Trust, Inclusion, and Tech: Key Takeaways from the CIRCLE Workshop on Neighbourhood Mental Health Centres
What does it really mean to move mental health care closer to communities? The launch of the Reimagining Community-Based Mental Health Care research theme created a space to explore this question at an important moment, as 24/7 Neighbourhood Mental Health Centres are being developed as a more accessible, integrated and community-based approach to support. But the theme is broader than one model of care. It brings together people with lived experience, practitioners, community organisations, researchers and policy colleagues to raise questions and develop ideas for mental health research together.
This reflects wider national debates. In December 2025, the House of Commons Health and Social Care Committee identified five features of high-quality community mental health care: being timely and accessible, providing continuity, taking a person-centred and equity-focused approach, and being shaped by lived experience. These principles closely align with the ambitions of Neighbourhood Mental Health Centres, while also providing a useful test of whether bringing care closer to communities leads to meaningful change.
The launch discussions suggested that transformation is about more than moving services into a different building or bringing professionals together under one roof. It raises deeper questions about trust, relationships, accessibility, inequality, risk and whose knowledge shapes care.
Rather than offering another report of the event, this blog brings different perspectives into conversation. Myra reflects through her research on migration, inclusion and co-production, while Blue considers the discussions through her work on technology, surveillance and relational care. Together, they show how the same conversation can open up different questions and possibilities for future mental health research.
Inclusion, migration and co-production
Myra Mufti, School of Sociological Studies, Politics and International Relations
Transforming the mental health care landscape means more than putting a new sign on an existing service or co-locating teams under one roof. It requires a shift in how services build trust with communities, share power and involve people who use services in shaping them. The launch event made this particularly visible: if the Neighbourhood Mental Health Centres are going to deliver on their promises, implementation needs to draw on lived experience, frontline practice and local community knowledge from the very beginning, rather than relying only on top-down plans or one-off consultation.
Centering Communities in Mental Health Reform
For me, one of the strongest messages from the event was the importance of shifting focus from doing research on or about communities towards ‘with’ them. The workshop was deliberately designed to value different forms of expertise, and the CLEAR IDEAS approach created structured opportunities for participants to identify barriers and develop possible solutions together. This matters because academic, clinical and policy knowledge can illuminate only part of the picture; people who use services and communities themselves also hold essential knowledge about whether support feels understandable, accessible and trustworthy. The value they bring is equal to the clinical or academic expertise.
This is particularly critical when thinking about migration and cultural differences. In my research with migrants, I regularly see how structural barriers such as fear of discrimination or complex administrative jargon prevents vulnerable groups from accessing basic rights and services. One of the central flaws in standard health policy is assuming community homogeneity. Administrative, umbrella labels like “South Asian”, “African” or “European” can undermine the distinctiveness of languages, faith traditions, socio-economic contexts and migration histories of each group, thereby deterring the delivery of culturally appropriate care. Similar concerns surfaced during the workshop. Participants highlighted that what works for one neighbourhood group may completely alienate another as cultural understanding, expression and experiences of mental health embedded within different family dynamics or spiritual frameworks may vary from existing Western models. Without hyper-local tailoring, services remain culturally invisible or deeply untrusted. Crucially, ignoring these realities creates severe operational blind spots. Even seemingly simple language matters: participants noted that describing a service as a “24/7 Centre” could be misunderstood as meaning an emergency department. A neighbourhood approach therefore cannot assume that a ‘community’ is homogenous; what feels welcoming and appropriate in one context may not do so in another.
Ensuring Inclusion & Co-production in Practice
Delivering culturally responsive and inclusive care in practice requires methods that actively address traditional power dynamics. In my own PhD research with migrant communities, who often face severe language barriers and systemic distrust, I have used visual drawing tools as a participatory methodology. These methods help to decentre the power imbalance between researchers and participants and allow people to map out their lived experiences, emotions and systemic challenges on their own terms. Seeing the launch event use the CLEAR IDEAS methodology felt like a natural extension of this philosophy. By bringing NHS practitioners, clinicians, academics, frontline workers and people with lived experience into the same discussion, the framework created structured opportunities to identify barriers and solutions together. For me, this reinforced how participatory tools can move us from identifying problems towards co-designed action.
This participatory ethos came to life through project ideas developed at the event. Action Plan 5, “Work with, not for communities”, focused on engaging excluded voices and reducing barriers to support. Other ideas included Service Open Days to demystify care and developing inclusive communication strategies through Easy Read materials, British Sign Language (BSL) support and neurodivergent-friendly spaces. For me, these proposals demonstrate how inclusion and co-production can be built into implementation and drive us to real systemic change.
My PhD has taught me that people who are often described as vulnerable or excluded hold endless wisdom and essential knowledge about what they need, and that lived experience should not be supplementary evidence in service design. We need to build the right spaces to listen and act. The launch reinforced for me that bringing researchers, practitioners and communities together with shared power and participatory tools can move us beyond one-off consultation towards genuine co-production.
Conflicting priorities in the 10 year Health Plan for England?
Blue Maignien, PhD Student, University of Sheffield
The number of people admitted to inpatient mental health services has increased consistently over the past decade alongside rising levels of acuity and distress (CQC, 2021; Ward et al., 2025). Neighbourhood Mental Health Centres are being piloted as part of a wider shift towards delivering more mental health care in the community rather than in institutional settings. This new model, inspired from international examples of successful community mental health practices, is in line with the priorities set as part of the 10 Year Health Plan for England: community care, prevention and digital rather than analogue.
