Reimagining health and wellbeing

The challenges of creating a society where all can flourish require bold examinations of human wellbeing. If subjective wellbeing was made a critical component of productivity, what types of social infrastructure would emerge as a driver of prosperity? What role does technology play in our health systems? How can social movements be utilised to improve public health? How might this influence the design of our built environment and physical infrastructure? How might we integrate emotional literacy into the education system, as psychotherapist Susie Orbach proposes, to help people maintain better relationships at work and home?

With these questions in mind, The RSA is reimagining approaches to health and wellbeing, and has just embarked on it's most ambitious project yet. As one of three national learning partners for NHS England’s Health as a Social Movement programme, the RSA – with NEF and Nesta – is driving support for health beyond the healthcare system. It is hoped that through this programme we will start to see a step change in prevention, a shift in power to people and their social networks, and deeper engagement with communities to better help them serve their own health needs.

The way we deliver healthcare has become highly adept at remedying acute illnesses and injuries but has been less successful at preventing disease, ensuring high quality of life for people with chronic conditions, or sustaining the World Health Organisation's definition of health as “a complete state of physical, mental and social wellbeing”.

This more holistic approach can better make the distinction between illness and sickness in order to properly address long-term health needs as it is more useful to view health as an interconnected 'helix' rather that an up or down scale of ‘well’ or ‘unwell’. In sum, instead of focusing just on acute illnesses, services should focus on ensuring that those patients are supported before they require clinical interventions.

The NHS Five Year Forward View takes this on as a central component of it's plan for England's health system, which says in order to better realise the ‘renewable energy of communities’ we must harness the power of social movements in order to rapidly improve health.

In order to do this, we need to design services that are built ‘with, not for’ people.

I recently visited Norwich and Waveney’s Wellbeing Service that is at the forefront of this change. Alongside NHS IAPT (talking therapies) the Service is delivering an ambitious social programme supported by peer-to-peer support workers and self-guided treatment, with 'wellbeing advisors' facilitating workshops allowing service users to choose to manage their own treatment. One leader of the service told me: "We don't like the word prescribing". Their interventions, some as simple as taking someone with social anxiety to a café, to walking groups and workshops on resilience and relationship commitment are reimaigning health and social care and breaking down the traditional clinician-patient relationship.

Norfolk Clinical Commisioning Group made the strategic decision to invest £10 million from secondary care in order to fund this new service, which was mandated to embed preventative health initiatives. We need more of these approaches if we are able to meet the huge challenges to the health service and our collective wellbeing.

Previous RSA work in this area

The RSA is evaluating what an economy centred around human welfare looks like. From our research on recovery, to opening up health data, to understanding and unleashing community capital, we are reimagining wellbeing. The aim of our Cabinet Office funded mental health data project was to enable the public to compare local services, make more informed choices and help service-users and their families, regulators and local organisations to hold providers to account. We argued that the physical health of mental health patients was being neglected by GPs and others in primary care services, and found that mental health patients were up to 25% less likely to be offered basic tests, such as cholesterol, blood pressure and cervical cancer screening.

Our Connected Communities report sought to understand how community and social interactions affect people’s wellbeing. The report makes the case that connected, supportive communities are not only critical to building the kind of society that we'd all like to live in, but can also be mobilised to bring about better individual health outcomes. We know that these connected communities are ‘contagious’ and foster trust and inflate a sense of purpose and wellbeing.

As demonstrated in Norwich, we’ve found that peer-to-peer support is crucial as a preventative tool for good mental health. We need to highlight the ways support networks don’t just act as coping mechanism for stressful lives. The RSA’s Whole Person Recovery project advocates for personalised recovery goals supported by a community-based approach. It recognises that recovery involving lasting changes to an individual doesn’t have a discreet ‘end point’ and is a journey.

We’re demonstrating that the future of healthcare has to move beyond the remedial approach to addressing health and that it no longer appears to be sufficient to sustain wellbeing and also fails to meet the challenge of today’s social problems; from increasing inequality and entrenched social isolation to rises in long-term illness, mental health disorders and an aging population.

We're reimagining wellbeing - Join us to help develop our vison of a healthy society and help deliver our mission to give people the Power To Create by following #RSAWellbeing @theRSAorg, downloading our Wellbeing Guide or by keeping up to date by visting our project page for all our work on health and wellbeing.

@_Tom_Harrison

Tom Harrison is the RSA's Emma Lindley Intern for mental health and wellbeing.