Case Study

Scalable innovation for mental health care and support

NHS and public health services in Shropshire worked in partnership to provide early mental health intervention and rapid-access pathways.

6 April 2023

Local authorities, NHS providers and commissioners in Shropshire began working with partner organisations, including online mental health support community Togetherall, to provide innovative and immediate access to mental health support that compliments existing local NHS pathways.

Key benefits and outcomes

  • Scalable, whole-population and early intervention support.
  • Three-quarters of members say they found Togetherall tools helpful.
  • Over 70 per cent of Togetherall members say the resource is helpful while on a waiting list or post discharge. Over half of Shropshire residents who accessed Togetherall used the service outside standard hours.
  • 24/7, active clinical moderation and supervision with robust safeguarding case-management procedures, tailored to local place needs.

What the system faced

The COVID-19 pandemic brought mental health challenges into sharp relief. Face-to-face support came to a halt at a time when greater support was needed. Despite many services shifting online, many one-to-one support models could not address the scale of demand for support.

Solutions that can be scaled across a large area with a fragmented population is essential for Shropshire’s public health strategy. Residents can experience long waits for IAPT (improving access to psychological therapies) appointments with symptoms worsening during that time. Shropshire Council identified mental health support as a key priority and knew it needed more early intervention and rapid-access support pathways.

What the system did

Shropshire commissioned Togetherall, an online community where members support each other anonymously with matters concerning their wellbeing, supervised and safeguarded by a 24/7 team of experienced mental health professionals and clinicians. This support complimented a range of existing services in Shropshire to support early intervention measures and offer instant-access support routes.

Togetherall was able to provide immediate online support for:

  • people waiting to be seen by local IAPT services
  • people with low-to-moderate mental health problems
  • people living with long-term mental health conditions
  • people looking to supplement their NHS treatment
  • eople looking for aftercare mental health support.

Results and benefits

The peer-to-peer support pathway was well received. People in Shropshire were able to connect instantly and remotely with a safe community of peers for support with the lived experience to offer valuable support in-the-moment.

Shropshire and local partners saw a positive impact in having a rapid online mental health support pathway in place.

  • Around 13,000 page views on the local authority’s website.
  • People using the platform on average for over half an hour.
  • Members taking part in at least one clinical assessment.
  • Over half of members using the service outside standard hours.
  • Referrals into the service via both GPs and public health sources referrals.
  • Three-quarters of members say they found Togetherall tools helpful.
  • Over 70 per cent of members say Togetherall is helpful while on a waiting list or post discharge. Over half of Shropshire residents who accessed the service used the service outside standard hours.
  • 24/7 active clinical moderation and supervision with robust safeguarding case management procedures, tailored to local place needs.

Overcoming obstacles

While successful, this partnership has highlighted several other issues, including the need to have both online and offline mental health support. The council is aware that some residents find connecting with people online more challenging for various reasons, including not having reliable access to the internet. As such, Shropshire and other local authorities understand the need for integrated services that partner with the NHS and provide both online and offline complimentary support.

Takeaway tips

The Shropshire partnership example demonstrates several things:

  • Health outcomes must be data driven.
  • Patient choice is crucial to success – having the option to choose when, where and how you access a mental health support service like Togetherall is critical in supporting positive mental health outcomes.
  • Anonymity is also a consideration – many people find it hard to talk openly about their mental health for the first time. Providing clinically supervised anonymity can encourage people to talk before their mental health deteriorates, placing additional burdens on pressured NHS services.
  • Early intervention works – helping people build mental resilience and talk to someone in a safe manner to prevent issues from developing further and to encourage help seeking.
  • Online mental health support can be scaled beyond local partnerships across the country.

Further information

For further information on the work in this case study, please contact Emily Bromiley.