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Community Navigators: Reducing loneliness in people with depression and anxiety

What is this research?

Though everyone experiences loneliness from time to time, people with mental health problems report having smaller social networks. Research has found links between loneliness and shorter life expectancy, as well as reduced rates of recovery from depression and anxiety. It is therefore important that we find out what is effective at helping people with depression and anxiety to feel more connected to others.

The Community Navigator Study involved the development and testing of a programme that connected people with persistent depression and anxiety, who experience loneliness and are receiving support from secondary mental health services, with a Navigator.

What is a Community Navigator?

The role involves:

  • Working with participants to understand their current social network and what they would like to do going forward.
  • Researching opportunities that fit people’s needs and interests.
  • Going with participants to try out activities and other social opportunities.
  • Bringing participants together at group ‘meet-up’ sessions.
  • Providing encouragement and focusing on what a participant can do, rather than focusing on symptoms and what is holding them back.

In the study, people who met with a Community Navigator had up to ten sessions over a six month period. The Community Navigators worked with people to understand their current social network and what they would like to do going forward, research opportunities that fitted with a person’s needs and interests, and accompanied participants to try out groups and other social opportunities. Participants were also given the option to attend a group with other people taking part in the study, which was run by the Community Navigators. The Community Navigators aimed to be encouraging, focusing on what people could do, rather than symptoms and what is holding people back.

What did the study tell us?

This work was a feasibility and acceptability study. This means that the number of people taking part was not large enough to tell us whether the Community Navigator intervention is effective in improving mental health problems and reducing loneliness. It did, however, allow us to test whether the study processes work (feasibility) and to explore what key stakeholders thought of the intervention (acceptability). This can be used to justify and seek funding for a larger study to test effectiveness.

Feasibility: We did not have difficulties recruiting to the study – recruitment of 40 participants was completed within 4 months. We also found that it was possible to retain participants in the study and 80% of people met with their Community Navigator for at least three sessions. This shows that it is possible to run a trial in this context.

Acceptability: We interviewed 32 stakeholders (25 service users, 3 family members, 7 mental health staff and 3 Community Navigators) and found that that intervention was broadly acceptable across stakeholder groups. Interviewees welcomed the idea of the intervention, describing how social connections are an area of need often under-prioritised by mental health services. Nearly all service users reported that meeting their Navigator had been a positive experience, which challenged them to do things they were not that comfortable with, such as meeting other people. They described feeling understood and valued by their Navigator and liked the fact that they were forward-looking and encouraged them to make changes. As a result of taking part, some service users reported that they were now regularly attending activities, had increased contact with other people, experienced improved mood and felt less lonely. Some stakeholders did, however, feel that the intervention was not long enough to achieve sustained change, especially when life circumstances limited the extent to which service users could engage with the intervention.

Overall, the study was feasible to deliver and the intervention was generally acceptable to stakeholders, suggesting it would be worth running a larger study to determine the effectiveness of the Community Navigator intervention for this group.

When did the study run?

The project ran from February 2017 until June 2018, when the final report was submitted to the NIHR School for Social Care Research. We held an event to report the findings to study participants in May 2018 and a wider stakeholder event in June 2018. As soon as the report is finalised and published we will be making it available to the public and hoping to publish in academic journals in the coming months.

Who ran the study?

The study was led by Professor Sonia Johnson and Dr Bryn Lloyd Evans from the Division of Psychiatry at University College London (UCL). The McPin Foundation led on the qualitative component of the study and the running of a co-production group, made up of people with experience of depression/anxiety and loneliness, staff working in the mental health services taking part in the study, and researchers. The co-production group helped develop the intervention, advised on its delivery and assisted with data analysis and reporting of the findings.

Where do I find more information?

For more information about the project, you can visit the UCL Community Navigator page. For more information about this study, please get in touch with Vanessa Pinfold: vanessapinfold@mcpin.org.