Teaching offenders to code: supporting digital skills and reducing reoffending among those leaving prison

Breaking the cycle of reoffending by teaching prisoners to code

In the UK, we have one of the highest numbers of adults in prison in western Europe, and of those who have been in prison, almost half will re-offend within a year of release. Reoffending in the UK is estimated to cost as much as £15bn each year. One of the major factors in reducing reoffending is finding and sustaining employment upon leaving prison, however, it has been suggested that the skills and training that offenders receive while in prison only prepares them in a limited way for life “on the outside”.

The importance of digital literacy and the disadvantage caused by a digital skills deficit

Whether it is applying for benefit payments, booking a doctor’s appointment, online shopping, paying council tax or word processing and data navigation in a wide range of today’s job roles, having a basic understanding of digital literacy is important. For many people these skills are acquired over time, sometimes even by accident as we come into contact with more and more digital services in our day to day lives, including in many of today’s jobs where word processing and email skills seem to be a given.

However, for people leaving prison, perhaps who have been away from the fast pace of digital development for a few years, the leaps and bounds in terms of technological change and how we use digital platforms for a range of tasks can be a daunting prospect. While there is some exposure to digital platforms inside prisons, there are increasing calls to ensure that in order to better reintegrate into society on release from prison, digital skills should be higher up the agenda for those prisoners being prepared for release.

Linking digital skill programmes to labour market need

While we raise concerns about digital literacy, it is also widely reported that the UK is facing a digital skills deficit, with job roles going unfilled because there are not enough skilled individuals to fill them. Why not then, supporters argue, align the two policies to meet a need within the skills market and better support offenders to be able to live a full, digitally literate life on their release from prison.

In his Ted talk on teaching coding in prisons, Michael Taylor highlights some of, what he sees as, the key issues with the current skills and training programme in prisons: it is mundane and repetitive, and it is not linked to skills or labour market need. Coding, he argues, in addition to being accessible, cheap to teach and not requiring any pre-requisite qualifications, is an easy way that prisoners can be equipped with high-level digital skills to help them find employment, and teach skills that employers want and need to employ.

He also argues that coding is a way to equip offenders with the basic tools to go into a range of careers or further training across a range of occupations, in a range of sectors doing a wide range of different jobs – giving the variety and scope for development that many offenders simply don’t get from current skills and training programmes. The benefits, he argues, go beyond just teaching the ins and outs of how to code, with digital skills having wider applicability around managing information, communicating, transacting, problem solving and creating as well as raising confidence and self esteem.

Learning from digital skill programmes in prisons elsewhere

The Last Mile programme in California is being used as a model to create a UK based coding programme for prisoners. The programme teaches digital skills, specifically coding, to allow offenders to find employment once they leave prison. The American programme is based out of San Quentin prison and has consistently shown positive outcomes for participants, with a recidivism rate for participants dropping from over 70% to 0 in the latest cohort of “graduates”. These positive and tangible outcomes are one of the reasons supporters have been so keen to roll out a similar scheme in the UK.

The UK Government has acknowledged this evidence and in March 2019 the Department for Digital, Culture, Media and Sport announced it is investing in two pilot schemes, one at HMP Humber and one at HMP Holme House which will see a selection of “carefully vetted prisoners” participate in new digital skills programmes. Prisoners will learn CSS, HTML and JavaScript before moving on to more advanced coding techniques. They will then be invited to work for partner companies, eventually on day release, with a view to better preparing them for work when they are released from prison, while also helping employers manage perceived risks that come with hiring former offenders.

Final thoughts

Offenders leaving prison face a number of barriers to successful reintegration into the community, and preparing them fully to meet all of these challenges can be a difficult task in itself. However, by better equipping offenders with digital skills we will enable them to leave prison with knowledge employers are looking for. Coding programmes could be one route to developing skills for prisoners due for release which can help them adapt to life outside prison, give them purpose and options and, it is hoped, reduce the likelihood of reoffending in the future.


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The unusual suspects: how to make sure Citizens’ Assemblies are representative

Citizens’ Assemblies have been in the news a lot recently. Among the ideas mooted have been a Citizens’ Assembly to sort Brexit, a Citizens’ Assembly to discuss the potential details of Scottish Independence and a Citizens’ Assembly to decide on steps to tackle climate change.

They have been heralded by some as a new democratic process which will put the public at the heart of policy development and decision making at a local and national level; one of a number of “deliberative democratic tools” to help engage people more in decision-making processes, allowing people to decide not only what outcome they want, but which issues should make up the agenda in the first place. However as experiences so far have shown, the theory and the execution do not always match up.

With some arguing that they are just another opportunity for those who already have a voice to make their voice even louder, advocates of Citizens’ Assemblies and similar projects have their work cut out to ensure they are both representative and effective.

What is a Citizens’ Assembly?

The basic principle of Citizens’ Assemblies is this: collect a representative group of people from a particular area, invite them to a discussion, and allow them to identify and discuss potential policy issues and options based on an initial question. They are then invited to come to an agreed consensus which is then reported to politicians/ government.

The members of a Citizens’ Assembly are typically selected at random from the general public – like a jury – and can, in theory, be any size, but the larger they are the more likely they will be to be representative of the electorate. The aim is to secure a group of people who are broadly representative of the electorate across different characteristics such as their gender, ethnicity, social class and the area where they live. Depending on the topic they will be discussing, information about party political affiliation or voting in referendums may also be taken into account.

