The global Covid-19 pandemic forced a real shift in the way we think about mental health. The global prevalence of anxiety and depression increased by a massive 25%, according to a scientific brief released by the World Health Organization, creating a surge in people seeking help. A Centre for Mental Health report from 2021 found that 10 million people in England will need support for their mental health as a direct result of the pandemic over the next three to five years, piling stress on an already overloaded system.
Figures from the NHS suggest that while there has been an increase in spending on mental health services over the past five years, there has been a reduction in other public services which support people in crisis. A recent Care Quality Commission report found that people’s experience of mental health services in England is the worst it’s been in years – 48% of respondents reported that their mental health had deteriorated as a result of changes to their care, while referrals to crisis care services rose by an average of 11%, and as many as 42% reported waiting too long to receive therapies. With the NHS mental health services buckling under the pressure, charities such as Step One in Devon are stepping up to provide support and crisis relief.
Mind and body
“Mental health has really come to the fore during the pandemic,” says Step One trustee Mark Lambert. “We didn’t have an off-the-shelf textbook mapping out all the challenges that we were going to face, and for many of us, it can still be hard to speak up about our mental wellbeing. This is where organisations like Step One are doing so much.”
Founded in 1937 by Dame Georgiana Buller at St Loye’s College in Exeter, the charity supports people in Devon with disabilities in developing skills and achieving their potential by overcoming any societal barriers. The Queen became a patron in 1946, when the charity was still known as St Loye’s, and remains the patron today. Over the decades the college adapted its name and how it supported people – providing residential training, and tuition in areas such as occupational therapy and technical, catering and office skills. Though the focus of Step One’s work remains in community support services, in 2015 the charity merged with Clinical Care Trust in Devon and started to focus more on mental health by opening a new acute hospital in Newton Abbot in 2018.
According to Step One, recent years have seen increasing recognition of how issues such as mental health, and invisible disabilities including autism spectrum conditions, can affect people’s wellbeing and ability to fulfil their potential. The charity provides a range of support including community support work, training, crisis support, and more. “The mission is to ensure that people can live their lives more independently,” says Lambert. Because there is a big focus within Step One on assisting people struggling with their mental health or recovering from a crisis, demand for its services has never been greater. With NHS services “experiencing rising demand”, according to Lambert, “That’s where you need charities like Step One, which play an important role within a local community, and help relieve some of the challenges facing the health and social care system.”
During the Covid-19 pandemic, Step One increased its efforts to provide additional community access to anyone in Devon who was struggling with their mental health. “We worked with Devon Partnership NHS Trust to provide communi-ty support around Exeter and Torbay to enable individuals to resolve issues which had an impact on their mental health,” explains Amanda Malcolm, senior business services manager at Step One. “We launched a telephone service for individuals on the waiting list for NHS services during lockdown and supported almost 200 people with over 800 support sessions.” Additionally, the charity did not suspend face-to-face contact for any patient who needed it. “We didn’t close the hospital,” she adds. “We didn’t even have an outbreak.”
It’s this dedication to the local community that makes a charity like Step One so important. “You don’t realise what these amazing healthcare professionals do on a daily basis,” says Lambert, who has personal experience of mental health issues, with someone close to him suffering. “I think when you have lived experience, it makes it even more powerful. You really appreciate how wonderful, caring and supportive these people are.”
“We launched a telephone service for individuals on the waiting list for NHS services during lockdown and supported almost 200 people.”
It was all about building up his confidence
How Step One helped one young man on the road to an independent life
A few years ago, senior support worker Adele Maker was approached by a boy’s family member seeking help. “Alfie* struggled to be in school throughout his whole education background,” she says. He was called disruptive, wouldn’t engage, and refused to eat at school. “Eventually, he was expelled from school.” Now Alfie was at home with his mother, struggling to engage with the home-schooling process and suffering from what Maker observed to be a crippling anxiety disorder.
Alfie had previously been diagnosed with a degenerative visual impairment that will result in him losing his sight completely in the long run. His mother, who also has visual impairment, was struggling to cope with his myriad complex needs and as a result her son had not left the home for years. He barely left his bedroom, Maker recalls. In addition to his visual impairment and anxiety, Maker suspected he might be autistic, which was later confirmed with a diagnosis. “He didn’t have any support package in place at all,” says Maker. “He struggles with sensory overload, with people, to me it was clear that a lot of it was due to very, very high anxiety.”
Step One got involved. “We began supporting Alfie at his mother’s home,” explains Maker. “He’d been out of education and hadn’t seen people for a very long time. It was all about building up his confidence.”
Alfie started seeing only Maker at first. They would meet weekly, alternating supported trips outside of the home with cooking lessons. “He found going out hard, but he really flourished at cooking,” she recalls. Eventually, Alfie felt secure enough to work with other support workers as well as Maker, and began to thrive. Returning to education was not possible but they explored the possibility of Alfie, now 19 years old, living on his own. With the support of a partner charity, he viewed flats, and advocated for his needs during the process. “It needed to be a ground floor flat because of his vision, and near a bus route so his mother could visit,” Maker explains.
All about what works for him
Eventually, and despite Covid-related delays, Alfie found an apartment and now lives independently with help from support workers. Maker continues to visit twice a week. The two are working together to enable him to visit the corner shop independently. Step One has supported Alfie for over four years already, and Maker is looking at the future: “He is going to lose his vision completely, so we will be working with him to ensure that he doesn’t lose the skills he has and can adapt as his vision decreases.
“If Alfie wants it, Step One will continue to work with him,” says Maker. “It’s not about us, it’s about what works for him.” With Maker’s support, Alfie has been able to not only live more independently but also to develop stronger relationships with people in his life, and even meet and embrace the help of new support workers – which once would have seemed impossible. Through this kind of essential support work, Step One has earned a vital place in the Devon community, and with the lasting impact of the pandemic on mental health the charity will be an increasingly critical resource for Covid-19 recovery. Step One is urgently working to create a new service specifically tailored to the long-term changes brought about by Covid-19 and the charity needs your help. A donation of just £5 would support a 20-minute phone or video call from a trained volunteer to someone experiencing mental health difficulties, raising awareness of available peer support and reducing their sense of isolation.
* Not his real name
“Through this kind of essential support work, Step One has earned a vital place in the Devon community.”
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