Lived experience

The Environmental Factors chapter of the Cambridgeshire and Peterborough Mental Health Needs Assessment (MHNA) recognises the critical interplay between our environment and mental well-being. This summary introduces the lived experience data collection undertaken to explore this connection.

Between January and February 2025, the Lived Experience Coordinator engaged with 40 organisations across the region, receiving valuable data contributions from 21of these. We are deeply grateful for the time and expertise shared by each contributor, which has been invaluable to this work. While acknowledging the time and resource constraints faced during data collection, we have taken these into account throughout our analysis.

This introduction sets the stage for a deeper exploration of how environmental factors, such as socioeconomic deprivation, access to green spaces, and the impact of climate change, influence mental health within our community. The subsequent report delves into the specific insights gathered, highlighting the lived experiences that inform our understanding of these crucial environmental determinants.

This page is currently under development

Introduction:

This report presents findings from a collection of lived experience data gathered across Cambridgeshire and Peterborough, focusing on the critical interplay between environmental factors and mental health. This data, sourced from service users and professionals, provides a rich and nuanced understanding of the challenges faced by individuals within our community. It underscores the importance of considering the broader context in which people live when addressing mental health needs. This report aims to illuminate the key environmental stressors impacting mental well-being and to highlight the urgent need for systemic change and improved support services. It is also important to acknowledge that the data collection process, while valuable, faced limitations. These limitations included challenges in capturing the full scope of lived experience due to resource constraints, the potential for a bias towards professional perspectives, and the need to clearly articulate the value of participation to interviewees. Therefore, while this report offers crucial insights, these limitations should be considered when interpreting the findings.

Mental Health in Cambridgeshire and Peterborough: Environmental factors Cambridgeshire CPSL MIND

“Mental health in Cambridgeshire and Peterborough is influenced by a range of environmental factors, including socioeconomic conditions, housing quality, education, employment, crime rates, and community well-being. These elements collectively shape the mental health outcomes of the local population”

Allan Hughes, CPSL Mind, Co-production Lead

Key findings

The Weight of Environmental Stressors:

Socioeconomic Hardship:
- Poverty, unemployment, and financial instability are significant drivers of mental health deterioration. Case studies like Barbara’s and Donald’s (Cambridge CAB) where mental health issues are compounded by low income, illustrate this stark reality.
- Poor housing conditions, insecure houses of multiple occupancy (HMOs)(Family Action) and homelessness, create a constant state of stress and fear, further damaging mental well-being.

Produced by the Cambridge CAB, the graph below shows the Proportion of Clients With a Given Issue by Mental Health Status:

A wellbeing survey conducted by the environmental charity PECT among those requesting home energy support reveals a significant prevalence of “Depression/stress,” highlighting the potential mental health consequences of these hardships.

Social Isolation and Exclusion:
- Lack of social support, particularly immigrant communities, contributes to profound isolation and exacerbates mental health problems.
- Discrimination and stigma, especially surrounding mental health, create barriers to seeking help and fostering a sense of belonging.
- Digital exclusion further isolates individuals, limiting access to information, services, and social connections.

“From the lived experience shared, it’s evident that there’s a knowledge gap within our broader community regarding Special Educational Needs and Disabilities (SEND), specifically ADHD and Autism. This lack of understanding is compounded by the severe social isolation experienced by some sections of our migrant communities, which is directly impacting their mental health. We need to consider the fact that digital solutions intended to bridge gaps are proving ineffective. Whilst health checks conducted in trusted community locations are demonstrating their value in identifying mental health needs and connecting individuals to support.”

Yasmin IIlahi, Co-director/Manager GLADCA

Service Delivery Issues:
- Barriers to accessing mental health services, including lengthy waiting lists and lack of culturally sensitive care in some cases, can leave individuals feeling abandoned and unsupported.
- Funding gaps and staff turnover within services disrupt continuity of care and create an unstable environment for service users.
- Feelings of a lack of empathy and cultural understanding from mental health workers.

“The system is failing to adequately respond to the needs of diverse communities. Cultural differences are leading to misinterpretations and missed opportunities for support. The lack of mental health support is a key driver of homelessness and other environmental challenges. Language barriers and a lack of cultural competency among mental health workers exacerbate these problems.”