Citizens’ Assemblies tend to rely on a few key values in order to function effectively, and participants should be made aware of these expectations and values (or any additional objectives) at the outset:

  • Debate should be informed and informative and should allow for discussion and deliberation based on sound argument and evidence;
  • Experts in a particular field and campaigners from all sides and all possible viewpoints should be invited to discuss their arguments with participants and be willing and able to be questioned;
  • Participants should be willing to talk and listen with civility and respect;
  • Participants should be representative of the general population as far as possible and should reflect a range of perspectives.

The sessions of the assemblies themselves vary but will usually include learning and evidence sessions introducing the assembly, the participants and the question to be discussed as well as background and contextual information and additional evidence from invited experts; sessions in which campaigners are able to present their arguments and be questioned; and sessions which focus on deliberation, discussion, consensus building and reporting. Facilitators will often be used to ensure a fair spread of opinions are heard – but facilitators cannot participate in the discussions themselves, and organisers will often pre-plan elements such as seating plans or evidence presented to assembly participants to ensure an even spread of opinions.

The fundamental idea is that if you randomly select a representative group and give them time, information and a safe space to discuss issues, you can create an illustration of what it would be like if everyone had the tools and time to discuss and debate the important issues. There is, however, no legal obligation for Government to take the recommendations forward.

What has happened elsewhere?

In the Republic of Ireland, they have held a number of “democratic experiments” and the Irish examples have been cited as examples of how Citizens’ Assemblies can effect change.

In 2012-13 the Irish Constitutional Convention led to the bringing forward of legislation and the eventual legalisation of gay marriage in the Republic of Ireland, and the 2016-17 Citizens’ Assembly paved the way for the 2018 referendum which legalised abortion. Ireland has been cited as a major inspiration for a Scottish Citizens’ Assembly to be established, something Nicola Sturgeon expressed support for in her speech at the 2019 SNP conference.

Ireland is, supporters of the concept argue, an example of how Citizens’ Assemblies can be effective at helping to reach consensus on contentious issues and allowing people to have a meaningful say in what legislation is put forward to parliament, not just having the choice of policies that are prescribed to them by politicians. Critics have argued however that the Irish experience has, to a degree, been oversold in Britain and shows how “the symbolic value of the ordinary citizen can be exploited for political purposes”.

And, for all the perceived successes of the Irish experience, the somewhat contrasting experience of Iceland also has some potentially useful lessons for anyone looking to implement Citizens’ Assemblies at a national level. The experience there shows that it doesn’t always go to plan. Citizens were invited to input into the new values of Iceland’s constitution following the 2008 economic crash. Consultations took place across the country and a series of recommendations were presented but these were not taken forward by parliament.

Other models of Citizens’ Assembly have been trialled in Belgium, the Netherlands and in Canada. The Canadian model invited public input into electoral reform proposals in British Columbia and Ontario, while the G1000s organised in Belgium saw 1000 participants randomly selected to deliberate for one day on major policy issues. Success in Belgium inspired the Netherlands to run a similar scheme.

How can we ensure everyone feels able to participate?

Deliberative models, like Citizens’ Assemblies, aim to encourage consensus building and finding common ground. They also aim to take opinions and make decisions based on a diverse spread of participants, however identifying and encouraging those on the fringes of democratic processes to participate can be a challenge. But it is a challenge that Citizens’ Assemblies and other local community engagement models need to address.

Research conducted around improving local community empowerment initiatives highlights a number of relevant questions and opportunities to improve engagement in deliberative democratic processes such as Citizens’ Assemblies.

  • Is it appropriate to pay participants to attend?
  • Should organisers actively invite participants from certain underrepresented groups or highlight to people that they are part of an underrepresented group to encourage participation (minimising self-selection bias)?
  • Will holding meetings at evenings or weekends enable or disable certain groups from attending and what impact might this have on the make-up of the assembly?
  • Have organisers considered holding meetings in facilities that are accessible via public transport?
  • Have organisers considered holding meetings in facilities which are accessible to disabled people and people with children (perhaps with creche facilities)?
  • Have organisers ensured that the information presented is robust but varied, so that everyone feels their views are represented in some way by the evidence?
  • Have organisers considered additional support for participants? (Organisers should provide effective and complete support throughout the process, making no assumptions on previous knowledge or understanding of how participation in activities like Citizens’ Assemblies work and understanding potential anxieties around participation, particularly of first-time participants).

Final thoughts

Citizens’ Assemblies and other similar mechanisms like Citizens Juries have the potential to revolutionise the democratic process in the UK. Although not intended to be a replacement of the traditional mechanisms of government, if done well, engaging citizens more meaningfully in not only the decision making process but in setting the options under discussion in the first place could transform how policy is made and how politicians interact with their public.

The emphasis on weighing available evidence and consensus building is also valuable, particularly in instances where politicians are unable to come together over contentious issues. However, to be truly transformational, the assemblies must have a level of self-awareness which recognises the difficulties some groups may have in participating in the process.

Finding ways of tackling this, and engaging the “unusual suspects”, giving them a voice and showing them that their opinion can have a direct impact on the choices taken by politicians could potentially repair some of the damage which appears to have been done to the relationship between those who govern and those who are governed, but it is clear we have a long way to go yet.


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Helping people to reconnect: positive projects for people with dementia

This Photo is licensed under CC BY Via Microsoft Word images

Every three minutes, someone in the UK develops dementia. Over 850,00 people in the UK are currently living with a form of the disease; 40,000 of these are people under the age of 65.  This week (20th– 26th May) is Dementia Action Week 2019. This year the focus is on encouraging people to talk about dementia, and to talk to people with dementia in order to help tackle loneliness and isolation among those who suffer from the condition, as well as to raise awareness and improve understanding around the condition and the impact it can have.

