Background: People live socially complex lives and have different health care needs influenced by socioeconomic factors such as deprivation, unemployment, and poor housing. Lack of access to community based social care results in people seeking social support from health care services. This study explores the Life Rooms as a social prescribing model addressing the social determinants of mental health by providing support and access to resources in a local community setting. With an aim to identify key elements that contribute toward enhancing the effectiveness of the Life Rooms social prescribing approach. Methods: Data were obtained through six semi-structured focus groups with mental health service users from two locations in the North West of the UK. Postcode data was collected to generate an Index for Multiple Deprivation (IMD) score, to understand their socioeconomic background. Data were analysed using thematic analysis. Results: A total of 18 participants took part in the study. The majority of participants came from disadvantaged backgrounds; 14 participants measuring 3 and below in terms of overall IMD scores and 9 participants belonged to the poorest decile (IMD score = 1). Participants reported on different elements of the Life Rooms which they found as an effective approach to care. Four main themes emerged from the data: 1) social belonging: being able to just 'be' 2) resourceful and accessible; 3) social inclusion and connectedness; and 4) moving forward: self-development and independence. Conclusion: Findings support the need and benefit social prescribing to improve mental health wellbeing and reduce the burden of mental illness.

2 Word count (not including abstract, refs etc.): 9,174 Abstract Different aspects of the neighbourhood social environment have been linked with mental illhealth, however the mechanisms underlying these associations remain poorly understood because of the number and complexity of the components involved. We used a novel statistical approach, network analysis, to explore the complex associations between neighbourhood social cohesion, social disorder and mental health symptoms in a sample of 3,670 adults from an economically deprived region of the UK (mean age [SD] = 49.34 years [18.87]; 57% female). Elasso regularised networks were estimated, and network comparisons were conducted by level of deprivation. Mental health symptoms and neighbourhood components formed relatively distinct clusters of items. These domains were linked primarily by paranoia, although only in the most deprived group. Drunken/rowdy behaviour was particularly influential within the neighbourhood cluster, therefore policies aimed at reducing such disruptive behaviour could have positive knock-on effects for social cohesion and mental health.

Background: Socioeconomic status (SES) has been linked to treatment outcomes for mental health problems, whilst little to no literature has explored the effects of SES on access to both medication and psychological therapy. The aim of this study was to explore whether access to mental health treatments differed by SES. Methods: The North West Coast Household Health Survey (HHS) collected data from residents aged 18+ from across 20 disadvantaged and 8 less disadvantaged neighbourhoods in 2015, and from 20 disadvantaged neighbourhoods in 2018. Logistic regression was used to explore the effects of SES on access to treatment (medication, psychological therapy) for people who had experienced mental health problems in the past 12 months. Results: Of 6860 participants, 2932 reported experiencing mental health problems in the past 12 months. People from more disadvantaged backgrounds experienced greater rates of anxiety and depression. Anti-depressant and anti-psychotic medication treatment was significantly more common in residents with lower SES, as well as counselling. Regression analysis showed that residents from more disadvantaged neighbourhoods who reported mental distress were more likely to receive medication. Conclusions: This appears to be the first study showing higher levels of treatment with medication and psychological therapy in people from disadvantaged backgrounds. Future research needs to address the underlying factors associated with increased mental health treatment uptake in people from lower socioeconomic backgrounds.

Background Brief psychological therapies may be helpful for people who have recently self‐harmed. The current paper reports on a service evaluation of a novel brief therapy service based within an Emergency Department, Hospital Outpatient Psychotherapy Engagement (HOPE) Service. This service combines elements of psychodynamic interpersonal and cognitive analytic therapy to help people who present with self‐harm‐related difficulties. The primary aim of this service evaluation was to ascertain the feasibility of HOPE in terms of attendance rates. The study also examined variables associated with engagement, and change over time in psychological distress for those attending the service. Method The HOPE service was evaluated over a ten‐month period. Consenting patients completed measures of psychological distress and working alliance across four therapy sessions and one follow‐up session. Measures of emotion regulation style and self‐harm function were also completed at the point of referral. Results Eight‐nine patients were referred to the service (83 eligible referrals). Fifty‐three (64%) attended at least one therapy session. Baseline variables did not distinguish people who attended and people who did not. Psychological distress decreased significantly across the sessions. Most people reported a good working alliance with their therapist. Conclusions The results of this service evaluation support the feasibility of the HOPE service, demonstrating good engagement rates given the complexity of the population and context. Whilst there was evidence of reductions in distress, randomized controlled trials are needed to determine if HOPE has clinical efficacy. Practitioner points Rates of engagement with HOPE suggest the service is feasible in an Emergency Department context Working alliance scores were positive for the majority of patients The HOPE service shows promise as a brief intervention for people who self‐harm but requires further evaluation Randomized controlled trials are needed to determine the clinical efficacy of the HOPE service