Jawaid Khan, Retired Cohesion Manger PCC and prominent community member

The lived experiences gathered for this report highlight several key challenges within the delivery of mental health services. Further insight into these issues is provided by the Sun Network, a user-led mental health network in the region, whose long-standing themes (since 2022) offer a valuable perspective from service users:

The Perspective of the Sun Network on Service Delivery:

Older People’s Mental Health: Support is often disjointed, with a primary focus on Dementia/Alzheimer’s, neglecting other significant mental health conditions like depression and anxiety. Discharge from hospital to home or care homes is often poorly supported, with unrealistic expectations placed on carers. Access barriers remain significant, including digital exclusion, lack of GP appointments, use of stigmatising language, and a sense of societal devaluation.
Support for Complex Trauma: Individuals with PTSD or complex trauma increasingly report difficulty finding appropriate support.
Dual Diagnosis: Joined-up support for individuals with co-occurring substance misuse and mental health conditions remains inadequate.
Lack of Person-Centred Care: Many feel the system prioritises its own structure over individual needs.
Information Gaps: People lack awareness of local mental health support options beyond their GP.
GP Access: Difficulty securing GP appointments is a significant barrier.
Discharge and Follow-Up: A lack of information and referral to other services upon discharge leads to feelings of being “dropped.”
Referral Knowledge: CPFT staff often lack sufficient knowledge of or ability to refer to external services.
Waiting List Management: Long waiting lists are exacerbated by a lack of proactive communication, despite the introduction of the “Waiting well” initiative which many are unaware of.
ADHD/Autism Assessments: Waiting times for these assessments are excessively long (2-3 years, sometimes longer).
First Response Service (FRS): Long phone waiting times and experiences of feeling patronised are reported.
GP Referrals: There is inconsistent referral to social prescribers and community navigators by GPs.

Positive Experiences: Positive feedback exists for specific services like CGL and CRS.

These points raised by the Sun Network strongly reinforce the concerns identified through other lived experience data, highlighting systemic issues that require urgent attention.

The following section presents case studies from several organisations, providing concrete examples of the issues discussed in the key findings and the diverse strategies employed to offer support:

Case study 1: Family Action

Case study 2: Family Action

Case study 3: Family Action

Case study 4: Cambridgeshire Libraries

Case study 5: Cambridgeshire Libraries

Case study 6 : St. Marks Hub

Impact on mental health

Increased Stress and Anxiety: Chronic exposure to socioeconomic stressors, carer strain, (Caring Together) and environmental insecurity leads to heightened anxiety, depression, and hopelessness.
Social Isolation and Loneliness: Poverty, digital exclusion, and stigma contribute to profound isolation, damaging self-esteem and hindering recovery.
Reduced Self-Esteem and Confidence: Unemployment and social exclusion erode self-worth, leading to feelings of marginalisation and despair.
Increased Vulnerability: Individuals with complex mental health needs, those who have experienced trauma, and those facing barriers to services are particularly vulnerable to mental health deterioration. Gareth’s Case Study (Cambridge CAB) exemplifies this vulnerability.
Cycle of Disadvantage: The interplay of these factors creates a cycle of disadvantage, where poverty, poor housing, social exclusion, and mental health problems reinforce each other.

The Importance of Support and Connection:

The importance of fostering trusted relationships and a sense of purpose is further highlighted in an Appreciative Enquiry report to the Cambridge Poverty Strategy Commission, conducted by the Cambridgeshire Appreciative Enquiry Learning Network. This report, which gathered insights from community conversations about the cost of living, identified key themes that resonate with the findings discussed below.

Value of Peer Support: Peer support groups provide essential connection and understanding, fostering a sense of belonging and promoting recovery.
Trusted Relationships: Positive relationships are crucial for mental well-being, providing support, encouragement, and a sense of belonging.
Sense of Purpose: Having a sense of purpose, whether through work, volunteering, or community involvement, is vital for mental resilience.
Community and Connection: Fostering a sense of community and connection is essential for combating social isolation and promoting well-being.

This perspective is further echoed by a worker at HAY, who emphasises the critical difference between inclusivity and belonging and highlights the success of community-based initiatives in fostering connection and wellbeing:

Belonging, Food, and Kindness: Nurturing Mental Wellbeing in the Community

Below are some thoughts from Jack Avison, Digital and Community Engagement Coordinator (Fenland) along with some feedback from a Christmas appeal project.

I think the key to success is fostering a sense of belonging, which is not the same as fostering inclusivity, your group can be as inclusive as you like, but if people don’t feel like they belong when they go……

Food has been the key to success of a lot of groups. Pairing food surplus, free tea and cake with connectivity has been very successful. The opportunity to gain support from trusted people there has also helped and diverted people away from other services. We can’t underestimate the role of food as a mental wellbeing intervention.