The power of music

You may have recently come across the BBC programme featuring Line of Duty’s Vicky McClure Our Dementia Choir (if you haven’t you should try and find a copy).  The documentary follows a group of people who suffer from varying degrees and types of dementia and highlights in sometimes painfully sad detail the changes and challenges that can occur when someone develops the disease. However, it also shows the great joy and relief that music brings to dementia sufferers and their families. We blogged a few years ago about the benefits of music therapy in dementia care – and since then the literature and research on its usage in different settings has only grown.

Research shows that music, in various forms can help encourage participation and trigger positive associations which can be really helpful for people suffering from dementia, particularly if they feel like a lot of other things may have changed. In our previous blog we highlighted a Care Inspectorate backed scheme called ‘playlist for life’ which encourages care homes to integrate music into their care for patients with dementia. Moving beyond just allocating a time to place headphones onto a patient and leaving them to listen alone (although at times this may be helpful too), the aim is for music to be a vehicle for connected care. It allows carers to use music as a tool to find out more about the person they are caring for and encourage them to engage through the music.

Tackling isolation with art, culture and the natural environment

Research has shown that it is not only music that can have a positive impact on quality of life for people with dementia. Painting and drawing, making use of the natural surroundings by encouraging gardening or light walking in safe spaces, and games like dominoes and draughts can all help in their own way to improve the quality of life for people living with dementia and provide an opportunity for loved ones to re-connect.

In a 2014 study researchers examined the experiences of people with dementia and their carers when they participated in an 8 week programme based in an art gallery designed specifically to tackle social isolation and improve quality of life for both the person suffering from dementia and their carer. The study found that while the impact in terms of qualitative measures was negligible, participants were unanimous in their enjoyment and satisfaction with the programme. They highlighted that the interventions at the galleries helped to foster social inclusion and social engagement, enhance the caring relationship between the carers and people with dementia, and stimulate cognitive processes of attention and concentration. In a similar study, looking at the impact of art and gallery settings and programmes delivered within these settings, similarly positive emotional effects on study participants were found.

In Liverpool, they are making the most of their city landscape and the fact that specific locations, building and objects around the city can act as positive triggers for people who suffer from dementia, stimulating memory and interest. Those individuals who are mobile enough can participate in “memory walks” (different from the Memory Walks convened by the Alzheimer’s Society, which are sponsored walks designed to help raise money and offer a public show of support for people with the illness). This not only helps to improve physical activity, it can also be an opportunity for people with dementia to connect with other people as the walks are usually carried out in small groups, they are also linked to befriending schemes across the city to help reduce social isolation among multiple groups.

Similarly, many care homes now also promote interaction with nature and outside spaces for residents with dementia, with many developing specifically landscaped “sensory” gardens for residents, while other innovative supported living accommodation projects have gone a step further and created entire villages on site, which allows residents to perform tasks such as shopping or visiting a hairdresser. (This project is based in the Netherlands, but there are suggestions that a similar scheme could also come to the UK in 2020.)

VR and creating virtual experiences for people

Using digital technologies has also become increasingly popular, particularly in care homes. Apps and VR headsets which allow people to be immersed in an experience they perhaps once enjoyed, such as flying (if for example they had previously been a pilot or air crew) or driving have been shown to have a significant positive impact on people’s wellbeing allowing them to reconnect with their past and memories and freeing them from the sense of being trapped and losing their independence which can sometimes come with moving away from home into supported accommodation.

Tablet computers and touchscreen technology can also sometimes be easier for people with dementia to use as they do not require the same level of dexterity as writing. Apps have been developed which can help with word association or use pictures which can be helpful in allowing people with dementia to communicate when their use of language becomes more of a challenge. While the technology its self is relatively new, research has shown definite scope and benefit of further development of this in the future, as well as relevant training for staff and carers on digital literacy to help support users.

A support to clinical interventions

Dementia is a cruel illness – 1 in 3 of us in the UK will develop a form of the condition at some point in our lives. As yet there is no cure and as the population ages, and life expectancy improves more generally, the number of cases is expected to rise dramatically in the coming years. However, where science is trying to cure, art and culture is trying to supplement and support the clinical interventions and, where possible, provide opportunities to improve the quality of life for people suffering with the condition and provide opportunities for people to re-connect with loved ones.

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Museums as facilitators of health and wellbeing in communities

GNM Hancock, Newcastle

Great North Museum Hanckock, Copyright Rebecca Jackson

It’s estimated that there are over 2500 museums in the UK, ranging from world-famous collections in major cities to small local ones on niche themes. Over 50% of adults have visited a museum or gallery in the last year and there were an estimated 7.5 million visits by children and young people under the age of 18 to the major museums in England.

As well as their educational and leisure value, and their role as drivers of the tourism economy, there is a growing body of research which is considering the wider societal role of museums and in particular, their potential positive impact on health and wellbeing.

Museums and the rise of social prescribing

Within health and social care, we have seen increasing recognition and interest in the role of psycho-social and socio-economic determinants on health and wellbeing. Treatments now often look at the whole person and their lifestyle, not just at the specific medical condition to be treated. This awareness of the impact of lifestyle has led us to view spaces like museums and theatres in a new way and consider how they can be used as a tool to help people to live well.

March 14th was social prescribing day in the UK. And Museums on Prescription is one of a number of culture-led projects which encourage people to use assets in their local communities such as museums, galleries and theatres to help manage conditions linked to depression and social isolation, in combination with traditional clinical medicine.

