ABSTRACT

There is a lack of in-depth understanding of the experiences and needs of people with severe and complex mental health problems. This chapter draws on a realistic evaluation (Pawson and Tilley 2003) of two public health interventions examining the significance of voluntary groups in supporting a vulnerable group of older adults. In order to provide focused insight, and capture the reality of patients’ experiences, it includes insights from subsequent interviews with two patients with self-directed service budgets. 1 Studies in the UK and other countries (Bryant et al. 2010; Connell et al. 2012) have identified that a combination of socio-economic and community factors, some within and some beyond the control of clinical staff, can affect quality of life for older adults with severe and complex mental health problems. The chapter will explore some of these social factors and discuss findings that suggest the value of sustained low key activities as a basis for community support.