HOPE(S) model regarded as a significant success by leading University study

A major national programme of support for people with the most complex needs in mental health hospitals has been assessed as a significant success in an independent evaluation from Manchester Metropolitan University.

The HOPE(S) programme, developed and led by Mersey Care NHS Foundation Trust, has helped nearly three quarters of people in long-term segregation successfully transition out of these restrictive environments. Remarkably, one in three of those supported have been able to return home to their communities.

Trish Bennett, Mersey Care’s Chief Executive Officer, explained: “This study strongly supports the work of our experts. This independent evaluation is a powerful endorsement of our commitment to human rights and compassionate care. Restrictive practices can have devastating effects—not only on individuals, but also on their families and staff teams.”

Long-term segregation (LTS) is often used when people are seen as a risk to others. But mounting evidence, including Manchester Metropolitan University’s new evaluation, shows it can cause profound psychological, emotional, and physical harm, leaving people isolated for months or even years.

Ms Bennett added: “These practices are intended to protect people from harm but too often what we see are increasingly cycles of distress and restriction which is concerning. There are so many powerful stories of HOPE(S) working in partnership with people, their families and staff teams and as a result, we’re proud to see people’s lives have been transformed by this pioneering programme of work.”

In response to national concerns about the use of LTS, NHS England funded a series of projects aimed at reducing its use in mental health hospitals and Mersey Care was commissioned to lead the national rollout of the HOPE(S) model. Over the past three years, a dedicated team of practitioners has worked with 40 organisations across the country.

They delivered intensive support to more than 120 adults, children, and young people who are autistic, have a learning disability or experience significant mental health challenges. In addition, the programme has trained over 3,800 staff nationwide, equipping them with the skills and confidence to deliver care that is relational, trauma-informed, and grounded in human rights. The programme was guided by a national oversight group, co-chaired by Sir Norman Lamb and Gavin Harding MBE, both long standing advocates for mental health reform.

Sir Norman Lamb said: “The HOPE(S) programme is a landmark in the journey toward a more humane, rights-based mental health system. It demonstrates that with the right support, people can thrive outside of segregation. This is about dignity, justice, and doing what’s right for some of the most excluded and vulnerable people in our health system.”

The study by researchers at Manchester Metropolitan University has revealed compelling evidence of the impact of the HOPE(S) model in mental health settings. Researcher described significant improvements in quality of life across a range of critical outcome. These include reduced use of restraint, increased access to fresh air, enhanced autonomy, more meaningful activity and a renewed sense of personal identity. Of those supported by HOPE(S), 68 percent were able to leave segregation, and of those with six month follow-up data, 94 percent remained out of LTS.

The University team concluded that Mersey Care’s work should continue to be rolled out nationally. The report calls for the approach to be made universally available to all individuals in segregation, backed by mandatory staff training and for the integration of long-term segregation oversight into national quality frameworks.

Family members described a renewed sense of hope, emotional safety and trust, as they observed their loved ones begin to engage meaningfully with practitioners. For many, this was the first time in years they felt professionals were advocating alongside them.

“This research was urgently needed,” said Dr Alina Haines-Delmont, who led the independent study at Manchester Metropolitan University. “For too long, long-term segregation has been used in services, despite the serious harm it causes. Our study provides the first robust, national evidence that it does not have to be this way.

“HOPE(S) is a rights-based, trauma-informed intervention that delivers real change: it improves quality of life, reduces restrictive practices, and transforms how services understand and respond to distress. The evidence is strong and points clearly to what good care looks like — relational, human, and grounded in dignity. This is not just about better practice; it is about policy reform and accountability at a national level.”

Following the nationally funded pilot, providers and commissioners are able to continue to work with Mersey Care to support the work in their own areas.