Summary

This is the third article in our series focusing on the benefits of a whole population approach to mental health. In each piece, we look at one of the four main pillars that come from providing inclusive, accessible, and effective mental health services for an entire population:

• Healthy individuals
• Healthy communities
• Healthy systems
• A healthier whole population

Coordinated action across each pillars is important for a successful whole population approach.

If you’d like to hear about the successes and learnings of real-world whole population approaches first-hand from commissioners who have implemented them, register to receive the full report by clicking here.

The Community Pillar

Focusing on the community pillar, a whole population approach looks at ways to scale the positive impact for individuals across a community. This is achieved by taking local action to improve and prevent poor mental health.

Before detailing our approach further, we must acknowledge the wider context influencing our health. Evidence suggests mental health services make a relatively small difference to people’s overall mental health outcomes when compared to things like income, employment and housing. Some models even suggest that clinical care accounts for 20% of health outcomes while social, economic and physical environment factors together make up 50% of our health and wellbeing.

The World Health Organisation (WHO) provides the below as examples of social determinants of health;

• Income and social protection
• Education
• Unemployment and job insecurity
• Working life conditions
• Food insecurity
• Housing, basic amenities and the environment
• Early childhood development
• Social inclusion and non-discrimination
• Structural conflict
• Access to affordable health services of decent quality.

While Kooth works to improve resilience and provide on-demand support to manage life’s stresses, sustainable nationwide action is needed to address the wider determinants of health. This is essential to make lasting changes in people’s health and overall quality of life.

With that said, our Whole Population Approach supports community mental health through four key enablers - an adaptation of the ADPH “What Good Looks Like For Public Mental”;

Individuals and communities will face challenges that impact their mental health. We aim to strengthen individuals at scale and support their resilience, capabilities and skills to adapt and grow in face of poor mental health episodes. 

Therefore community-wide activity is necessary to improve mental health at all stages of life, especially at pressure or transition points when individuals and families may experience greater difficulties. 

The Importance of Community Mental Wellbeing

Community level approaches to mental health have been shown to positively impact individual wellbeing, reduce health inequalities, and reduce the usage of more expensive clinical care pathways. Building on our four key enablers of community mental health, here are the effective tactics Kooth utilises to support community mental health across the country;

1. Increase Community Mental Health Literacy 

Improving mental health literacy can act as a strong counter to attitudes and beliefs that may deter access to and acceptance of, evidence-based mental health care. Stigma, as well as a lack of understanding of mental health and treatment options, can be important influencers that can leave those with common mental health disorders unable or unwilling to access effective self-help and appropriate support from others in the community.

Projects to improve mental health literacy aim to provide education on mental health and raise awareness of effective treatments through population-level communication channels and campaigns. Public mental health campaigns can be particularly effective,  especially in communities that experience higher levels of stigma or are at heightened risk of developing mental health problems compared with others. Doing this provides opportunities to recognise knowledge gaps, grow individual capabilities and actively support communities in managing their own mental health. 

2. Targeted Support Towards Schools - Whole School Approach

A high proportion of mental health problems emerge in late childhood and early adolescence, but many could be prevented with earlier support. As environments where children spend the majority of their days, schools have an important role to play in supporting them to be resilient and mentally healthy. 

Mental health programmes delivered in schools help protect the mental health of young people as well as create more tolerant and supportive environments that enhance young people’s abilities to learn. Evidence also shows that school-based mental health programmes, together with interventions for parents that consider their role as well as the role of carers, are important as this relationship impacts the educational attainment and experiences of the child.

Teacher wellbeing is also key to creating mentally healthy schools, therefore it is important to provide opportunities and access to resources that help protect and improve the mental health of teachers within the school environment. 

3. Support the Mental Health of the Whole Family 

Family and household circumstances can have a significant impact on young people’s mental health and wellbeing. Poor mental health prevalence rates are highest in children and young people living with parents with poor mental health, yet most mental health services still focus on treating the individual and may not provide proactive support to other family members. 

A whole population approach to mental health supports parents and carers to manage their own mental health, as well as young people to create mentally healthy homes. Approaches that teach coping mechanisms promote self-care and self-management techniques.

4. Targeted Outreach to Under-Represented Communities

Marginalised communities are at comparatively higher risk of poor mental health, and are disproportionately impacted by social determinants associated with poor mental health. Black individuals are over four-times more likely than their white counterparts to be detained under the Mental Health Act. Meanwhile, South Asian communities in England have disproportionately higher rates of psychiatric disorders but are less likely to seek help than others. 

