Measuring what matters and tracking progress
Data, research and evidence
In order to understand the issues of mental health and wellbeing – including determinants/risk factors, experiences, service use and outcomes – appropriate data, intelligence and research is necessary. A common criticism of much public sector work is the use of short-term, service-based data to measure success, rather than focusing on the long-term outcomes which matter most to the communities we serve. Often, there is a perception that what is measured is what matters. Instead, we must ensure that we measure what matters to the mental health and wellbeing of our communities.
Mental health data
Mental health data often focuses on healthcare data such as numbers of referrals, prescriptions and hospital bed occupancy. Much less data is available on population level mental health and even less on non-clinical and positive aspects of wellbeing. Commonly used wellbeing measures such as WEMWBS (Warwick-Edinburgh Mental Wellbeing Scale) are more often available at national level and rarely at local level. Moreover, wellbeing is much less well researched than measures of mental illness, such that we still do not have as good an understanding of what the data is telling us. Within the North East of Scotland, we must begin to routinely measure the wellbeing of our population, collating measures already available and identifying any gaps in measurement which we must use our research capabilities to address. In 2007 and 2012, NHS Health Scotland attempted to collate and develop mental health and wellbeing indicators for adults and children and these will be a useful starting point for this work.
Qualitative data
Another bias in health data and intelligence is an undue focus upon quantitative data at the expense of qualitative data. As subjective information, qualitative data is often dismissed as ‘soft’ and has historically been less valued in decision-making processes. Mental health and wellbeing encompass intrinsically subjective experiences and so extensive qualitative data is required to understand them. Using quantitative and qualitative data together allows us a deeper understanding of the experience of both positive and negative mental health and wellbeing; qualitative data will enable us to appreciate which aspects of wellbeing matter most to people and the things that enable and hinder them from experiencing better mental health and wellbeing.
Participatory forms of data collection
A focus on qualitative data also fits in with the principle of community empowerment, seeing the priorities, experiences and expressed needs of our communities as part of our dataset. In the same spirit of empowerment, we should explore and move towards a greater focus upon participatory forms of data collection, intelligence and research, such as Participatory Action Research (PAR) methodology and the ‘citizen science’ approach. Just as communities should be involved in design, planning and implementation of projects and programmes, they should also be central to our data, intelligence, evaluation and research. Through participatory approaches, we can facilitate and enable communities to collect and analyse the information that is most important to them and to research populations and areas which may not be as accessible to professionals working within our organisations. By engaging in the research, communities may also be empowered to take action on health issues that interest them, gaining in-depth knowledge and understanding through the process.
Working with our academic partners will be key to strengthening our understanding of population mental health and wellbeing in the North East. Academic partners bring expertise in study design and data analysis that will help us to establish indicators for mental health and wellbeing.
When we have developed a range of indicators and approaches, we must use these to track the changing picture of mental health and wellbeing within our populations, and to gain an understanding of the impact of projects and programmes of work upon mental health and wellbeing.