Rethinking Mental Health from the Ground Up
- Trevor Sherwood
- Apr 23
- 5 min read
A new model for thinking about prevention, inequality and community mental health
The LilyAnne’s Wellbeing Leadership Papers
Position Paper No.1
Why Community Itself May Be Part of the Mental Health Infrastructure We Need
A Position Paper on Mental Health, Neurodiversity and Protective Infrastructure
By Trevor Sherwood BSc (Hons) Founder & CEO, LilyAnne’s Wellbeing
Leadership is not only about delivering support, but designing the conditions in which people can belong, recover and participate. - Trevor Sherwood.
About this Leadership Paper
This article forms part of The LilyAnne’s Wellbeing Leadership Papers, a series of policy, practice and leadership reflections exploring mental health, neurodiversity, inequality and community-led prevention through ideas grounded in practice.
This paper proposes the Protective Infrastructure Model as a practice-informed framework for understanding community support as part of preventative mental health architecture.
What if community is not adjacent to mental health support, but part of the infrastructure that prevents distress from deepening?
For too long, mental health has too often been discussed as though it can be separated from the conditions in which people live.
Yet in places shaped by poverty, exclusion, housing insecurity, trauma and fragmented access to support, mental distress is rarely experienced in isolation from those realities.
In Hartlepool, this truth is hard to ignore.
According to the 2025 English Indices of Deprivation, Hartlepool ranks among the most deprived areas in England, with some neighbourhoods within the most deprived one per cent nationally.
Around 35.7 per cent of the population lives in income-deprived households. Nearly a quarter of working-age adults live in employment-deprived households. In some neighbourhoods, crime-related deprivation ranks among the highest in the country.
These are not abstract statistics.
They shape stress. They shape hope. They shape mental health.
They also shape loneliness, confidence, belonging, and whether someone feels able to reach out for support at all.
This matters because in communities facing entrenched deprivation, poor mental health often cannot be understood apart from social conditions.
It may be shaped by debt, housing instability, welfare pressures, trauma exposure, social exclusion, barriers to education or employment, and the cumulative burden of trying to navigate systems that can feel hard to access.
For many people, these pressures do not arrive one at a time.
They interact.
For people who are neurodivergent, including those with Autism spectrum disorder or Attention deficit hyperactivity disorder, those pressures may be intensified further.
Sensory stress, executive functioning challenges, rejection sensitivity, masking, social exclusion and delayed access to appropriate support can compound vulnerability, particularly where poverty and unmet need already exist.
This is why mental ill-health and loneliness may be shaped by interacting pressures, with neurodivergent people often experiencing those pressures acutely.
Mental Health Is Also a Social Conditions Issue
Traditional models have often framed mental health primarily through diagnosis and treatment.
These remain vital.
But they are not always the whole picture.
Too often, systems intervene when distress has already escalated.
A practice-informed framework showing how inequality can shape mental distress, and how community support may help buffer those impacts.
If distress can be shaped by social conditions, protection may also be built socially.
Yet many drivers of poor mental health may sit upstream:
Poverty and financial insecurity
Insecure or unsuitable housing
Loneliness and social fragmentation
Barriers to legal or welfare support
Exclusion from education or work
Trauma and adverse experiences
Unmet needs among neurodivergent communities
If upstream conditions contribute to distress, prevention must also sit upstream.
That requires a broader understanding of mental health, one that recognises the role of place, inequality, connection and practical support.
It requires us to rethink support from the ground up.
Community as Protective Infrastructure
At LilyAnne’s Wellbeing, we have increasingly come to see community itself as part of the answer.
We have begun describing this through what we call a 'Protective Infrastructure Model.'
Trusted relationships, inclusive community spaces and practical support may form part of the preventative architecture of public mental health.
This is not about replacing statutory services.
It is about recognising that prevention often begins before formal intervention.
Sometimes it begins with belonging.
Sometimes with being known.
Sometimes with having somewhere safe to walk into before crisis deepens.
That understanding has shaped the development of LilyAnne’s Wellbeing.
This perspective is informed not only by wider inequalities evidence, but by direct community practice and thousands of support interactions at LilyAnne’s Wellbeing.
Through peer support coffee mornings, wellbeing hubs, one-to-one support, our mobile wellbeing unit and Support on the High Street outreach, we aim to make support easier to reach, less stigmatised and grounded in human connection.
For people experiencing loneliness, these spaces can reduce isolation.
For people who are autistic, have ADHD, or face barriers engaging with traditional services, they can offer flexible and non-judgemental routes into support.
For people struggling with housing concerns, welfare pressures, legal problems or uncertainty about education and employment, support may also involve helping people connect into wider systems of help.
Because sometimes practical navigation is mental health support.
Helping someone resolve a housing issue, access advocacy, understand their options, or reconnect with education may not be separate from wellbeing.
It may be part of restoring hope.
This is what we mean by protective infrastructure:
Support that connects.
Support that buffers.
Support that helps prevent escalation.
A Different Understanding of Leadership
Leadership in community mental health is not simply about delivering services.
It is about designing conditions where people can belong, ask for help earlier, and rebuild confidence before crisis deepens.
It is about understanding that social housing pressures affect wellbeing.
That poverty affects cognitive load.
That exclusion shapes identity.
That loneliness is not a side issue, but can itself be a driver of distress.
And it is about recognising that communities hold assets that formal systems alone cannot always generate:
Trust.
Belonging.
Reciprocity.
Hope.
The question is not only how we respond when people reach a crisis.
It is how we help build communities where crises become less likely.
That is a design challenge as much as a service challenge.
A Challenge for Policy
If mental ill-health is shaped partly by social conditions, then this has implications for national thinking.
Three propositions follow:
1. Community anchor organisations should be recognised as a preventative mental health infrastructure.
2. Mental health policy should more explicitly integrate deprivation, neurodiversity and loneliness.
3. Funding should invest in relational prevention, not only crisis response.
If we value early intervention, funding models should support the community conditions that make it possible.
A Ground-Up Vision for Mental Health
In areas of entrenched deprivation such as Hartlepool, mental ill-health, loneliness and neurodivergence are often shaped by interacting pressures including poverty, exclusion, trauma and unmet need.
Community anchor organisations can function as protective infrastructure, Strenghtening connection, resilience and enabling early support.
That is the proposition.
It is rooted in practice.
It is shaped by community.
And it points toward a broader vision of mental health, one that sees relationships, inclusion and practical support not as optional extras, but as part of the response.
If distress can be shaped by social conditions, protection may also be built socially.
That may be where prevention begins.
That may be where mental health can be rethought from the ground up.
About LilyAnne’s Wellbeing
LilyAnne’s Wellbeing is a community mental health and social inclusion charity based in Hartlepool, supporting people experiencing loneliness, mental distress and barriers linked to inequality, while developing neuro-inclusive and community-based approaches to early support and prevention.
Citation
Sherwood, T. (2026). Rethinking Mental Health from the Ground Up. The LilyAnne’s Wellbeing Leadership Papers, Paper No.1.
