Appreciative inquiry - the voice of people delivering mental health services

In 2018, NHS Kernow commissioned Healthwatch Cornwall  to carry out an Appreciative Inquiry style engagement report into commissioned mental health services in Cornwall. The explicit objective was that the information and insight gathered would be used to inform the development of a co-produced joint strategy for mental health for Cornwall and the Isles of Scilly and, importantly, to inform ongoing development work. 

Healthwatch carried out sessions early in 2019 reflecting the first two stages (‘Discovery’ and ‘Dream’) with approximately 230 people from 30 mental health teams across the county.

Overall, the report highlights that the mental health workforce is highly committed, compassionate, and motivated to provide person-centred care. Staff across services consistently demonstrated dedication to achieving positive outcomes for service users, often going beyond their formal roles to ensure individuals receive appropriate support. Strong teamwork, a holistic approach to care, and the use of evidence-based treatments were identified as key strengths. 

The findings also emphasise the importance of collaboration across primary, secondary, and voluntary services. While teamwork is already a strength, participants felt that improved integration and communication between services would lead to better care coordination, smoother referral pathways, and improved service user experiences. 

Staff identified several areas for improvement. These included the need for clearer service pathways and team responsibilities, increased availability of early intervention and preventative services, and improved access to mental health support at earlier stages. There was also a desire to expand treatment options, address gaps in service provision, and ensure that resources and environments better meet the needs of both staff and service users. 

Workforce development emerged as an important theme, with staff expressing a need for more training, professional development opportunities, and strategies to improve recruitment and retention. Many staff reported regularly working beyond their formal duties, highlighting pressures within the system and the need to better align roles, capacity, and demand.

The report also notes the importance of adopting a more community-based and preventative approach to mental health, recognising wider determinants such as housing, employment, finances, and social isolation. It suggests that stronger partnerships with community organisations and increased use of approaches such as social prescribing could enhance outcomes for service users. 

Police feedback included in the report indicates that officers take pride in their empathetic approach to people experiencing mental health issues but experience pressures due to gaps in mental health service responsiveness. Greater collaboration, quicker access to mental health support, and increased resources were identified as priorities to reduce demand on police and improve outcomes for individuals in crisis. 

In conclusion, the report recognises a strong foundation of committed staff and existing good practice but highlights the need for improved collaboration, clearer pathways, enhanced early intervention, and strengthened workforce capacity to deliver a more effective and integrated mental health system.