I’m not sure if you’re aware of the Christmas appeal that we did to give older people a Christmas present. We gave out 200 shoe boxes filled with presents like puzzle books, chocolates, biscuits and socks/gloves etc, and a handmade gift from a community group. They also had info on local support and services. Whilst not a mental health intervention I just thought it may be worth as an example of the community coming together to support people they don’t know. Which all has a mental wellbeing benefit.

Some were given out by our older people’s mental health team, social prescribers, P3/Age UK and care network. Some of the feedback included:

‘she had not thought about doing word puzzles but had started the puzzles provided in her gift and found that this was a good distraction for her from her anxiety. Consequently, she has purchased more.’

‘The boxes were taken to people we work with on visits at home, people thought it was such a lovely idea, one gentleman was just SO PLEASE to have received a pair of warm socks and some biscuits, they were really appreciated.’

‘I delivered a gift bag to a lady in March this week who asked would I mind if she left opening the gift bag until Christmas Day as this would be the only gift that she receives. The lady in question was overwhelmed to say the least and wanted me to pass on her thanks to you and the team. I just wanted you and the team to know that you have no idea how much this gesture means to others and the impact this has. I have to say that this was a humbling experience for me for sure and I cannot wait to deliver more gift bags and share the joy’

Examples of clubs which foster a sense of belonging:

Wisbech Phab club

Wisbech and district stroke club

Shredders and Fixers

N.B The full Cambridge Poverty and Truth Commission report can be read here.

Recommendations

Proactive and Person-Centred Care: Mental health services must adopt a proactive approach, meeting individuals where they are at and providing culturally sensitive care.
Addressing Socioeconomic Factors: Services must recognise and address the impact of socioeconomic factors on mental health, providing support with housing, finances, and employment.
Improving Accessibility and Equity: Services must address barriers to access, including lengthy waiting lists, lack of translators, and digital exclusion.
Investing in Community-Based Solutions: Supporting community-led initiatives, such as peer support groups and community hubs, can create positive social environments and promote well-being.
Focus on Preventative Measures: Implement locally led, preventative solutions to tackle the root causes of mental health problems.
Improve Carer Support: Recognise and address the significant burden placed on carers.
Holistic Approaches: Implement holistic approaches that understand the importance of food, art, and community involvement.
Increased Funding: Adequately fund mental health services to ensure consistent and reliable support.
Capture Positive Stories: Document and share positive case studies to demonstrate the impact of effective support.

Conclusion

The lived experience data presented in this report highlights the profound impact of environmental factors on mental health in Cambridgeshire and Peterborough. Addressing these factors requires a holistic and systemic approach that prioritises prevention, early intervention, and accessible, culturally sensitive care. By investing in community-based solutions, addressing socioeconomic inequalities, and improving service delivery, we can create a more supportive and equitable environment for all individuals within our community. This report emphasises the urgent need for action, ensuring that lived experience informs policy and practice to improve mental health outcomes for all.

Limitations and further considerations

While this report provides valuable insights into the interplay between environmental factors and mental health in Cambridgeshire and Peterborough, it is important to acknowledge certain limitations and areas for further consideration:

Data Collection Challenges:
- There were challenges in effectively capturing the full depth of lived experience data. Many individuals who were struggling offered interviews, but resource limitations prevented these opportunities from being pursued.
- A significant amount of lived experience data remains unrecorded, existing primarily within the knowledge and experiences of individuals.
- The process of engaging with interviewees highlighted the need to clearly articulate the value of their contribution and what they would gain from participation.
- There is a risk that the professional lived experience can outweigh the service user lived experience, and this should be taken into account when reading the data.
Service Delivery Gaps:
- The limitations of mental health services operating only during standard office hours were not adequately addressed.
- The lack of robust support for individuals upon release from hospital requires further investigation.
Broader Contextual Factors:
- The report did not explore the connection between adult and children and young people (CYP) mental health services.
- The impact of climate change on mental health, particularly concerning heat, fuel, and food costs, was only partially addressed.
- The positive effects of green spaces on mental health, and the unequal access to these spaces, were not explored.
Recovery and Trust:
- While the importance of support for recovery was highlighted, the report could have placed greater emphasis on the role of trust-building in the recovery process, and the challenges posed by overstretched services.

These limitations and considerations should inform future research and service development, ensuring a more comprehensive and equitable approach to addressing mental health needs in Cambridgeshire and Peterborough