To tackle mental health inequalities like these, a proactive co-production approach to service design and engagement with the communities least likely to access services is key. For Kooth, this looks like;

• Reviewing local priority populations and Kooth uptake data to identify unmet mental health needs across different demographics with an appreciation of differences between marginalised groups 
• Partner with local VCSE, faith groups and community stakeholders tp co-develop specific outreach plans for specific marginalised groups with a focus on understanding and incorporating their lived experiences
• Co-creating culturally aware anti-stigma campaigns, materials and therapeutic content with lived experience participants and experts from the marginalised groups
• Ensuring representation and cultural competency within our mental health workforce so that support provided reflects the cultural influences of the marginalised group
• Evaluating the effectiveness of interventions using both quantitative outcome measures and qualitative experience measures, including feedback from community members.

How Kooth Supports Community Mental Health Across the UK

As a digitally-enabled service provider, we see our role not only as providing greater access to mental health support but also as influencing and sustaining favourable mental health outcomes through maintaining a presence in local communities. Great work is already happening so we support this by increasing access to inclusive, accessible, evidence-based support.

Our approach moves from a deficit model of mental health, which focuses on what is impaired and eradicating the problem, to a strengths-based model where mental health is viewed as a universal asset to be strengthened and protected. Working with local health systems to manage poor mental health is still an important factor, but we also look to community and settings-based outreach and solutions that support communities proactively protecting and managing their own mental health.

Ultimately, our approach eases pressure on local mental health services - a topic we will explore in our next article.

Supporting Mentally Healthy Communities in Practice 

Kooth and Qwell are accessible, inclusive, and effective interventions for children, young people, and adults. Together, they enable commissioners to implement a whole population approach to mental health care in their locality.

We support people to become more engaged with their mental health. We do this through empowerment and encouraging them to build positive ecosystems and support mentally resilient communities. In particular, our services support commissioners to provide instant access to digital mental health support to whole families, communities and schools. In practice, our on-the-ground engagement teams provide support through:

• Daily school assemblies promoting help-seeking behaviours and self-management techniques
• Provide teachers with resources to normalise mental health conversations in schools
• Host regional and national webinars for education, VSCE and healthcare professionals on supporting CYP mental health
• Participate in local CYP mental health boards and network meetings to provide the voice of the young person to service providers.

 Our digital platforms also foster positive virtual ecosystems by;

• Promoting peer support and online community engagement to reduce feelings of isolation and instil hope in recovery
• Pre-moderated discussion boards supporting CYP and adults to speak about issues important to them in a safe and monitored environment
• Clinically moderated user-created stories exploring the experiences of our young people and adults
• Supporting CYP and adults to engage with their mental health in fun and interactive ways through national social media campaigns.

Supporting Mentally Healthy Homes with Kooth and Qwell

We’ve provided children and young people mental health services for more than 20 years, and adult services since 2018. Kooth supports the entire family unit and partners with family-focused services (e.g. Family Hubs) to support a positive mental health environment in the household.

Kooth supports mentally healthy homes through:  

• Sharing therapeutic and educational content on our platforms that encourage positive relationships between caregivers and children, as well as the relationship between caregivers themselves
• Local mental health awareness raising campaigns that aim to challenge stigma surrounding mental health within families 
• Partnering with Family Hubs and community centres for outreach opportunities to parents and carers, supporting them to develop their own positive relationships with mental health services and professionals 
• Therapeutic content collections and activities equip parents and carers with skills to engage and listen to their children’s worries and mental health concerns.

A Whole School Approach to Mental Health 

By offering mental health services for children, young people, and adults, Kooth is well-positioned to support the development and implementation of a comprehensive school approach. This enables us to integrate our services across all aspects of school life, aligning with National Institute for Health and Care Excellence (NICE) guidance.

Kooth supports the wellbeing of students, teachers and other school support staff by:

• Providing instant access to professional support so students, teachers and other staff can protect and improve their own mental health.
• Providing webinars for all teachers to support discussions on mental health issues.
• Providing lesson resources, lesson plans and awareness day materials for teacher-led education.
• Creating meaningful opportunities for students to have a voice and share in the decision-making around their support through goal-based outcomes and feedback channels.
• Reduce stigma and promote help-seeking behaviours by encouraging all students and teachers to engage with anonymous support, and sharing anonymous case studies of those that have achieved their mental health goals through Kooth and Qwell. 

Supporting Under-Represented Communities

Kooth supports under-represented communities by embedding within them and partnering with community leaders and lived experience experts. For example, in North East London, we worked with the Muslim community by partnering with the Muslim Women’s Network and Muslim leaders at the Maryam Centre in the East London Mosque.

