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The aim of this paper is to describe and detail a new workforce initiative developed by a third sector organisation: the Multi-Modality Practitioner (MMP) approach, in the provision of support for individuals and families presenting in the community with multiple and varied needs.

This paper presents a case study on a third sector organisation’s pioneering workforce initiative – the MMP approach.

The MMP approach has been developed as an alternative to existing approaches designed to address “single issues”, providing those working in the fields of health and social care and beyond, with a range of technically eclectic interventions from different modalities and approaches, to enable them to appropriately meet the needs of individuals and families presenting with multiple needs.

This case study is limited to providing a rationale for the development of the MMP approach and a description. It does not include any formal analysis as a future evaluative paper will report on an independent theory-based examination of the MMP approach via Theory of Change and Contribution Analysis methodologies.

This case study describes the innovative role that the MMP approach as a workforce innovation plays in meeting multiple needs in the community when deployed as either a stand-alone approach, or one that can be integrated with existing community-based services including, but not limited to, mental health, employability, addiction, housing, homelessness, public health and child and family services.

The MMP approach constitutes a disruptive, pionneering, client-centred, workplace innovation that is trauma-informed, relational, strengths-based and continuity of care focused, capable of supporting individuals and families with multiple needs, negating onward referral and with potential to reduce demand on public services. It also provides those working in a range of health and social care roles with the opportunity to expand their therapeutic repertoire through high-quality, multi-skilled training in evidence-based and societally important, technically eclectic interventions drawn from a range of modalities.

Pluralistic practice and multimodal theories have been in existence for over two decades, the MMP approach however, whilst sharing some of these concepts and philosophies, differs in that it provides those trained in the approach with a ‘toolkit’ of interventions that are technically eclectic, drawn from a range of modalities and approaches and aimed at meeting multiple needs in a pragmatic and accessible manner. Furthermore, the Diploma in Multi-Modality Practice is the first training course of its kind available at postgraduate level.

The purpose of this paper is to describe the development, implementation, delivery and evolution of a community-led, comprehensive, peer support service, including co-production approaches, peer support worker role development, outcomes, acceptability and lessons learnt over a five-year timeframe.

This case study presents a reflection on a charity’s peer support service development along with outcomes to highlight client progress.

Improvement in well-being as measured through the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) was evidenced along with demonstrating that the peer support service offers complementary support to Improving Access to Psychological Therapies (IAPT) services.

There was limited quantitative data, and that which existed was analysed on a service-wide basis as opposed to looking at individual components of the service.

This paper demonstrates the value of peer support provision as part of an overall primary care, community-based mental health service, including findings that suggest that for some individuals, where IAPT services did not help them as much, a peer-based service appeared to be more suitable.

The peer support service provided a complementary and alternative service to conventional primary care mental health services whilst offering individuals with lived experience to gain volunteering, employment and development opportunities.

Whilst peer support services have been well documented in the literature for clients experiencing serious mental illness, research on the use of such approaches in the management of common mental health difficulties including anxiety and depression is not as well established. The aim of this paper is to detail the experiences of a user-led charity in developing and delivering peer support services, including challenges encountered. Furthermore, this paper describes a peer support service that has been integrated with a co-existing low intensity IAPT service, reporting recovery rates for clients that have accessed both peer support and IAPT services.

Self Help Services is a pioneering charity in how it champions personal experience of mental health and uses these experiences in the treatment of people living with common mental health problems – anxiety, depression, phobias, and low self‐esteem issues. This paper aims to describe how the charity grew from one individual's journey with agoraphobia to being the main provider of primary care mental health services in the North West of England.

The paper charts the growth of Self Help Services over time, with a particular focus on its employment of people with personal mental health problems. It describes the experiences of its founder and Chief Officer and includes case studies of a user of its e‐therapy services and the charity's Informatics and Governance Lead.

The case studies illustrate how the charity has grown in both size and success as a result of harnessing the skills and experience of large numbers of staff and volunteers living with a mental health problem. The case studies illustrate that, rather than being an issue, these personal experiences are vital tools in helping others work through their own difficulties.

The paper provides a detailed overview of a charity which was unique when it was formed and now thrives as a result of its uniqueness. It provides other similar organisations with advice on lessons learnt along the way, and advice for individuals or groups looking to establish similar organisations.

Around the UK, a number of strategies are being employed to expand the availability and increase the accessibility of psychological treatments for anxiety and depression. Recommended interventions include supported self‐help programs based on CBT principles such as computerised cognitive behavioural therapies (CCBT) for mild‐to‐moderate depression, phobia, and panic. This paper seeks to describe innovative third sector, service‐user led CCBT clinics commissioned within Greater Manchester.

The paper describes how the project was initially set up, how the services are managed, how they work, and the impact of these services on the population they serve.

The CCBT clinic achieves a high throughput of service‐users, including more than one‐third accessing the service through self‐referral. Intake and outcome measures suggest that CCBT service users are representative of both the local population and those accessing increasing access to psychological therapies (IAPT) services for common mental health problems. For those engaging with the CCBT service, outcomes are equivalent to those reported in NHS‐based demonstration IAPT services. Service users highly value the service offered including the computer‐based programs and the support offered by paid and voluntary staff.

Roll out of this effective service model is recommended.

This paper has described a successful third‐sector, user‐led, CCBT self‐help clinic offering a Tier‐2 service for anxiety and depression that meets local needs. This will be of interest to service users, providers, and commissioners who want to develop similar services.

In recent years there has been a proliferation of computer-based psychotherapeutic interventions for common mental health difficulties. Building on this, a small number of such interventions have now been developed to address substance dependence, one of which is Breaking Free Online (BFO). A new “eTherapy” self-help service, which was set up by the UK mental health charity Self-Help Services, has provided access to BFO to service users presenting with comorbid mental health and substance misuse difficulties. The purpose of this paper is to evaluate a range of clinical outcomes in the first cohort of service users accessing this dual diagnosis service.

A number of standardised psychometric assessments were conducted with service users at baseline and post-treatment at discharge from the service. Outcome data were available for 47 service users out of an original cohort of 74.

Statistically significant improvements were found in terms of measures of social functioning, depression, anxiety, alcohol and drug use and social anxiety. Clinically relevant gains were also identified, with fewer service users reaching threshold scores for depression and anxiety at post-treatment compared to baseline. Effect sizes also indicated that the identified improvements across the psychometric measures were robust and significant.

These findings provide further support for the clinical effectiveness of BFO, and also provide evidence that an eTherapy self-help service may be appropriate for some individuals presenting with dual diagnosis. Further research is underway with larger and alternative clinical populations to examine the effectiveness of BFO and also this novel eTherapy self-help approach.

This paper has provided initial data to support effectiveness of a novel eTherapy service for dual diagnosis.