Arts-for-health settings can have an impact across a number of different areas, including supporting children who have been exposed to trauma and abuse, helping communities integrate and improve social cohesion through the co-production of exhibitions, and helping support people with mental or cognitive illnesses, as well as those who suffer from dementia and Alzheimer’s.

V&A Dundee

V&A Dundee, Copyright Rebecca Jackson

Helping people feel better

As the number of projects increase so does the evidence of positive benefits. There is a growing body of literature highlighting examples of how cultural experiences are supporting both physical and mental health.

A report from Art Fund looking at the calming impact of museums and galleries found that 63% of people surveyed have (at some point) used a visit to a museum or gallery to ‘de-stress’, however, only 6% visit a museum or gallery regularly (at least once a month). Over two thirds of survey respondents (67%) agreed that taking time out for ourselves and choosing to pursue a leisure activity is good for our personal wellbeing and this is where museums and galleries, along with a whole host of other providers like theatres, music venues, public gardens and parks can step in.

Funding is a challenge

A report (2018) from the English Civic Museums Network highlights that services often deemed  “non-essential” (like museums and libraries) actually encourage and foster personal and communal resilience: they stop the crime, the illness, the loneliness from happening in the first place.

However, despite the significant and positive preventative role that participation in cultural activities can play, over the past five years spending on culture in England and Wales has fallen by over 30%, and this has had an impact on museums and the services they can provide.

Natural History Museum, London

Natural History Museum, London, Copyright Rebecca Jackson

Galleries and museums must keep striving to do more

The growing realisation of the potential of museums and galleries to have a positive impact on the health and wellbeing of communities presents a significant opportunity for them to develop programmes and exhibitions which reflect the diversity of experiences within communities and look to develop new ways to engage new audiences. Ensuring that people feel represented and that exhibitions appeal to a broad base of the community is also important in making sure people feel they are able to visit exhibitions and can feel the benefits of doing so.

In their 2015 report, the National Alliance for Museums, Health and Wellbeing, led by UCL, outlined the priorities of the alliance and showcased some examples of the work being done by partner organisations. In February 2019 it was announced that some schools in London are planning to give pupils “theatre vouchers” which entitles them to one free theatre visit per year. Museums themselves are also trying to do more to help engage members of the community and encourage them to engage with new exhibitions.

Are healthy people more culturally active, or does being culturally active make people healthier?

Museums and galleries have the potential to make an enormous contribution to improving people’s lives and enhancing physical health and mental wellbeing. The body of research around the role cultural activities like attending museums can have on health and wellbeing is growing, but there is still scope to do more, and work is ongoing with a number of high profile museums across the UK to promote the link between cultural activities and health and wellbeing.

The question of which comes first – being well initially which allows you be more culturally active, or cultural activities facilitating wellbeing in their own right – will be discussed and disputed by academics and clinicians. But the existing studies highlight the significant positive impact that engaging with museums and exhibitions has had on study participants, particularly those who suffer from mental ill health or degenerative cognitive diseases like dementia.

Museums and galleries, it is clear, have a far greater communal role to play and can evidence their value far beyond being a source of knowledge transfer or a leisure activity. Museum curators and funders need to recognise this as they prepare and plan for exhibitions and outreach projects in the future and clinicians need to be aware of the potential positive impacts for patients when considering care and treatment plans.


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Treating violence as a disease: can a public health approach succeed?

Knife crime, especially deaths of young people, has been making the headlines in recent weeks. And an approach which has a proven track record in Glasgow is now being adopted by the GLA, MOPAC and the Met police to try to tackle the growing levels of violence being seen on London’s streets. Learning from the experience in Glasgow, the police and other agencies are being encouraged to see violence as a public health issue, related to poverty, wellbeing and social deprivation and which, if identified and tackled early, can be prevented.

Contagion: a new way to think about violence

The Violence Reduction Unit was pioneered by Strathclyde Police (now part of Police Scotland), working with health and social care practitioners. Launched in 2005, the approach aims to make earlier identifications of those at risk of becoming involved in violence, and to take a more holistic view of the reasons for violence of all types. The long-term strategy looked at more social and wellbeing interventions to tackle gang violence in Glasgow, which at the time was among the worst in Europe.

The VRU in Glasgow took its inspiration from a scheme in Chicago, which sought to use a World Health Organisation (WHO) approach to tackling the spread of disease but applied it to communities in the hope of curbing the significant rise in homicides in the city. The approach was three-pronged: interrupt transmission, prevent future spread, and change group norms.

In addition to changing the approach to tackling violent crime, the VRU also used a multi-agency approach, involving social services, health care, housing and employment support, to give people a route out of violence and opportunities to find work or training opportunities. One of the key elements to ensuring the VRU is successful are the relationships these people build with individuals in communities.

Identifying young people at risk

Another important aspect of the VRU strategy is to intervene early to identify children and young people who are at risk of joining gangs or becoming involved in gang violence. Research supporting the creation of the VRU suggested that violence (like a cold) is spread from person to person within a community, that violence typically leads to more violence, and that one of the key identifying factors in someone becoming a perpetrator of violent crime is first being the victim of violent crime themselves.

In order to prevent this, staff from the VRU regularly go into schools and are in touch with youth organisations. They also provide key liaison individuals called “navigators” and provide additional training to people in the community, such as dentists, vets and hairdressers to help them spot and report signs of abuse or violence.

There is also a broad view of what a culture of violence is. Work in schools focuses strongly on contemporary issues such as sexting, bullying and gender-based violence. It challenges the attitudes and beliefs that underpin such violence, and encourages young people to recognise and reject these.

A new approach to drug abuse too …?

