The NHS Bristol, North Somerset and South Gloucestershire ICB.

The Challenge: The NHS Bristol, North Somerset and South Gloucestershire ICB faced growing pressures around mental health, including siloed teams, poor internal communication, unclear language around cultural differences, and unrealistic public expectations. Despite efforts across departments, the complexity of the issue was proving too much to manage in isolation.

The Approach: We used the Many Answers method to reframe the problem. Rather than trying to fix internal operations inside the NHS, we understood that the challenges existed within the city. So, we asked a broader question: “Who is responsible for our mental health?” We brought together voices from across the region—NHS leaders, corporate businesses, local businesses, educators, community organisers, artists, faith leaders and more—for a closed conversation to answer One Question from many perspectives.

The Outcome: This led to a shift in thinking, from preventing poor mental health by understanding what keeps people mentally healthy. The group began developing a new social contract, a place-based approach focused on prevention and inviting businesses, communities and institutions to collectively understand and invest in what keeps the region healthy.

The pilot launched in Bristol in September 2023, focusing on key areas of prevention- research, language, environment, personal agency, technology and policy to reduce the rise of poor mental health and the pressure on the NHS by 2027.

“Many Answers’ approach to addressing some of our regional mental health challenges—by distilling them into a single, powerful question—not only helped us see those challenges differently, but also sparked a community-driven response. It shifted the focus from simply reacting to mental health difficulties to asking: how do we prevent them in the first place? How do we collectively invest in good mental health by understanding what keeps us happy? And crucially, how do we make this everyone’s responsibility, not just the NHS’s?  I am excited to see the first iteration of their place-based approach unfold over the next few years.” Caroline Dawes, Deputy Director, Performance and Delivery.