Understanding the mechanisms through which a novel model of community mental health care influences care trajectories: A mixed methods longitudinal study

The Neighbourhood Mental Health Centre (NMHC) in Tower Hamlets is pioneering a radically new way of offering care, which is due to be expanded to Hackey, Newham and Luton, and emulated nationally. It aims to enable people experiencing severe mental health conditions to stay in community settings, avoiding the need for inpatient or emergency treatment.

Understanding how and for whom this approach works, including its impact on the wider mental health system, is essential to address local mental health inequalities, as well as providing lessons for scale-up. While initial evaluations have explored the short-term impacts of the service, there is as yet no evidence on how it influences care trajectories over time.

This PhD project aims to map the care trajectories of people who use the NMHC and those with severe mental health conditions within Tower Hamlets who have not, to identify mechanisms through which the service influences these trajectories and its interaction with other local services. This analysis will inform the roll-out of integrated mental-social health care across East London.

The student will use a longitudinal mixed methods approach. They will learn ethnographic research skills, longitudinal qualitative methods, and analysis of routinely collected quantitative clinical data. They will gain experience of interdisciplinary working, collaborating with NHS partners, lived experience partners (the established co-production group), and community partners involved in the service.

Year 1: Review programme documents, undertake ethnographic and co-production training, conduct literature review, collaborative meetings, finalise fieldwork protocol, secure ethical approval.

Year 2: Conduct ethnographic fieldwork, collect qualitative data, facilitate collaborative analysis workshops with co-production group, identify and collect quantitative indicators to assess care trajectories and inequalities.

Year 3: Collect follow-up data (qualitative interviews and quantitative data), conduct analysis, present preliminary findings to local staff/service users/policymakers.

Year 4: Complete write-up, disseminate findings to academic audiences and national stakeholders.