In November 2018, the Scottish Government launched its new drug and alcohol strategy. One of the notable additions to the strategy was the acknowledgement that (like violence) drug abuse and addiction should be seen, not as a crime, but as a public health issue – an illness which people need support and treatment for.

Looking at how drug abuse is tackled within the criminal justice system and the interactions of addicts, policymakers have identified that many have had adverse childhood experiences, are exposed to drugs and/or alcohol at a young age, and are also at significant risk of being unemployed and homeless.

Creating a holistic package of support which seeks to identify those at risk and directs them towards a range of services to tackle not just the addiction but other trauma or socioeconomic barriers earlier, will, in a similar way to the VRU, give people a sense of purpose and value, and help them to see an alternate route that will allow them to contribute positively to society and improve their own outcomes.

A new way to tackle social issues in the UK?

Tackling the spread of violence through communities is not an easy task, nor is breaking the cycle of crime that many find themselves trapped within, often as a result of family allegiances or geographic location. It is often the case that either you participate, or you become the next victim yourself. More and more young people are feeling the need to carry knives for protection, due to the high levels of fear of becoming a victim.

Identifying those young people who are at risk of turning towards a life of violence at the earliest possible stage is difficult, but has been shown to be effective in helping to tackle violent gang-related crime. Although it is not the only tactic available to police, used effectively in conjunction with other outreach programmes it can be an effective tool in preventative policing, helping to keep communities safe.

The outcome in Glasgow has been largely positive, following the roll out of the Violence Reduction Unit programme. Whether this approach has the same success in London, operating on a larger scale, with different economic and social variables, and in a very different budget climate, remains to be seen. In particular it is worth noting that the Glasgow approach recognised there were no quick fixes, and was based on long-term planning covering ten year periods.

It is to be hoped, though, that changing the way we think about violence within communities may offer a route to tackling it.


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How empowering the community can help us create better places to live

Places can be defined in a lot of different ways: the geographic location, the physical buildings, the people who live there and the relationships that are formed. Central to places should be the people who live and interact there. Putting people, and communities at the heart of placemaking can benefit the physical infrastructure of a place, by identifying what is needed. And allowing residents a say in their local area can also give communities a sense of empowerment and ownership of their place, somewhere they can be proud to call home and somewhere they feel safe, included and valued.

Can places empower people?

In short… YES! Positive places have the power to lift the community up, give them a sense of empowerment, worth and inspiration. But places also have the power to alienate and dis-empower.

Places which are run down, with no or low levels of community engagement can contribute to communities becoming disparate, isolated and can reinforce negative stereotypes, particularly those which relate to poverty, deprivation and social exclusion. Making places that are thriving hubs for communities to be built upon can have a significant impact on the experiences and quality of life for communities living within them. Work being done by organisations like SURF show how important effective regeneration projects can be in revitalising places and the people who live there.

A recent RTPI blog post emphasised the importance of place on helping to reduce the impact of poverty and break some of the more significant socioeconomic barriers marginalised groups within communities can face. It emphasises the importance of place-based urban policy and how core policy features like the planning of a space or the design of a building can actually have a significant impact on the people who interact with that space.

A national standard for community empowerment

As important as the physical space are the people who live and work within it.

In the policy context of the Community Empowerment (Scotland) Act 2015, What Works Scotland, along with others drafted a set of ‘fit for purpose’ national standards for community empowerment, to build on those published in 2005. It was hoped that the new standards would provide clarity and focus on ways to help strengthen and improve participation and engagement at a local level. There are seven standards: Inclusion; Support; Planning; Working Together; Methods; Communication; and Impact.

Identifying and making the most of community assets

Asset based development was originally created as a description of how local residents grow collective efficacy and what they use to do so. It involves paying attention to what is in a local place – not what we think should be there, or what is not there. These ‘assets’ are found within a community and can be physical, such as infrastructure, but can also be the skills and knowledge of local people.

The key concept centres on the fact that everyone has something positive that they can contribute to a community. It follows that, if everyone does or is given the opportunity to contribute positively to their community, then there will be less requirement for spending on services from local government. It can also mean greater accountability at a community level for making changes that actually impact positively and directly on the lives and experiences of people who live and work there. Taking time to identify these assets and feeding this into how places are created can be a key part of ensuring communities feel empowered and valued.

Community anchors are an important tool

Community anchors have been identified as vital in many instances to ensure the continued development and capacity building of communities within a place. Their roles can extend across the community from building capacity and resilience, to supporting local democracy and helping to drive social change within a community. Community anchors play an important role in empowering communities and getting them involved in the design and delivery of services in their area.

A report published by What Works Scotland in 2018 examines the developing roles of community anchors within communities. The report explores the developing discussions between the community sector, public services and policymakers and considers how they might work more closely together to deliver bespoke and localised community driven policies.

Summing up

Empowering communities to feel valued and engaged is a key part of developing places that are inclusive and enjoyable places for people to live. Promoting communities as key agents of change within the areas in which they live not only improves the community, but can also help on an individual level, fostering a sense of pride and value. Creating better places is a key strand to regeneration and planning policy. Putting communities at the heart of creating places will ensure that places not only meet the needs of local people but are inherently connected to them.


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“For many children we are the first point of contact”: supporting children’s mental health in schools

A 2018 evidence review from Public Health England reported that one in 10 young people have some form of diagnosable mental health condition. This, the report suggests, equates to as many as 850,000 children and young people with a diagnosable mental health disorder in the UK. It also reported that half of all mental health problems emerge before the age of 14, and children with persistent mental health problems face unequal chances in life.

