Building a healthy environment: lessons from three RSPH award entrants

Safe Digital Environment

For most of us, our immediate surroundings are closely intertwined with the online world – whether that is speaking to colleagues via email, playing music through a virtual assistant such as Alexa, or using an app to order takeaways and taxis. That means a person’s online activity can affect their mental health, with very ‘real-world’ consequences.

That was what happened to Josh Hendy, who died by suicide in November 2020 after researching methods for taking his own life. Josh’s sister, Alice, developed R;pple as a way of dealing with her grief and to help prevent more families losing loved ones to suicide. R;pple is a digital tool, which is activated if a user searches for harmful content online – it first guides the user through a filter of breathing exercises and then presents strategies, forums, helplines, and mental health services which can offer support.

R;pple is aimed at individuals and institutions – including schools, universities, and employers – which can have the tool installed across the devices it provides to students and employees. Since launching in 2020, R;pple has been downloaded over a million times and adopted by a variety of businesses, from EDF Energy to West Ham United, National Health Service (NHS) Trusts, and colleges and universities. As a result, the tool has made nearly 6000 interceptions, gone on to win 23 awards (including RSPH’s Public Mental Health and Wellbeing Award) and, most importantly, it has saved at least 25 lives.

Most healthcare services are designed on the premise that an individual knows when they need help and is able to seek support. But that model does not well serve people experiencing a mental health crisis. R;pple works similar to many environment-based public health interventions, although using digital infrastructure instead of the built environment: it offers a nudge – away from harm and towards hope.

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Trauma-Informed Environment

Often, when thinking about the relationship between the environment and behaviour change, one thinks of nutrition and physical activity and questions, for example, does a built environment enable active travel? Or does the retail environment predominantly offer fast food? But what if the behaviour you sought to change was poor school attendance, disruptive classroom behaviour, or peer-on-peer violence?

Khulisa, one of the finalists in our Health at Every Age category, has found that, to sustainably support young people at risk of exclusion or involvement with the criminal justice system, they need to complement their intensive therapeutic programme (called Face It) with a whole-school trauma-informed approach.

Delivering a whole-school approach includes offering trauma training for school leaders, staff, and parents; resilience sessions for staff and emotional wellbeing sessions for parents, to help them with their own emotional regulation; and a social emotional curriculum for all students. Khulisa also works with school senior leadership teams to change a school’s culture and policies to be more trauma-informed (the sound of a school bell, for instance, can evoke memories of sirens).

Taking a whole-school approach may require a greater investment of time and energy than focusing on behaviour alone, but the outcomes from Khulisa’s programmes demonstrate it pays dividends for teachers and students alike. The results from their pilot in a school in London showed:

By creating a psychologically healthy learning and home environment, Khulisa’s work will have positive outcomes for the life chances of thousands of disadvantaged children – helping them to have stronger relationships, perform better at school, and avoid physical violence and criminal behaviours. They, in turn, will be able to create healthy environments for the next generation, hopefully putting an end to intergenerational trauma.

Looking Beyond the Immediate Environment

The 2022 Health and Wellbeing in the Workplace Award went to Grain LNG, a large gas importation terminal based on the Isle of Grain in Kent. Covering a total area of 600 acres in an otherwise rural area, the business has long been aware of the importance of good relationships with the local community. But, rather than having an employee wellbeing offer which looks inward, distinct from an outward-looking Corporate Social Responsibility policy, the organisation has woven the two together, bringing benefits both to staff health and wellbeing and to the wider area.

Grain LNG’s Health and Wellbeing Strategy is built upon the Five Ways to Wellbeing: connect, be active, take notice, keep learning, and give to others. To fulfil the routes relating to social connection, generosity, and purpose, staff are actively encouraged to participate in community days. This has involved volunteering as a team at a nursery for children with special educational needs; helping the restoration of Slough Fort, a community-led heritage project which aims to tackle social isolation; telephone befriending; and fund-raising for local charities through challenge events such as a London to Paris cycle ride.

For Stuart, the Wellbeing Specialist at Grain LNG, the most positive outcome of the wellbeing programme he has developed has been the greater sense of team spirit within the company and the strengthened relationships with the community. For example, when an employee called Brad set himself a New Year’s Resolution of losing weight, two dozen colleagues joined him and turned it into a competition. The money raised went to a disability charity of Brad’s choice, so it was an opportunity to both Connect, Give, and Be Active.

For Stuart, ‘Giving’ and ‘Connecting’ increasingly involves mentoring other local businesses and shaping best practice in the National Grid network on how to develop and implement an evidence-based health and wellbeing strategy. As well as giving talks for Medway’s Public Health team, Grain LNG has also sponsored the council’s Mental Health Award. ‘We’ve had that recognition, so we want to give back’, Stuart explains, demonstrating the virtuous cycle employee wellbeing can have to a business and the wider community.

The Policy Landscape and the Rsph Health and Wellbeing Awards

Each of our award winners and finalists are selected based on the positive outcomes they deliver for people’s health and wellbeing. But, to have the greatest impact, they require a supportive wider socio-economic and political landscape. For instance, continued cuts to education and low morale among the teaching workforce will limit Khulisa’s ability to support teachers to be trauma-informed. Increased regulation of online platforms, however, would bolster R;pple’s mission to protect people from harmful content online. That is why RSPH campaigns for high-level policy changes and strategic leadership to improve and support the public’s health – including through the Health and Wellbeing Awards. Our awards, particularly the Public Health Minister’s Award, bring national attention to areas of best practice, and it is our hope that with the increased visibility and the endorsement of our judges, we are doing out bit to create an environment where exemplars in their field can thrive.