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Positive Minds Learn Wellbeing - Blackburn and Darwen CLMH research - Phase 2

 

Image of Positive Minds Logo

Wider Context

In 2015, Blackburn with Darwen Borough Council Adult Learning successfully bid to the ESFA to become one of 62 DfE Community Learning Mental Health research projects. We renamed the project "Positive Minds" during the Summer of 2015 (year one) after feedback from a local "lived experience" forum.  Details of our Phase 1 journey, including the local context, are available here or on the link at the bottom of the page. 

Following on from Phase 1, we were invited to continue, as part of the Phase 2 research in 2016/17 to find out if short, part-time adult education courses can help people develop strategies to manage mental health problems, like stress, sleeplessness, worry, anxiety and feeling low.  We became one of 52 learning providers to be involved in the Phase 2 and one of 18 who were randomly allocated to the Group A intervention group.

As part of this group we worked to recruit research volunteers who self-assess themselves as having mild to moderate mental health problems and offer them the following to see if it can improve their mental health and help people feel able to get on with their lives:

  • courses of 15 hours over 6 weeks that specifically focus on helping research volunteers to manage symptoms and difficulties they experience. These symptoms may typically be linked to changes in peoples’ life circumstances (e.g. bereavement, illness, divorce, redundancy, etc.) or to life-course transitions (e.g. becoming a parent, retirement, becoming a carer, etc.) that triggered their vulnerability to mental health problems, or changed symptoms they were previously self-managing.
  • short (once-a-month) refresh sessions for graduates from our year 1 and 2 research courses

Progressing from year 1 to year 2

Locally our project has faced a number of challenges and opportunities in transitioning from year 1 to year 2.  

  • In year 1 we developed a mixed offer of courses. Some of our courses specifically targetted symptoms of mental health and some provided distraction opportunities, timeout and the chance to learn something new in a supportive environment. We  used the NEF Five Ways to Wellbeing model to help us to develop  the provision. During year one we had also allowed learners to engage in multiple courses where it was clear from discussion that the learner could benefit further from additional learning on the pilot.  
  • In order to produce more robust  data for the research and to comply with the requirements for Group A,  our year two courses specifically targeted learners self identifying as having mild to moderate symptoms of anxiety, stress, low mood or depression as per the specification.  This resulted in a revamp of the courses we offered to ensure they provided research volunteers with the opportunity to learn and develop skills and strategies to better self-manage their condition as well as sharing what worked for them.  The courses on offer included: 

 

Relaxation through Painting and Drawing Five Ways to Wellbeing 
Find Your Focus Through Digital Photography    Gentle Relaxation for Mind and Body   
Make and Mend Through Fabric Crafts   Moving Forward  
 Cook, Eat and Unwind on a Budget   Living Life to the Full 

 

  • As the year developed we recognised that some courses did not recruit particularly well.  We reviewed these and tried re-branding for example "Improve your mood through Art" was changed to "Relaxation through Painting and Drawing".  The change saw us improve recruitment to some topics whilst others we took the decision to withdraw from the offer as the year progressed

Photographs of some of the courses can be seen below:  

An image of a cut out activity being undertaken by learners exploring whether they jump to the worst conclusionsAn image of learners looking at an interactive whiteboard with stay and fight or walk away as part of an activity considering fight or flight responses

  • Some of our courses used a secondary topic such as art or cooking but still focused on ensuring learners had the opportunity to develop and practice strategies to improve their wellbeing, such as using art regularly as a distraction technique to reduce anxiety or exploring perspectives in photography whilst also discussing the importance of viewing life events from different perspectives. Further learner examples below help illustrate how learners found the opportunity to express themselves useful in order to explore their feelings and emotions:

 An image of a learners hands covered in paint and a piece of art she has been working on as part of relaxation through painting and drawing 

An image of a pine cone balanced on a fallen tree taken by a learner when exploring perspectives in a digital photography class

  • For Phase 2, we made changes to our marketing materials to ensure we were meeting the criteria for our group, Group A, and that potential learners/research volunteers were clear about the emphasis on exploring and developing coping strategies.  Please click on the images below to view the full versions of our marketing materials.

 An image of the front page of the Positive Minds Booklet      An image of the Positive Minds Leaflet

Partnerships

During year 2 we sought to maintain and build on partnerships developed with local NHS and third sector organisations involved in supporting mental health and wellbeing including: Care Network, Your Support Your Choice, Mind Matters (NHS IAPT service), Lancashire Womens Centres (3rd Sector IAPT service and wellbeing provider), The Carers Service, NHS Community Restart Services, Inspire (local drug and alcohol rehabilitation service), The Wish Centre, Transforming Lives and Family Support Worker teams within the Local Authority and our Local Jobcentre Plus network.  

