Coastal and rural mental health realist study

What works, for whom, in what circumstances, how and why?
Two women sitting on a stony beach in dry robes talking over hot drinks with beach huts behind them

Coastal and rural mental health realist study

What works, for whom, in what circumstances, how and why?
Title: Coastal and Rural Mental Health Realist Study (CARMHRS): what works, for whom, in what circumstances, how and why?
Funded by: NIHR
Funding amount: £1,265,247.42
Location: Lincolnshire, Cornwall, North East Cumbria, North Cumbria
Dates: March 2025 – June 2027
University of Plymouth PI: Dr Rebecca Hardwick  
Joint Lead Applicant: Professor Richard Byng  
University of Plymouth staff: Professor Sheena Asthana  
Collaborating staff: Dr Coral Sirdifield, Dr Mark Morris, Dr Natalie Forster, Dr Rachel Hayes, Ms Charley Hobson-Merrett
Contracting organisation: University of Plymouth
 
This research is about solving the problems people in rural and coastal areas face when trying to get mental health support. 
Mental health services in remote coastal and rural areas present challenges both for the people who live in these areas and for the organisations who provide the services. 
For people who need the services, challenges relate to poverty, inadequate housing and transport links, and services that do not meet their social and other needs. For service providers, as well as the challenges of responding to these issues, there are major difficulties related to staff shortages, poor digital infrastructure and transport infrastructure, and the need to provide standard services, including emergency responses, across large geographical areas.
This study aims to find ways to make mental health services better. 
It will look at different plans being used to improve mental healthcare in three rural and/or coastal areas (Lincolnshire, Cornwall and North East and North Cumbria). 
The researchers will work with local communities and produce a practical guide to help other rural and coastal places improve their services. Once the guide is ready, it will be shared through networks across England and on social media.
 
 
 

Aims

  • Improve community mental health systems in coastal and rural areas by assessing the impact of strategies (such as the Community Mental Health Framework) implemented to improve the accessibility and acceptability of mental health care services for people living there.
  • Facilitate a community of practice to co-produce a guide to improving accessibility and acceptability of mental health care services in coastal and rural areas.

Research questions

  1. What strategies for providing mental health support and promoting wellbeing are being put in place in coastal and rural areas? How, for whom and in what circumstances are they impacting on access, acceptability and inequality?
  2. How do the features of coastal and rural life affect residents' experiences of mental healthcare support and services? In what circumstances and for whom do strategies to increase engagement with support work and why? In what ways and how do residents draw upon rural and/or coastal strengths and assets from their family, friends and the wider community to meet their mental health needs? 
People outside preparing for a community project

Method

The researchers will do qualitative research which involves talking to local NHS staff and people in communities and understanding their experience of mental health care. They will also look at differences between places and how this affects mental healthcare. 

Month 1

Set up the study, including approvals and involving patients and the public.

Months 2–23

Data collection – exploring the social, historical, psychological, and geographical features that play a role in mental healthcare. Two researchers will work together. One (a researcher in residence) will look at what is happening in the mental health system. The other (a community researcher) will learn what the community thinks about that.

Months 24–28

Bringing the data and insights together to create a guide for anyone looking to improve mental healthcare access and quality in rural and coastal areas. 

Centre for Coastal Communities

Finding solutions to the challenges facing coastal communities
The University of Plymouth is one of the few UK Higher Education Institutions with a critical mass of academics with a proven track record of research on coastal communities. The Centre for Coastal Communities brings together researchers looking at coastal economic performance, deprivation, migration, educational underperformance, displaced populations, health and social care, the blue economy (renewable energy, fisheries, aquaculture, tourism, recreation and leisure), plastic pollution and economic, social and environmental policy for coastal communities.
 
Fishing nets