Research has also highlighted the impact of “key factors” like poverty and adverse childhood experiences (ACEs), including emotional trauma, abuse or neglect (which people living in higher areas of deprivation are more likely to experience) on an individual’s chance of developing a mental illness. However, an additional factor often cited in surveys around child mental health and wellbeing is the impact of school, including exam stress, and bullying. Mental ill health has also been found to have an impact on attainment, behaviour and a child’s ability to learn. As a result, teachers are often part of the front line of supporting adults for children who are suffering from mental ill health, with increasing pressure being placed on teachers and schools to identify and signpost children to other services.

Schools, as well as teachers,  are increasingly becoming a focus for the delivery of Child and Adolescent Mental Health Services (CAMHS) in their community. Often schools are at the centre of their local community, so it is logistically convenient to coordinate services there; it can for some be a less intimidating or stigmatising environment than attending a clinic at a GP surgery, for example. School is the primary developmental space that children encounter after their family, and children’s learning and development and their mental health are often interrelated, so it makes sense for teachers to take an interest in terms of attainment and progress in learning. In December 2017, the Department of Health and Department for Education (DfE) published the Green Paper Transforming children and young people’s mental health provision which highlighted the role of schools as key in promoting a positive message about mental health and wellbeing among school age children and young people.

Good work is already being done, but how can we do more?

Research has shown that there is already a lot of good and effective practice being done in schools around children’s mental health. Many schools already work in partnership with local health teams to provide in house CAMHS support in the form of mental health nurses and social workers who are posted on site for children to access. One of the major recommendations in a 2018 Audit Scotland report on child mental health in Scotland was to encourage more of this type of partnership working. The report stressed the importance of joint working between public services if child mental health is to be improved, and where possible to include as wide a spectrum of public services in the delivery of CAMHS support, including criminal justice and housing practitioners, as well as health and social care and education staff.

In some schools senior pupils and designated members of staff are being offered mental health first aid training, and wear lanyards to help students identify them should they ever need to talk to someone. While it is important – particularly for students who participate in mental health first aid programmes – to be made aware of the challenges the role may entail, it can be a rewarding experience for young people to participate in and can also be a vital in-road to support for some students who would otherwise feel uncomfortable talking to a member of staff.

Other programmes like those developed by the Anna Freud National Centre for Children and Families, Centre for Mental Health and the ICE PACK and Kitbag tools (which have been used widely in UK schools) look at resilience building  and promoting coping mechanisms among young people, as well as encouraging the creation of trusting relationships which focus on nurturing and normalising mental illness to encourage children and young people to feel comfortable discussing their feelings and thoughts. These programmes also integrate early intervention and prevention approaches, hoping to identify children and young people who are suffering from mental illness as early as possible and signpost them to appropriate support.

The specific role of teachers

Teachers need to remember that they are not health or social care professionals and that – as much as they would like to completely solve all of the problems of their students – they can only do what they can, and that is enough.

It is also very important for teachers to practise what they preach in as much as teacher self-care is as important as signposting children and young people who are struggling with mental health issues. A 2016 survey by the National Union of Teachers (NUT) found almost half of teachers had sought help from their doctor for stress-related condition. Teacher stress and burnout and those leaving the profession due to conditions like stress do not help to create an environment that is supportive of good mental health in the classroom. Teacher wellbeing is so important and building their own resilience is one way that teachers can start to embed good mental health in their practice. If you are doing it yourself it will be easier to help and show children how to do it if they come to you for advice!

Teachers simply being there and offering a safe space and first point of contact for many children is important. Listening and signposting can be so valuable for those pupils taking the first step and teachers should not be put off by any personal perception of a lack of expertise in mental health – a small amount of knowledge or understanding of what to do next is more than enough. In some respects, teachers should feel almost privileged that a student has chosen to come to them, someone they feel they can trust and talk to.

A poll conducted as part of a webinar held for educational practitioners found that rather than requiring more information about mental illness, what teachers actually wanted was more practical examples of how to apply support in the classroom and how to embed mental health into their teaching and the learning of their students.

A unique opportunity

Schools and teachers are on the front line of public services and have a unique opportunity through regular contact with children to help to build and promote resilience among pupils, and embedding this within the whole school can be an effective way of ensuring pupils feel the benefit without being singled out. Taking nurturing approaches to learning and teaching, and promoting the creation of trusting relationships is key to some of the already effective practice going on in schools. Sharing the learning and best practice that is already happening will be vital to ensuring that support for children suffering from mental ill health improves and adapts to changing needs in the future.


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The Changing Room Initiative: tackling the stigma of poor mental health in men through sport

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The Changing Room Initiative: tackling the stigma of poor mental health in men through sport

It’s shocking that 12.5% of men in the UK are suffering from one of the common mental health disorders (estimated by The Men’s Health Forum). And men are as much as two and a half times more likely than women to die by suicide each year, with one of the most at-risk groups being men in their 40s to early 50s.

Other key statistics which show the scale of the problem include:

  • three in four deaths by suicide are by men
  • the highest suicide rate in England is among men aged 45 to 49
  • men living in the most deprived areas are ten times more at risk of suicide than those living in the most affluent areas.

Despite this, men are significantly less likely to access mental health services than women. The Mental Health Foundation found that 28% of men had not sought medical help for the last mental health problem they experienced, and 35% of men had waited over two years or have never disclosed a mental health problem to a friend or family member. Another survey, from the Men’s Health Forum, found a majority of men would take time off work to seek medical help for physical symptoms, but less than one in five said they would do the same for anxiety (19%) or feeling low (15%).

It’s clear, then, that there are strong cultural barriers facing men in relation to mental health diagnosis. Perceived stigma and ideas of masculinity can cause them to avoid seeking help or fail to acknowledge mental health issues.

