How to understand people and places

blog | Words Ella Walding | 22 Jan 2021

Different communities and generations often relate to places differently. Everyone will have their own story to tell, their own sense of the place in which they live. By tapping into stories, understanding local wisdom, and community identity, we can surface shared narratives around challenges, fears, strengths and hopes that can be the basis for change.

When scaling Living Well systems of support for good mental health and wellbeing, it has been critical to develop them in sympathy with the underlying cultures, values and narratives held in local areas. In High Peak in Derbyshire, we are working with people from all parts of the local system, and most importantly, people with mental ill health, to improve wellbeing and transform mental health support.

We gathered local people together to define their shared sense of place and identity. They explored what made High Peak unique, the history, landmarks, community events that capture their collective identity, and the deeply held values and beliefs of the people that live there. A few people in a few hours were able to tell a story of the place in which they lived. They described a community that is home to many identities, where people care for each other and wave hello and smile to those they pass on the street.

It consists of people who feel they should be strong enough to take care of their own problems. People feel left behind and forgotten but are able to stand in solidarity and hold each other’s suffering and distress. High Peak has a beautiful backdrop, and using nature to heal is part of their shared history. Therefore, the mental health support they are co-designing must tackle the stigma associated with asking for help, and will take place in spaces and places that people hold dear, such as by providing therapy whilst out on a walk, or support workers meeting people in local pubs or libraries for example.

People’s difficulties can be exacerbated when they don’t have a sense of place. We discovered that this was particularly true for care leavers who had been in prison. In a project funded by the Oak Foundation which explored the lived experience of these young people, we learnt how care leavers without a safe place to call home are often moved to new areas to serve their sentence, making it hugely difficult to reintegrate. On release, they are often placed in anonymous hostels, located in poorer areas. EU research shows countries that have tackled this issue, such as the Netherlands and Germany work very hard to connect people in prison to the communities that they will join on release so that they have a familiarity with a place and a network of friends within it. Their levels of recidivism are far lower than ours. Our current work with Barrow Cadbury is testing out ways in which we can mirror this in the UK.

A powerful example of how the identity of a place can drive local transformation and strengthen communities is the Fogo Island Inn located on Fogo island, a fishing village, off the North East Coast of Canada. In response to their livelihoods being damaged by corporate fishing, local people collaborated to build an Inn. It was built upon the history of their past, grounded in the land in which they live. All of the furniture had been made on the island, chairs designed based on fishing boats. The juice served in the restaurant is made using local berries.

This has led to the development of a society of master builders, recyclers and innovators. Every object has a story of meaning, including who made it and where the money goes. Profit goes back into the local economy and into an ocean programme. This has led to a successful campaign by Fogo Islanders to replenish the midshore fishery through more sustainable fishing. Collectively they think they are turning money into fish.

The stories that bind and spark solutions

“A story communicates fear, hope, and anxiety, and because we can feel it, we get the moral not just as a concept, but as a teaching of our hearts. That’s the power of story.”Marshal Ganz

Our work starts with, amplifies and sustains the voices of lived experience. To tell new stories, hear new voices, and to see the system from new perspectives, (such as those the system is for), can be an immensely powerful way to both surface problems, and solve them.

In our Living Well work to redesign community-based support for mental health, we recently published anonymised stories of the people who have inspired and guided that work. One of these stories was Peter’s, which shared the story of a family, where each member was being individually supported to overcome the different challenges they faced, but none was addressing the different, yet connected, challenges that they were all facing.

The room is spilling over with the hallmarks of a family with three children. Toys and washing vie for space with art materials and lots of ornamental elephants. Peter tells us how much he struggles to keep the house tidy and functional – small things like the bins not being emptied every week means that mess stays in the house making life more difficult. The garage has been leaking too and valuable belongings in danger of getting wet are now also crowded into the kitchen. For years he has been trying to redecorate.

He tells us, “ten minutes a day is all I can find, if I’m lucky”. His wife Angela has to be accompanied to supermarkets because they cause her high levels of stress, and shopping has to be by taxi because, although they have a car, Peter can’t drive it. His licence expired and it has been so difficult to organise what is needed to renew it, finding his passport for example.

Peter tells us that the Social Services have so many “emergencies,” that appointments are often cancelled. When they do meet he does not feel they are helpful.

“Instead of feeling like they are there to help us it feels more like we are there to tell them things,” he says. Six years ago they told him he had an amount to spend.

“I chose to get a laptop but it was a nightmare: it was ‘wouldn’t you rather have a gym pass?’ I’m not going to get the opportunity to go out to the gym!

“When I got offered it the next year… No! It created so much stress for me, jump through so many hoops and I can’t get the things I need.”

Peter’s story calls us to reflect on the contexts of people’s lives that can cause poor mental health: past trauma resurfacing; a cramped house with no room to do the laundry, let alone sufficient space for two adults and three children, all suffering from mental ill-health; no reasonable income because of the need for the father to provide care for the mother. In summary, a family at breaking point, who could crumble at any moment, because support is inconsequential.

Stories of human experience such as this have led to new thinking about how support can be provided differently to families. For example, the Salford collaborative, a group of mental health system leaders, front line staff and people with lived experience, have explored how to tackle the practical and therapeutic issues families face so that families like Peter’s get tailored support to meet the actual challenges they are facing, rather than a generic service offer.

A similar team in Luton have developed a whole family approach that explores how teams can work fluidly, equally and holistically with the needs of the whole family, rather than providing uncoordinated support to each individual. This has expanded the vision of the work, from not just offering what is necessary to survive, but to providing what is needed to enable families to grow, flourish and live a happy life.

There is another side to this too, which is about how these stories are shared and the way in which they unite people around the reasons why change is so important. Stories are a culture’s coin and currency. They help to spread narrative, discourse and connect us to the everyday experiences of the other, and see the world through new eyes.

So much of the work of place-based transformation is about collaboration and coalition-building across diverse players who are not used to working closely together. One of the most powerful binding factors for these groups can be stories of lived experience that become common currency, and a touchpoint for any conversation about what to do next.

To this day many people still talk about Peter’s story. His experience has united people in moral outrage, towards a change we want to see, as well as helping to craft much better solutions. Stories such as Peter’s have been told within, between and beyond the four sites in which we are working to grow Living Well systems, to serve as a call to arms for a new vision for support for mental health, and a reminder of what it will take to realise it. This is the power of lived experience, to help us connect to the places and people we seek to serve, to challenge existing assumptions, design better futures, and to bind us together during the hard work of bringing them to life.