The Life Rooms - social model of health

Background and aims

The life rooms sits within Mersey Care NHS Foundation Trust, a mental health and community trust in Merseyside. Across the Mersey Care footprint, clinical services are under increased pressure and many communities face poor health outcomes. The life rooms social model of health is non-clinical in its aims and approaches, but is positioned to relieve some of the pressure that clinical services face, and work collaboratively to improve health outcomes within communities.

It is widely recognised that social factors such as housing, education, employment and social connection have a significant impact on health and wellbeing. Working within a social model offers opportunities to address such factors and prevents (further) deterioration in health.

Additionally, for those people receiving clinical support, providing access to a social model that focuses on increasing confidence, skills and connection promotes recovery and a life beyond services. The life rooms social model of health aligns with both the prevention and recovery approach; by providing people with support to address social need, as well as opportunities to develop skills and build community and belonging, individuals and communities become healthier and happier.

Healthier and happier communities means improved population health and reduced pressure on clinical services. Further, this approach to health becomes multi-dimensional, with cross-sector working between public, private and voluntary services being necessary to deliver a robust social model. Therefore, integration of a wide range of services is a necessary aim of this model.

Solution

The first life rooms was opened in Walton’s former Carnegie library in May 2016. Two additional sites in Southport and Bootle have since been opened, as well as peripatetic sites across South and Central Liverpool and the development of a comprehensive online offer.

The life rooms social model of health is designed to support the prevention and population health agendas by activation through a three-pillar model; learning, social prescribing and community. The three-pillar model enables people to become more activated in their own health; it operates within a social approach that focuses on prevention and the enabling of community and community assets to encourage system change. Through health activation and system change, population health is improved and pressure on clinical services is reduced.

The three pillar model:

• Learning: Delivering a wide range of evidence-based learning opportunities designed to improve population health. 
• Social Prescribing: Enabling individuals to connect with their wider community through the co-creation of a personalised pathway. 
• Inclusion: Listening to communities to understand need and aspiration. 

The non-clinical approach provides integration of public, private, voluntary and community sector services through the facilitation of existing and developing community-based assets. As such, the end user does not have to navigate the complexities of a fragmented system but rather experiences a seamless pathway of advice, support and care.

Key to this approach is working side by side with users, communities and stakeholders. Working side by side means the life rooms continuously changes according to the needs and experiences of stakeholders; whilst the fundamentals of the model remain static, how this manifests is flexible. This flexibility allows for a truly responsive service with population health at its core.

Outcomes and benefits

A range of approaches have been taken to evidencing the outcomes of the life rooms social model of health. Life rooms overall outcomes for 2021/22 are:

• 11,022 visits to the life room sites since reoperning for face to face learning in October 2021
• 4,820 contacts took place with pathway advisors which led to 8,507 social prescriptions
• 644 zoom sessions delivered to 2,870 members
• 2,210 successful contacts were made within Mersey Care service users by the wellbeing support team.

"We’re pleased to support community based models such as the Life Rooms, as good mental health and wellbeing makes life better. It helps us form positive relationships and build resilience to cope with the ups and downs that come to us all.”

Matthew Ashton, Director of Public Health for Liverpool

Side by side research project

A team of service user researchers have designed and implemented a qualitative study exploring what users of the life rooms consider to be meaningful outcomes. The participants of the project said that from the life rooms they got:

• Personal development: learning about yourself, improving emotional wellbeing and gaining hope for the future
• Environment: access to facilities and welcoming, non-judgemental culture
• Social inclusion: making friends and building networks
• Respite: release of pressure and provide a healthy distraction
• Support: from services and from peers
• “The ripple effect”: outcomes beyond the individual

Demonstrating the life rooms impact on systems

In 2018, a service evaluation followed cohorts of both life rooms and non-Life Rooms users, comparing their secondary mental health care activity (full evaluation report linked to below).

There was evidence to suggest that whilst engagement with secondary care increases whilst using the life rooms, use of secondary care subsequently reduces at a greater rate than for non-life rooms users. This is an interesting finding as it suggests potential evidence for increase in activation levels whilst using the life rooms (people engage with secondary care more) but also a potential reduction in pressure on secondary care after use. This data has undergone secondary analysis by Northumbria University to further understand these findings and to inform future approaches in this area.

Additional information

• Paper published on the value of social prescribing at The Life Rooms for people with mental health needs is available on the BMC website. 
• The research report on exploring the meaning of outcomes for service users can be found on the life rooms website.
• Case studies collected by the innovation agency on the impact of The Life Rooms are available on the Innovation Agency website. 
• The Life Rooms Annual report 2018 including service evaluation findings is available on the life rooms website.
• Early publication about the development of the life rooms approach is available on the Journal of Recovery in Mental Health