  • Some partners struggled initially with the change in emphasis of the courses and initially, referrals dropped
  • Strong partnership work assisted in ensuring research volunteers were signposted at the right time to access courses
  • New partnerships developed during the year providing fresh opportunities for collaborative working whilst changes in workforce lessened our engagement with other partners

Results

The analysis and findings of the study are currently being undertaken by Ipsos Mori and are due to be published early in 2018.  

During year 2 we received 264 enquiries from potential research participants, leading to us carrying out 172 IAG sessions. Unfortunately, some of the learners were not eligible for the research due to not self-assessing as having mild to moderate mental health issues. In these instances, we took time to ensure we could signpost ineligible candidates to suitable alternative provision or services.  In total, we had 126 enrolments on courses with 105 learners attending at least 50% of their course.  91 learners completed their course.

A big focus from our lessons learnt in year one was to improve our retention.  Overall during year two 83% of learners completed over 50% of their course, with 72% of starters completing their final week.  

During the year we continued to develop our strategy to improve retention. This included contacting learners who missed a week to help support them back to class and contacting all learners after week one to "check in" with how they found the first session.  This appeared to have a positive impact with 41 of the 45 learners enrolled in the April - July 2017 period attended the full course to the final week giving us 91% retention during this period.

What have our research volunteers told us?

As our project drew towards a conclusion we undertook a selection of case studies to capture some qualitative information on the impact our courses had on our volunteers. The full selection of case studies is available here, however, some excerpts from eight of our volunteers include:

"The course has helped me to cope with challenging times because it took me out of my comfort zone."

"There was no judgement on this course. I was previously embarrassed about my situation and I am no longer embarrassed. The course reinvigorated my ability to do art. I realised how much I enjoyed art."

"Art allows me to relax in and amidst the formal learning. The course has helped me with my relationship with my daughter. We are spending quality time together doing art. We can switch off and do something together with my full attention."

"I was blaming myself and coming on the course made me realise that it is not all my fault. I valued doing something and started to value my own time. During the course I realised that you cannot always give you have to take time for yourself." 

"Feels great that you’ve accomplished something. On the days when I attended the course if lifted my mood and this spilled over into the next day."

"The course helped me with my confidence. At first when I had to introduce myself, I spoke only 3 words. Now I am confident chatting in groups. Tutor was great."

"I believe in myself now.  I can change things now.  I know that there will be difficult times but the course has given me coping mechanisms.  I am now able to deal with challenging moments.  I’ve used the tools that were given to me.  I write notes to myself which helps me to organise myself. The tools were great!"

"I want to do more for myself.  I have taken out my art stuff at home and am doing more art. This is making me feel better.  I realise that I can do more. " 

"A positive outcome was it brought me out of a dark isolated place. I am now reaching out to old friends and we go for walks regularly. Doors are opening for me. I am embracing the changes and taking the initiative to look after myself more."

One learner from year one volunteered to make a short video talking about her experience on the Positive Minds Course and what she had achieved since attending. She has now completed her Level 2 Foundation in Art and Design and is progressing onto a level 3 qualification in September 2017.  You can watch her video clip  below by clicking on the image:

 

Image of a video still of a positive minds video showing a learner

 

While we wait for the analysis and findings we intend to continue to run a range of similar provision on a pilot basis through our mainstream Adult Education Budget funding.   Our new offer will appear here 

What went well and how has it influenced our work?

