OD) is a relational and network-based approach to mental health care that has been adopted by several NHS Trusts in London, Kent, and other regions across the UK. OD was originally developed in Finland and has been offered to people in crisis over the last 40 years, this model prioritises open, transparent conversations between individuals experiencing mental distress, their families, and a consistent team of mental health professionals. The approach focuses on shared decision-making, early intervention, and continuity of care, aiming to reduce hospitalisation rates and reliance on medication. In the UK, NHS Trusts implementing OD have integrated the approach into community mental health services, training clinicians in dialogical practices and emphasising listening, trust-building, and co-produced care plans. Preliminary research suggests that OD can lead to improved long-term outcomes, including reduced relapse rates and greater patient satisfaction. However, scaling the model within the NHS presents challenges, particularly in workforce training and adapting the approach to diverse healthcare settings.
3. Safe Spaces like Safe Havens and Crisis Cafés offer community-based alternatives to hospital emergency departments for individuals in mental health crisis. These spaces provide immediate, non-clinical support in a safe and welcoming environment, helping people manage distress before it escalates to the point of requiring hospitalisation. Operated in partnership with local NHS services, charities, and voluntary organisations, Safe Havens (i.e. The Bothy in Ashington, Northeast England) focus on crisis de-escalation and reducing unnecessary hospital admissions. They offer one-on-one emotional support, practical coping strategies, and signposting to ongoing mental health and social care services. Similarly, Crisis Cafés (i.e. Kettering Mind), run by the mental health charity Mind, create a calm and supportive space where individuals can access emotional support, guidance, and connections to further resources. These local services bridge critical gaps in traditional mental health care, providing early intervention that helps individuals regain stability, control, and a sense of connection during challenging times.
4. Digital Interventions (e.g., Kooth, Big White Wall, NHS Talking Therapies apps): Digital interventions provide accessible, flexible, and confidential support through online platforms, offering counselling, therapy, and peer support 24/7. These services help bridge gaps in traditional mental health care by reaching individuals who may face barriers to in-person support, such as long waiting times, stigma, or geographical constraints. Kooth (kooth.com) is a free, anonymous online platform designed for young people, offering professional counselling, self-help resources, and peer support forums. It provides a safe space where users can engage with trained counsellors or explore therapeutic content at their own pace. Togetherall and SilverCloud offer digital Cognitive Behavioural Therapy (CBT) programmes, helping individuals manage anxiety, depression, and other mental health concerns through structured, evidence-based interventions. Togetherall also includes peer-to-peer support, where users can share experiences and encourage each other in a moderated environment. The NHS Talking Therapies apps integrate digital mental health support into the public healthcare system, providing online therapy options that complement traditional face-to-face services. These platforms play a crucial role in early intervention and self-management, making mental health support more widely available and reducing pressure on in-person services.
5. Culturally Adapted Services (e.g., Black Thrive, Birmingham & Solihull Mental Health Trust): Lastly, there are several initiatives focus on addressing inequalities in mental health care for ethnic minority communities, recognising that cultural background, lived experiences, and systemic barriers shape how individuals access and engage with support. For example, Black Thrive is a partnership in Lambeth that works to improve mental health outcomes for Black communities by tackling racial disparities in service access, quality, and outcomes. It brings together health professionals, community organisations, and local government to co-design solutions that address structural inequalities and promote culturally competent care. Similarly, the Birmingham & Solihull Mental Health NHS Foundation Trust has developed specialised services to support ethnic minority communities. These initiatives focus on improving trust between service users and providers, increasing representation within the mental health workforce, and ensuring that interventions are culturally sensitive and responsive to the specific needs of diverse populations. These culturally adapted mental health services help reduce stigma, build trust, and create more inclusive and equitable mental health support systems.

Expanding mental health innovations across the UK requires a sustained commitment to long-term funding that goes beyond short-term pilot programmes. Community-based services play a critical role in providing accessible, person-centred support, but their effectiveness depends on financial stability. Ensuring consistent investment in these services allows them to scale, adapt, and respond to changing mental health needs. Additionally, fostering stronger collaboration between the NHS, local authorities, and the voluntary sector is essential for integrating health, social care, and community-led initiatives. A more connected system ensures that individuals receive holistic support that addresses not only clinical needs but also the social and environmental determinants of mental health.

A key aspect of this integration is co-designing services with users and grassroots organisations, ensuring that mental health support remains relevant, accessible, and responsive to lived experiences. Embedding social prescribing into routine care—making non-medical interventions a standard part of mental health and primary care pathways—further enhances the reach of these services. Strengthening partnerships with local charities and social enterprises will also help expand access to holistic, community-driven mental health solutions.

From an urban research perspective, enhancing data sharing and incorporating spatial analysis into measurement is essential for advancing mental health interventions. Establishing shared digital records across the NHS, local councils, and voluntary organisations can improve coordination, minimise service duplication, and create a more comprehensive understanding of both individual and community mental health needs. Additionally, leveraging spatial data can help identify geographic disparities, enabling targeted, place-based interventions. Systematic long-term data collection and analysis will not only strengthen the evidence base for scaling successful initiatives but also support more effective policy development and resource allocation.

Furthermore, enhancing digital and remote mental health services can improve accessibility, particularly for those facing geographic or mobility barriers. Expanding access to online therapy, self-help tools, and digital peer support platforms can provide continuous care outside of traditional clinical settings. However, ensuring digital inclusion—especially for older adults and disadvantaged groups—is essential to prevent widening health inequalities.

Data-driven approaches are set to play a crucial role in shaping the future of mental health care. By clustering and geographically visualising population characteristics, lifestyle patterns, social and physical environments, economic conditions, and health outcomes, researchers can uncover spatial patterns and highlight areas with urgent mental health needs. This analytical approach enables the design of more targeted, place-based interventions that align with community-specific challenges. Integrating data collection and visualisation will not only enhance service delivery and inform policy development but also provide deeper insights into the intricate relationship between urban environments and mental health, fostering more proactive and equitable mental health strategies.

Reference:

British Medical Association (2025). Mental health pressures in England. Available at: https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/mental-health-pressures-data-analysis (Accessed: 02 February 2025)

Researcher’s bio: Jiayi’s transdisciplinary research spans the fields of architectural and planning theories, digital technologies, sustainable development and participative design. She has led multiple research projects funded by the British Academy and the Arts and Humanities Research Council (AHRC), focusing on creative and inclusive participation in urban transitions. Her work emphasises bottom-up approaches that empower local communities to shape their environments, advocating for spatial practices that address the diverse needs and voices. Dr Jin served as the PI for AHRC project: “Participatory Neighbourhood Planning for the ‘Brown to Green’ Transition in Tyneside” and the Co-I for the British Academy project “Navigating Eco-Social Vulnerabilities Through Participatory Design: Uncovering Knowledge and Practical Gaps Across the UK, the Netherlands and Norway” with Dr Cheng Siew Goh (PI) at Northumbria University.

February 2025