INtersectional Network Of community and stakeholder Voices, And research to Tackle (in)Equities (INNOVATE) in mental health and well-being

新的全英格兰综合护理系统（ICS）为减少结果、经验和获取方面的卫生不平等创造了动力，同时支持更广泛的社会和经济发展。“基于地方的伙伴关系”被认为是推动这一变化的关键，有几份报告提出了建立伙伴关系的关键职能和原则，并强调采取地方行动，制定以社区和资产为基础的改善健康的办法。利用社区成员的资源和能力的地方行动是这方面的核心。然而，实施“基于地方的伙伴关系”并惠及那些处于多重不利地位和被排斥的人以确保“人人享有卫生保健”的最佳方式仍未得到充分开发。谁仍然处于卫生和社会保健规划的边缘？是什么因素造成了他们的排斥和孤立，这些因素如何相互作用，以告知精神不健康和福祉的状态？我们怎样才能使众多弱势群体的声音和生活经验为卫生和社会保健规划和资源分配提供信息？这些问题是INNOVATE的核心，该联盟汇集了来自埃塞克斯大学、埃塞克斯中部和南部ICS委员会、关键知识用户、法定服务机构、第三部门组织和社区成员的主要研究人员，旨在推动埃塞克斯心理健康和自杀预防的新变革议程，这是埃塞克斯中南部地区面临的一个优先挑战，该地区以严重的不平等和剥夺为特征。我们注意到，对联合王国健康不平等的突出理解主要基于基于地区的剥夺或社会经济不平等。社会劣势的其他方面（性别、残疾、民族/种族）及其相互作用被忽略了。这限制了我们对一个人的社会地位或劣势的不同方面如何相互作用、形成这些方面的过程（即原因的原因）以及这些方面产生的不健康状态的理解。交叉性已成为更好地理解和更有效地应对卫生不公平现象的一种有希望的方法。然而，尽管它在公共政策和第三部门行动者中越来越受欢迎，但以与受影响社区合作的方式将交叉性纳入研究和规划资产/资源分配的最佳方式仍然不发达。创新将产生新的方法来考虑卫生不平等的挑战，利用前沿交叉分析，并提供有根据的见解、实用工具和创新方法来建设能力，并促进有弹性的系统和健康的社区。我们将把交叉性与社会-物质性观点结合起来，在心理健康和预防自杀的政策领域制定一项参与性研究和行动议程，这是一个连接医疗保健和社会护理的领域，需要将两者有效地结合起来。这将通过挑战实验室、创意研究社区、资产测绘和倡导论坛等4个相互关联的工作流程和一系列创新参与性活动来实现。总的来说，这一雄心勃勃但可实现的工作方案的产出将支持继续努力，并响应呼吁，寻找最佳方法，准确地概念化和解决保健不平等问题，并在实施“基于地方的办法”时纳入交叉视角。本研究提出的跨学科和社区参与将促进一种基于交叉性的科学严谨方法，以了解人们的不同心理健康需求及其社会决定因素的交叉性，为埃塞克斯中南部的“综合护理战略”提供信息，但与整个埃塞克斯相关，并在整个英格兰的ics中具有更广泛的适用性。

The new England-wide Integrated Care Systems (ICS) create the momentum for reducing health inequalities in outcomes, experience, and access, while simultaneously supporting broader social and economic development. "Place-based partnerships" are recognised as key to driving this change, with several reports putting forward key functions and principles of partnership building and emphasising local action to develop community and asset-based approaches to health improvements. Local action to harness community members' resources and capabilities is central to this. Yet, the best ways to operationalize 'place-based partnerships' and reach those experiencing multiple disadvantages and exclusions to ensure 'Health for ALL' remains under-developed. Who remains at the margins of health and social care planning? What factors shape their exclusion and isolation and how these interact to inform states of mental ill-health and wellbeing? How can we bring the voices and lived experiences of multiply disadvantaged groups to inform health and social care planning and resource distribution?These questions are at the heart of INNOVATE, a consortium that brings together leading researchers from the University of Essex, the mid and South Essex ICS Board, key knowledge users, statutory services, third sector organisations and community members to drive a new transformative agenda for mental health and suicide prevention in Essex, a priority challenge for the mid-South Essex region marked by stark inequalities and deprivation. We note that prominent understandings of health inequalities in the UK rest primarily on area-based deprivation or socio-economic inequalities. Other aspects of social disadvantage (gender, disability, ethnicity/race), and their interactions, are missed. This limits our understanding of how different aspects of one's social location or disadvantages interact with each other, and the processes that shape these (i.e. causes of causes), and the states of ill-health these produced. Intersectionality has emerged as a promising approach to better understand and more effectively respond to health inequities. However, despite its growing popularity among public policy and third sector actors, the best ways to incorporate intersectionality in studying and planning distribution of assets/ resources, in a collaborative way with affected communities, remains underdeveloped. INNOVATE will produce new ways to consider health inequalities challenges, drawing on leading edge intersectional analysis, and offer grounded insights, practical tools and innovative approaches to build capabilities, and foster resilient systems and healthy communities. We will combine intersectionality with social-materiality perspective to develop a participatory research and action agenda in the policy field of mental health and suicide prevention, an area that bridges healthcare and social care, and requires effective integration of the two. This will be achieved through 4 inter-related work-streams and a range of innovative participatory activities via Challenge labs, Creative research Community, Asset mapping and Advocacy forum. Collectively, the outputs from this ambitious yet achievable programme of work will support the continued efforts and respond to calls to find the best ways to accurately conceptualize and tackle health inequalities and to incorporate an intersectional perspective in operationalising a 'place-based approach'. Interdisciplinary and community engagement proposed by this research will promote a scientifically rigorous approach based on intersectionality to understand the diverse mental health needs of people and the intersecting nature of their social determinants informing the 'Integrated Care Strategy' of Mid-South Essex, but have relevance for whole of Essex, and wider applicability in ICSs across England.