  • The consistent introduction of pre-course IAG using the Discovering Potential model. Learners have reported feeling they have benefitted from clearly identifying the changes they want to make before they start the course.
  • We developed strategies to support learners with english as a second language or those with low levels of literacy/numeracy to better understand their feelings and emotions and how to cope with them including recruiting learning advisors/learning support workers from different cultures who could explain mental health symptoms to learners in a meaningful way 
  • Retention improved in year two reaching 91% in the final term.  Potential reasons for this include mandatory IAG at the start and of course, receiving a telephone call from the tutor if a volunteer misses a week to keep them involved and engaged and a "check in" telephone call for each learner after the first week to check how they found it and if there is anything else they need to support them. 
  • Top up/Refresher sessions were well attended and beneficial to learners after courses completed.  Learners reported finding it useful having a chance to re-visit topics particularly at times of transition or when issues arose.  Top ups will continue to be a feature of our offer going forward
  • Enhanced confidence in delivery staff when tackling mental health topics, exploring strategies with learners and signposting effectively to other services for mental health
  • Improved Mental Health awareness across entire service.  Resilience techniques embedded into mainstream provision were beneficial to learners not involved in the research.
  • Learners responded positively to the provision and fedback verbally and through case studies how much it helped them to better self manage their feelings and emotions. 
  • Our learner forum, set up in July 2017 helped us to gather objective feedback to inform our future planning of provision at the end of the research phase, by asking learners a series of questions as on the document here   - including continuing to use the mood and wellbeing assessment tools to help measure change and maintaining IAG for each learner before and after the course, both of which learners fed back were helpful to them during the courses.  We will ensure this forum continues to meet termly to provide regular input and feedback on our provision 
  • Improved partnership working with local mental health services
  • The service have committed to continuing to develop the work in this area and enhance provision
  • Partnership working with other providers including attending meetings with North West providers to peer review our Group A offers and Peer observations which provided useful ideas on how to enhance our own offer as well as ensuring the fidelity of group A
  • Weekly webinars with a focus on sharing good practice, discussing emerging themes and issues arising helped us to be agile and responsive 
  • Termly face to face meet ups gave opportunity to network effectively as well completing relevant CPD
  • Exposure to digital technology leading to enhanced digital skills which have benefitted both the project and the service more widely including creating learner videos, using social media to promote and share activities and use of webinar technology to communicate across projects
  • Digital equipment provided for data collection in Phase 2 has also been used widely within the project for classroom activities, learner forums and top ups/refreshers

What didn't go so well and what have we learnt

  • Throughout the life of the project locally we have seen a significant turnover in tutor staff due to reduced budgets and ongoing uncertainty in the sector resulting in the need to train new staff to feel confident to deliver courses on a number of occasions.  With the introduction of increased emphasis on tackling symptoms and developing coping strategies our own tutors have been supported to gradually increase their confidence in this area, although this has taken time to achieve.
  • Changes in the offer to align with Group A took time to communicate effectively to partners resulting in a considerable number of inappropriate referrals at the start of Phase 2.  This gradually reduced as the phase progressed
  • Some learners fed back to us that they experienced issues outside of the class room which impacted on their wellbeing during the course. This included changes in benefits, ongoing domestic violence issues and divorce.  Tutors and support staff were encouraged to explore how to best support issues arising through signposting to partner agencies or introducing topics sensitively in class in response to specific issues.
  • Where courses have maintained an additional learning topic (e.g. art, cooking or digital photography) we have ensured that there is still a clear focus on development of coping strategies for outcomes for the course. However, tutors have found that as learners become more confident in the classroom environment they can have a tendency to steer the session towards the additional topic.  Tutor's have addressed this by embedding mental health outcomes into the topics more effectively.
  • Class sizes have been smaller than hoped due to challenges with recruitment and retention.  It has been evident also that where classes have started with lower numbers they can be prone to further drop out, for example an Improve your Mood through Art course started with 4 learners, but two withdrew after the first week with the remaining learners reluctant to continue.   Conversely where courses have started with larger numbers there has been greater peer support and improved retention.  A Relaxation through Creative Art course, starting with 8 learners retained all 8 throughout the six weeks with most learners continuing to attend subsequent sessions.
  • Delays beyond our control such as Purdah, General Elections and a change in Government Department between years 1 and 2 caused disruption, delays and uncertainty which impacted on our ability to deliver or communicate our offer clearly.

 What are we doing next?

  • We will continue to offer Positive Minds courses on a pilot basis whilst we wait for the published results of the research in order to maintain momentum
  • Continue to use the Discovering Potential IAG model of Thinking, Getting, Keeping on the Positive Minds programme as we have found this supports learners to think about the change they want to make and help us recognise how we can best support them to succeed
  • Continue to upskill tutors to embed resilience and wellbeing strategies into learning both on Positive Minds courses and more widely across our curriculum
  • Train two tutors to be able to deliver Mental Health First Aid and to begin to offer this within our provision
  • Work with neighbouring providers in the local area (Blackpool Adult Learning, Lancashire Adult Learning and Bury Adult Learning) to share best practice and develop complementary offers to meet the needs of our local population including looking at the types of courses we offer, partners we work with and how we engage learners
  • Disseminate the work we have done to date in line with our dissemination plan here
  • Seek opportunities to secure funding where possible to help enhance and develop further learning opportunities for those experiencing mild to moderate mental health conditions working  towards seeking commissioning funding in the future

If you would like any more information on our work to date or future plans please contact our co-ordinator, Chris Truckle on 01254 507725 or via email at chris.truckle@blackburn.gov.uk

 

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