We take a data-led approach to identify communities under-served by local services and prioritise outreach to the groups experiencing more barriers to care. We then work in partnership with voluntary, community and social enterprise organisations (such as BlkOut UK - a not-for-profit social enterprise, and media/arts collective, run and owned by a collective of Black bi, gay and/or trans men based in the UK), local faith groups to plan, design, and deliver outreach activities and embed our services within these networks to sustainably meet the needs of under-represented groups.

Case Study:

Boosting Mental Health Support Uptake by 25% Through Local Community Partnerships in Bradford

Summary 

In 2024, in support of the West Yorkshire Integrated Care Board’s mental health priorities, Kooth collaborated with a Bradford community organisation. This partnership aimed to assist parents and carers of children with Special Educational Needs and Disabilities (SEND) and neurodivergence in understanding and accessing our mental health support.

Together, we ran informational sessions in deprived areas developed using learnings from previous work with Family Hubs in the area. The work resulted in a 25% increase in Kooth usage by children and young people. Parents also reported finding significant value in Qwell for their own mental health, and we saw a 13% increase in registrations of adults wishing to use it as a safe space to get support.

Background

The West Yorkshire Integrated Care Board (ICB) covers a population of 2.4 million people in the areas of Bradford District and Craven, Calderdale, Kirklees, Leeds, and Wakefield District. As part of the ICB’s work to improve health and wellbeing, it jointly commissioned both Kooth in 2019 and Qwell in 2020.

In Bradford, an area with high levels of deprivation, parents were sharing concerns about their children’s mental health. At the time, Child and Adolescent Mental Health Service (CAMHS) waiting times were more than two years, and there were very few alternative supports available for those waiting. 

Supporting families with one or more children with Special Educational Needs and Disabilities (SEND) or neurodiversity were priority areas for the ICB, due to increased need and waiting times for this cohort. 

The solution

To ensure high uptake, and therefore maximum benefit, Kooth undertook several projects in partnership with local community organisations. One in particular, Bradford’s Thinking Big, focused on supporting the parents and carers of children with Special Educational Needs and Disabilities (SEND) and neurodivergence to understand the available help and how to access it. 

We had previously worked closely with Family Hubs in the area - including training on spotting the signs and supporting those exhibiting behaviours of self-harm, eating disorders, and neurodiversity - and used the learnings and positive feedback to inform the engagement programme. 

We ran three coffee morning-style sessions in cafés and community centres in the most deprived areas of Bradford, aiming to spread awareness and encourage uptake. Thinking Big already had deep connections with parents of children with SEND through its existing work and used these to encourage attendance through its daily interactions with the local community, and social media outreach.

The impact

Sixty parents attended these sessions and in the month afterwards, there was a 25% increase in usage of Kooth by children and young people in Bradford - the highest usage had been in six months.

Reanna Knights, Friends and Family Coordinator at Thinking Big told us how one of the reasons for this is that, “many parents and carers are experiencing long waiting lists to receive more specialist interventions, assessments and support from CAMHS. Information about Kooth and Qwell was welcomed in Bradford; it was helpful for them to be aware of a service that they can get a response from now. Being able to access resources, counselling and one to one support made them feel they had somewhere to turn in the meantime.”

“Very informative session. Good coping mechanism described when adults or kids are struggling with mental health issues.”
- Parent and Participant in Bradford

As a result of the engagement project, the use of Kooth by young people in the area has increased significantly, and parents have also shared how valuable they find Qwell for themselves. We saw a 13% increase in adult registrations on Qwell in the weeks directly following the sessions with Thinking Big.

Parents have told us how they feel it is a safe place to vent when needed, and get support for their own mental health challenges.

In Bradford, we continue to work closely with Thinking Big and others to reach underserved communities and run monthly drop-in sessions at all four of the Family Hubs so that members of the local community can learn more about the support available from Kooth and Qwell. 

We’re excited to share our learnings on the potential impact of a whole system approach and hope you join us as we explore the four pillars and share examples of success from across the UK. 

We’ll be publishing more about each pillar in the coming weeks, with our next article focusing on pillar 3: How a whole population approach leads to healthier health systems.

In the meantime, if you'd like to learn how other commissioners are pioneering a more joined up approach to mental healthcare provision, we're publishing a full report showcasing their experiences, challenges, and share practical advice in the coming months. Pre-register to secure your free report: 

To get in touch with us directly, contact on of our teams;

London and South Team

Midlands and North Team

Scotland, Wales & Northern Island Team