Changing attitudes in changing rooms

We’ve written previously about the success of Men’s Shed projects in providing a safe, social space for men’s mental health issues to be addressed. We were interested, therefore, to hear about another scheme which is also using a community-based approach to explore men’s health.

The Changing Room Initiative is a two year pilot project which sees the Scottish Professional Football League (SPFL) Trust and Hibernian (Hibs) football club working in partnership with the Scottish Association for Mental Health (SAMH) to engage men in their community around issues of mental health and wellbeing. The project uses football and sport as a tool to encourage men to discuss their mental health and wellbeing and to help direct them to additional support and services within their community.

The initiative is part of a wider program from SAMH which is using sport to improve equality and reduce stigma around mental health. In February 2018, SAMH launched Scotland’s mental health charter for physical activity and sport. Signatories of the charter include Sport Scotland, SPFL Trust, Jog Scotland and Glasgow Life.

In October 2018, following the success of the initial pilot scheme, SAMH announced a second changing room initiative was due to be rolled out at another Edinburgh football club, Heart of Midlothian FC (Hearts).

Using sport to engage and improve mental health

There is a lot of research available which highlights the links between positive mental health and physical activity. Even low-level physical activity has been found to have a positive impact on our mood and general wellbeing. Activities like walking, cycling or gardening have been shown to reduce stress improve self-esteem and have a significant positive impact on depression and anxiety. However, research has also shown that people with mental health issues are also more likely to have poor physical health, and often face additional barriers to participating in sport and becoming active.

The Get Set to Go programme was launched with the support of Sport England and the National Lottery in July 2015 to help people with mental health problems benefit from being physically active. An evaluation of the project published in 2017 showed that physical activity has an important role to play in building resilience, enabling and supporting mental health recovery and tackling stigma and discrimination.

New support networks

There is a continuing push among healthcare and third sector professionals to stress that mental health is just as important as physical health. However, funding for mental health is comparatively low and research shows people are far more willing to acknowledge or accept help for physical illness.

With the roll-out of projects like the Changing Room Initiative to promote mental health in familiar environments, it’s hoped that those struggling with poor mental health will receive the support and treatment they need.


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Tackling health inequalities: what does the data tell us and how can it help?

Health inequalities in Scotland are significant. Every year we hear about how Scotland has some of the biggest gaps in the health and wellbeing of the poorest and richest in society. In some cases, Scotland has the largest gaps in equality in the whole of Europe. And in many instances, they are rising. Scotland also has the lowest life expectancy of all UK countries.

A number of studies and research projects have been commissioned to try to identify the key indicators and factors that are creating and reinforcing these inequalities, and what sorts of interventions would work best to try and reduce or eradicate them altogether. It is hoped that by conducting research, and compiling data, policymakers can use this to identify groups and geographic areas where health inequalities are significant, and to intervene to reduce them, with data to help back up and evaluate the effectiveness of these interventions. In Scotland, work is being done by a number of organisations including the Scottish Government, Glasgow Centre for Population Health (GCPH) and Public Health Innovation Network Scotland (PHINS).

What indicators and factors are being measured?

Income inequality has a related impact on health inequalities, and the scale of low pay is significant. The relationship between health inequalities, poverty and household income is one which has been explored at length and is often highlighted as one of the main factors which influences health inequalities. Studies which look at income, and also at relative levels of deprivation can provide useful comparison points, with comparable datasets on employment status and income readily available at a national and local level. Data also considers trends over time, comparing pre- and post-economic crash data, as well as relative earnings and expenditure relative to inflation and the rising cost of living. Other factors include age (those under 25 and earning a lower minimum wage for example) and by gender, with more women in lower paid, lower skilled and part time or insecure work.

How usable is the research being created?

The research which examines health inequalities explores a whole range of interrelated factors, and highlights just how complex the landscape of inequalities is. Creating a clear and holistic picture of all of the factors which contribute to health inequalities is not easy. Many studies, while detailed and effective, are niche, and focus on a very limited number of factors across a limited demographic source. As a result, questions have been raised about the utility of this research and its applicability and scalability at a national level. In an attempt to tackle this, combined data sets are being produced which provide opportunities for comparison across data from a range of studies.

The “Triple I” tool from NHS Health Scotland is designed to help policy designers to create effective interventions to reduce health inequalities. A second edition of the tool is due to be released in 2018/19. Triple I aims to provide national and local decision makers with practical tools and interpreted research findings about investing in interventions to reduce health inequalities in Scotland. It does this by modelling the potential impact of different interventions and policies on overall population health and health inequalities.

 

What can be done to act on the data?

While the research being produced is high quality, and thorough in relation to findings, the real question is what can actually be done with the research, and what steps can policymakers and practitioners take to use the findings to inform their own practice.

There are, researchers suggest, significant opportunities presented by the recent research which has been done on income inequality. In particular, they cite the public sector and public sector pay as a key way to reduce the income, and therefore the inequality gap, particularly among higher earners and those who would be considered “working poor” or “just about managing”. In Scotland, significantly more people are employed in the public sector than in any other part of the UK, and there is, researchers suggest, an opportunity to better align and increase low wages to help to reduce the gap.

The adoption of new initiatives, such as the “housing first model”, which is due to be rolled out in Glasgow to help homeless people break the cycle of homelessness, are also opportunities not only to address inequalities, but to ensure that long term help and support is in place to prevent any relapse into chaotic or risky behaviour. In relation to housing first, the savings on front line services such as emergency admissions to hospital, or contact with the police after committing a crime are significant, and while more in depth research is needed to create a full cost benefit analysis model of the scheme and its effectiveness, early studies show that the impact on health and wellbeing on those who had previously been homeless is huge in terms of reducing inequalities and improving wellbeing. However further data on homelessness in Scotland shows how far we have to go, and that housing first is only one mechanism which can be used to begin this process of reducing inequalities among the most and least deprived communities in Scotland.