In the workshop organised by CIRCLE, I learned more about the new model and felt a sense of hope for genuine change in mental health care. This connects directly with my research on inpatient care, where I see worrying trends including medicalisation, securitisation and coercion. My concern is that the promise of the Neighbourhood Centres sits alongside another competing priority: to digitise and datafy services. In my research I have seen how ‘digital-by-default’ can increase coercion and harm when they are not designed around the needs and rights of people experiencing distress.
During the event, the topic of data infrastructure came up in discussions about how multiple teams could work together, particularly staff access to patient records and information across different systems and patients’ privacy needs. The ‘Data saves lives: reshaping health and social care with data’ strategy is seeking to improve data sharing between services, through greater integration of health data. However the perspectives of people experiencing mental health distress have been less visible in these discussions, despite the potential impact of data sharing on their care. This is particularly important in mental health, where records often include diagnoses that can be sensitive, stigmatising and contested:
- There is significant stigma attached to mental health diagnoses.
- Mental health diagnoses are often challenged or contested by patients.
- The experience of psychological distress is closely intertwined with psychosocial factors such as housing or trauma, while diagnoses can narrow this complexity to a clinical label.
With the datafication of mental health services, the question of how to ensure this process serves rather than harms people using services therefore needs urgent attention.
Technology can support joined-up, person-centred care without reproducing surveillance or control, but this requires more than making systems interoperable or joining teams under one roof. If technology is designed with genuine leadership from people with lived experience it may improve care. The Ada Lovelace Institute’s work on data trusts offers a good example of a more participatory data stewardship. while also showing co-design and co-production require time. Neighbourhood services need the same attention to participation in their digital infrastructure as in their service design.
My caution is shaped by research on digitalisation in inpatient care where coercive practices remain a concern. Oxevision - a vision-based patient monitoring system used in inpatient mental health care - is one example. It creates a digital interface for clinical observations previously carried out in person and on paper. Although the manufacturer states that it should not replace in-person observations, reports show that these surveillance technologies significantly alter interaction between healthcare workers and inpatients. Oxevision has been associated by some people using these services with distress and has been scrutinised as part of the Lampard Inquiry. For me, this illustrates why “digital rather than analogue” needs careful scrutiny in health care. The question is not simply whether a technology is innovative, but whether it protects autonomy, privacy, and human contact, and whether people with lived experience have a meaningful and genuine role in the process of design and use.
To avoid simply moving institutional logics into the community, Neighbourhood Centres will have to consider how health innovation interacts with their core values. During the workshop, participants discussed the need for genuine change in mental health practice, including addressing stigma and medicalisation. That transformation is not only a matter of changing clinical practices; it also means ensuring that technology does not amplify practices the neighbourhood model is trying to move away from.
The development of digital technology in mental health care is fast, which can make it difficult to involve people with lived experiences meaningfully or to understand how technologies affect therapeutic relationships. In his keynote, Professor Tim Kendall spoke about the development of Neighbourhood Mental Health Centres across England. What struck me most was the emphasis on relationality. He described supporting a young person in severe distress by taking the time to speak to them and encouraging them to go out after they had not been able to leave their room.
This relational aspect of care resonated with my research. In interviews with people admitted to mental health wards where surveillance technology is used, I have repeatedly heard that relationality can make or break a caring relationship. High staff turnover, disinterest, judgment or stigma can undermine care; consistent relationships with a key worker, a care coordinator, an advocate, can make the difference. Continuity is not only about sharing information across services, but also about sustaining human relationships.
The relationality of care is therefore central to the shift from analogue to digital. Technology should not be introduced simply because a process can be digitalised. During the Lampard Inquiry, Laura Cozens, then Head of Patient Safety and Quality at Oxehealth Limited, argued that it was not right for a clinical process to continue to be carried out with pen and paper (interview here). For me, this reflects a wider assumption that digitalisation is inherently beneficial, which is not necessarily the case in mental health care. For Neighbourhood Mental Health Centres, the key question is whether digital tools strengthen continuity, trust and human connection or risk reproducing surveillance and control in new settings.
Conclusion
Taken together, these reflections suggest that the move towards community-based mental health care is not only about WHERE care happens, but about HOW care is organised, WHOSE knowledge shapes it and WHAT KIND OF RELATIONSHIPS it makes possible. Services can be geographically closer while remaining culturally inaccessible; organisations can share a building without genuinely sharing power; and digital systems can connect information while also creating new questions about privacy, monitoring and control. Moving care out of institutions does not automatically remove the assumptions and practices that have historically shaped mental health care.
Myra and Blue approach these questions from different research perspectives, and that is precisely what the Reimagining Community-Based Mental Health Care theme is intended to make possible. The aim is not necessarily to arrive at one view of what mental health research should focus on, but to create spaces where people can bring different knowledge, experiences, concerns and ideas into conversation. Those perspectives can challenge assumptions, reveal issues that might otherwise be overlooked and generate new questions for research and practice.
The launch was therefore not an endpoint, but one example of how the theme can work: bringing academics, people with lived experience, practitioners, communities and others together to explore mental health care from different angles and identify areas that deserve further attention. The challenge now is to sustain those spaces and turn the questions, connections and ideas that emerge from them into collaborative research and action.
If you would like to continue the conversation, contribute to the developing research theme or explore the ideas that emerged from the workshop in more detail, please get in touch and read the full event report.