Mental Health System Dynamics

Identifying and simulating opportunities for reform of the mental health system in South Devon and Torbay


Mental health systems across England are under increasing pressure. Bold solutions and radical reform are required in order to deliver an effective and sustainable mental health system whilst at the same time making provision for investments in prevention and resources in the community.

South Devon and Torbay CCG is one of fifty NHS England Vanguard sites – developing innovative models of care to act as blueprints and inspiration for the wider health system.

Our role

The Dartington Service Design Lab have been commissioned by South Devon and Torbay Clinical Commissioning Group (CCG) to engage widely with system leaders, practitioners and service users in order to understand the structure, functioning and dynamics of the local mental health system, and to build a preliminary system dynamics simulation model to help inform commissioning decisions in the context of the wider-Devon Sustainability and Transformation Plan (STP).

In addition to this ongoing system mapping and modelling, during 2016/17 the Lab also conducted a comprehensiveĀ  epidemiological survey of the mental health and well-being of almost 6,000 children and young people living in the area. This was designed to inform investment decisions around prevention and early intervention, alongside wider system reform activities.

The initial phase of this work commenced in March 2016 and concludes during the autumn of 2017.


The work was commissioned by South Devon and Torbay (CCG). It was funded through the NHS England Vanguard Initiative.

The Lab are supported by our strategic collaboration with the Social Systems Design Lab in St Louis, Missouri. Through an ongoing Skills Lab they are providing technical support in system dynamics model building. In addition, PenCHORD in the south-west of England have provided pro bono support in framing challenges and model development.

For further information, contact: Vicky Baker

Project Timeline


AugustFinal report published. A final report describing the work undertaken over the last 18 months and key recommendations is published.

JulySchool survey complete! The last schools taking part in the ChildrenCount Well-being Survey finish up data collection before the summer holidays.

JunePresentation to the Centre for Social Policy. Tim Hobbs presents key messages from the research to the Centre for Social Policy.

AprilResearch features on BBC Spotlight. Tim Hobbs speaks talks to regional radio and television news about the work to date.

MarchSkills Lab with the team from St Louis. The Social Systems Design Lab from St Louis, Missouri - a strategic collaborator of the Dartington Lab, spend the week in Dartington. We spend a week learning key aspects of system dynamics modelling and work together on building preliminary models.

CAMHS Workshop. We facilitate a workshop in Dartington with Child and Adolescent Mental Health Services and representatives from primary care and schools. We explore dynamics and challenges faced within these parts of the mental health system.

FebruaryPrimary Care Workshop. We facilitate a workshop with representatives from primary care, community mental health and crisis teams, exploring the challenges faced at the interface between primary and secondary care.

JanuaryCommunity and Crisis Teams Workshop. We facilitate a workshop with representatives of the community mental teams and crisis resolution teams, exploring dynamics related to escalation of mental health needs.


November2-day event: 70 people from across the whole system. Along with Peter Hovmand from the Social System Design Lab, we host a two day event with over 70 representatives from across the whole mental health system to map the structure of the system, explore dynamics operating with the system and consider opportunities for system reform.

OctoberAdult service user workshop. Workshop with adults experiencing mental health difficulties exploring their perspectives on system reform. Young person service user workshop. Workshop with young people that have experienced mental health difficulties exploring their perspectives on the mental health system reform.

SeptemberChildrenCount Well-being Survey beings in schools. Schools across South Devon and Torbay start administering the mental health and well-being survey across the region. Data collection runs until the summer break.

AprilInterviews and system mapping. Extensive engagement and interviews of professionals working across different parts of the mental health system is undertaken over the Spring and Summer period.

MarchWork commences. Initial reconnaissance about the structure of the mental health system begins.