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Solving Problems, Transforming Lives - Tackling Social Triggers of Mental Health Crisis

Background and Aims


Mental ill-health is a growing challenge, with rising service demand and readmissions. Many patients admitted to acute mental health wards face unresolved social stressors, such as debt, housing, and employment issues that clinical teams are not equipped to address. This pilot aimed to evaluate whether embedding Citizens Advice (CA) caseworkers directly on wards could improve patient outcomes and reduce healthcare costs.

Results


The pilot involved 64 patients, with 50 matched to controls for analysis. Over a 9-month post-discharge period, this was found to be a successful model.


Over the 9-month pilot, £244,850 was saved by preventing readmission or shortening length of stay (£4,897 per patient). Importantly, there was significant benefit in patient experience, with reported reduced financial stress and increased hopefulness.


“When I got out of Melbury Lodge they introduced me to the council housing group to help with my housing. Without the service I would have struggled much longer and harder than I did.” – Darryl, patient


The pilot study also had positive feedback from staff on the wards, who reported reduced work-related stress, improved morale, and greater job satisfaction.


“Patients are happier having someone that can help in matters regarding life problems outside the hospital. Nurses can focus on the health of the patients.” – Clinical staff member


Impact & Innovation


  • Award-Winning Model: Winner of the NHS Parliamentary Award for Excellence in Mental Health Care (Southeast)

  • Unique Approach: First NHS Trust to embed Citizens Advice caseworkers directly on mental health wards, rather than relying on external referrals

  • Economic Evaluation: First Trust-level analysis demonstrating cost savings from addressing social determinants of health

  • Scalable Model: Potential for replication across other NHS Trusts and integration into national commissioning strategies

  • Policy Influence: Contributing to the national Citizens Advice Health Strategy and informing future health-social care integration


Future Plans


  • Scale the service with embedded evaluation to validate long-term outcomes

  • Shift delivery into community settings for earlier intervention

  • Pursue additional funded research to determine optimal service locations

  • Continue influencing national policy and collaborating with Citizens Advice nationally



Poster


Take a look at a poster created by Jon Pritchard and Sue Campbell on this study.




News Article


This study was featured in The Times on Wednesday, 7th May 2025. Please click below to read the article.





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