It does what it says on the tin…

Featured article - 14 September 2021
By Alex Fox OBE, CEO Shared Lives Plus; Kathryn Morgan, Development Manager, Shared Lives and Homeshare in Wales; and Karyn Kirkpatrick CEO KeyRing


Earlier this year, at the global launch of their new WHO Guidance on community mental health services: ‘Promoting person-centred and rights-based approaches’ the World Health Organisation showcased 28 mental health services. The South East Wales Shared Lives Mental Health Crisis Project and KeyRing were 2 of only 3 in the UK that featured.

Included are examples from all over the world – Brazil, India, Myanmar, New Zealand, Norway and the United Kingdom. All follow a rights-based approach. From the ‘Open dialogue’ crisis service, Lapland, the ‘Friendship Bench’, Zimbabwe - to a social care service in South East Wales that joined forces with a local Health Board and KeyRing that enables people to become an active part of a community network of support.

If someone believes in you, more than you believe in yourself

Before a person is discharged from a mental health ward, the South East Wales Shared Lives Mental Health Crisis team undertake a careful matching process. The person is actively involved in the next stage of their recovery journey. They meet their Shared Lives carer, visit, or see pictures of the family home, helping them to visualise the support and opportunity for family life. Personalities, hobbies, experience and interests, together with location and lifestyle are all considered and discussed with the person and the Shared Lives carer.

People who have moved from a hospital ward to live a Shared Life speak about the one-to-one attention in their new home, everyday activities like cooking, walking, ironing, and seeing family - vital to maintaining a healthy lifestyle, building confidence, self-esteem and wellbeing.

I feel like a normal human being rather than a statistic

KeyRing is a service that breaks down barriers to independence through connecting people, flexible support and skill-building. People in crisis become an active part of a network of support and contribute to its success. They secure and maintain their own accommodation, learning new and building upon existing skills to move to the next stage of independence. Everyone who joins a KeyRing network has skills and experience to offer their fellow network members. They become engaged in their local community.

KeyRing has had a tremendous impact on Mark's life - ‘he is living independently now for the first time in his 52 years and is absolutely loving it. I have nothing but praise for the excellent support that KeyRing have provided’.

There was such diversity across all the 28 services featured in the WHO Guidance but they share the same qualities and philosophy – supporting people to gain or regain purpose in their lives. They demonstrate how services can be provided within a legal framework, protect human rights, promote legal capacity whilst avoiding coercion.

These examples demonstrate that we already know the solutions to what could be a mental health crisis riding the coattails of the pandemic. But we have to be much more ambitious about initiatives which are currently small and not let their current scale become a self-fulfilling prophecy. We have learned that scaling these approaches starts with co-designing services with people who use them and the groups and communities who miss out. ‘Asset-based’ or ‘strengths-based’ approaches like ours avoid thinking only about people’s problems or labels and look for what people can or could do with the right support. They think whole-person, whole-family, whole-lifetime, and they help people to combine what they can do as an individual, what the community can offer and the resources and expertise of public services.

A radically different way of thinking which needs to start with local areas setting out a different kind of vision for what they are trying to achieve, using tools like the Asset-Based Area, so that services like ours don’t remain endlessly ‘piloted’, but become ‘core business’.

Alex Fox is also a SCIE trustee.

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