Alternatively, some have suggested a more radical overhaul of how we distribute welfare and wealth within the country. Research has been coming thick and fast on the subject of a “citizens basic income”, particularly following the trial which was rolled out in Finland (the findings of which have not yet been published). Research on how this could impact on inequalities is not widespread yet, as pilots have been small scale, However, it is suggested that a total overhaul of welfare, replacing it instead with a citizen’s basic income would be a more effective way to reduce inequalities across the board, including in health.

Summing up

Health inequalities are significant in Scotland. Much of the research focuses on the impact of deprivation, poverty and low income on health inequalities and how, in order to tackle health inequalities in Scotland we must also tackle some of the other significant social problems within our communities, including low income and insecure work, and the impact of homelessness or chaotic lifestyles on health.

Data can be used in a number of ways to help inform policy decisions, some more radical than others. But creating a complete understanding of inequality in Scotland is challenging. It is up to researchers and policymakers to work together to create a better understanding of the conditions and factors which contribute to inequality, and what can be done to help tackle systemic and entrenched inequalities in our communities through policy levers and evidence based policy making.

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Creating caring places: placemaking in our town centres

What do caring places look like? How can planners, developers and project organisers contribute to the discourse around creating caring places? And what responsibility do they have to communities to help develop places that put people at their heart?

They are just some of the questions being increasingly raised by organisations in Scotland, trying to identify if there is a new way to focus on place and wellbeing in Scotland’s towns. Projects such as Carnegie Trust’s Kindness, Scottish Towns partnerships’ Town Centres First, or Architecture and Design Scotland’s Creating Caring Places are all exploring the importance of the quality of a place to the wellbeing of people who live there. But what does this mean for people who actually plan these areas, and what could they consider in the future to help develop more caring places?

The 3 P’s: place, people, practice

Many of the discussions around creating places which foster wellbeing and wellness centre around 3 key concepts:

Place: Understanding place and the impact that it has on wellbeing is a significant part of this agenda. The environment in which people live day-to-day has a significant impact on individuals and can be both a positive or negative influence. It can help to facilitate positive community interaction, creating stronger community ties and helping organisations and people to feel more valued within their community.

In order for places to be caring a number of factors have been identified, and these are common across research done by a number of organisations including Architecture and Design Scotland and the Carnegie Trust. These include: a sense of support (from people); a sense of purpose (stuff to do); a sense of place (familiar surroundings); and a sense of worth (feeling wanted).

People: Loneliness or social isolation has the same impact on health and mortality as smoking 15 cigarettes a day. Traditionally, it has often been assumed that older people are most often victims of social isolation (as they are less mobile and less willing or able to participate in community activities). Recently however more research has been produced which highlights the growing isolation of younger people. Understanding the nature of isolation, which impacts across the whole community, can help us to identify effective solutions which benefit and engage multiple groups.

Practice: This particularly relates to care within communities. The process of deciding where and how we care for the old or ill is a vital part of how we function as a society. Effective care extends far beyond the physical act of caring for someone, although this is obviously a key element. It also includes creating more and better jobs within the sector, and encouraging people to enter the profession as a worthwhile career choice; shifting the focus from acute to primary care settings and away from hospital-based emergency care; and giving people greater choice about how and where they receive care through increasing and improved personalisation of services.

There is a responsibility on both spatial and community planners to identify need and to create places which facilitate wellness, choice and care at home. This could be through the building of new infrastructure or more effective transport, or it could be through the creating of a community centre which offers recreational classes to someone who would otherwise have no contact with the outside world. Putting place at the centre of discussions provides an opportunity for a community approach to wellbeing, with strategies on placemaking being linked to other approaches such as asset-based, or strengths-based, planning.

Thinking about people like we think about the environment

Even as little as 10 years ago, the prevalence of environmental impact assessments for development projects was limited. Now we take for granted that we measure the impact of a project on the environment. What if we thought about people and in particular the risk of isolation, in the same way during planning processes? What if developers, planners and project organisers considered the “isolation impact” of a project, how it would impact the people of a local area, and whether it would specifically impact one group more than another (either for good or for bad), and reported on the steps they were taking to mitigate any adverse impact?

It is a striking notion, but creating a set of criteria to measure the social impact of developments, may be hugely useful if we are trying to place an increasing emphasis on inclusion and community within our town centres.

In fact, planners are beginning to realise the critical role they play in connecting services to people, and the necessity of understanding which services are needed in an area and how to make them as accessible for the whole community as possible. And while it is down to the community to use the resources they are given by planners to create connections and networks that help to combat things like poor mental health and social isolation, the decisions that planners make about how and where to plan in services and infrastructure can be the difference between someone leading an active and engaged life, and someone living a life where the only human contact they have in a day is a carer.

Planners can and should recognise the significant role they can play in making someone’s life more livable.

Final thoughts

Creating caring places for people to live and grow old in is vital to the success of our communities. Effective and thoughtful decisions on investments such as infrastructure and community planning projects can have a significant positive impact on wellbeing and reduce loneliness not only among older people, but throughout the community.

Increasingly, policy makers in Scotland are being asked to consider the human element of planning in their work. Creating places that allow people to feel safe, valued and happy is key for planners to help bridge the gap between the creation of places, and the wellbeing of people who live in them.


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