Effect of the Connecting People Intervention on Social Capital: A Pilot Study

Background and purpose

People with severe or enduring mental health problems, such as severe depression, psychosis or bi-polar disorder, have smaller and less resourceful social networks than the general population. This limits their ability to access social capital (resources held within networks) which may assist their recovery. Mental health social workers have the potential to support people with mental health problems to enhance the resourcefulness of their networks, but our systematic reviews found limited evidence-informed interventions to guide them. Therefore, we developed the Connecting People Intervention (CPI) which supports people to grow their networks. This study aimed to evaluate the effect of the CPI on access to social capital. In particular, it tested the hypotheses that where the CPI is implemented with high fidelity, participants will experience greater access to social capital, improved mental well-being and higher levels of social inclusion at a lower cost to those receiving low/moderate fidelity CPI.

Methods

A one group pretest-posttest quasi-experimental design was used. The CPI was piloted with 155 new referrals to 14 health and social care agencies supporting people with a mental health problem or learning disability in England. Training in the CPI was provided to workers in each agency. Study participants were interviewed by researchers at baseline and nine month follow-up. The primary outcome was access to social capital, measured using the Resource Generator-UK (RG-UK). Additional outcome measures were the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS), Social & Communities Opportunities Profile (SCOPE) and the EQ-5D. Fidelity to the CPI was measured using a triangulation of participant and worker self-report, and researcher observations. Paired t-tests and repeated measures MANCOVA were used to test our hypotheses.

Results

117 (75.5%) participants were followed up at nine months. 30 participants received high fidelity CPI while 87 received low/moderate fidelity CPI. Moderate effect sizes for pretest to posttest changes on RG-UK (d=0.51), SCOPE perceived social inclusion (d=0.52) and WEMWBS (d=0.53) were found for those who experienced high fidelity CPI. Controlling for demographic characteristics and the use of psychiatric medication, significant CPI group by time effects were found for only the RG-UK (F(1,98)=4.81, p=.03, partial η²=0.05) and SCOPE perceived social inclusion (F(1,93)=7.06, p=.01, partial η²=0.07) with moderate effect sizes. Costs in both fidelity groups fell over the follow-up period, but the difference at posttest was statistically significant with the high fidelity group costing a mean of £1,331 (95%CI=£69 to£2593) less per participant than the low/moderate fidelity group. However, the difference in change in quality-adjusted life years between the groups was not statistically significant (0.02 (95%CI=-0.03 to 0.06)).

Conclusions and implications

This study found evidence that the CPI increases an individual’s access to social capital and their perceived social inclusion when implemented with high fidelity. Improvements in mental well-being were found for all participants. However, the CPI was mostly implemented with high fidelity in third sector agencies. Further research is required to evaluate the implementation of the CPI in statutory community mental health services where mental health social workers are more prevalent.