Social Enterprise and the Struggle for Health Equity: A Localised, Human Approach to Mental Wellbeing
- Matty Caine
- Aug 7
- 6 min read
As part of my "Community-led Action" research series, this article provides an opportunity for learning and deep reflection on the key issue of social enterprise, health inequalities, and mental health.
Please read the article carefully and take time to reflect on the ideas shared. After reading, you’ll be asked to answer a short set of questions — including multiple choice, open text, and one reflective question. Your responses should show your understanding and thoughts on the topic. Once completed, you can submit your answers for review. If successful, you will receive a certificate as recognition of your learning. This activity should take around 1–2 hours in total and can be completed at your own pace.
By the end of this activity, you will be able to:
Say what a social enterprise is and how it is different from other businesses.
Understand what health inequalities are and what causes them.
Explain what an asset-based approach is and why it matters.
Describe how social enterprises and asset-based approaches can help improve mental health.
Spot some of the challenges these approaches face, like funding or support.
Think about how these ideas relate to your own work or community.
Come up with ways to use these ideas in your own setting.
Introduction
Health inequalities are still a big problem all over the UK, but especially in places like the Liverpool City Region. These inequalities don’t just show up in data — they are lived and felt every day by people whose environments, circumstances, and opportunities limit their chances to live happy, healthy, and fulfilling lives.
Health problems are often caused by things like unsafe public places, bad housing, and not having enough access to health services. These problems often arise before a person even goes to the doctor. As a result, people who are already economically, socially, or geographically disadvantaged have worse health outcomes and fewer ways to get out of that disadvantage.
But what if the answers to some of our greatest public health problems weren't in clinical pathways or top-down interventions? What if the answers were already in the energy, imagination, and strength of local communities? That's where Asset-Based Approaches (ABAs) and Social Enterprises (SEs) come in - not as vague ideas, but as useful, strong tools for making things better.
What are social enterprises and why are they important for health?
A social enterprise is a company that trades to help people or the earth. Its goal is not to make money for its owners, but to use the money it makes to solve problems that affect communities, such as hunger, social isolation, unstable housing, health issues, and a lack of jobs/training opportunities.
SEs are different from charities because they make their own money through trading (although some charities do have a trading arm). This gives them independence and sustainability. A lot of the time, they are smaller, quicker, and closer to the people they help. Their goals are often shaped by people who have been through the problems they're trying to solve and understand how complicated and subtle they are.
How does this relate to health? Because many of the drivers of poor mental and physical health are social. If a person doesn’t have stable housing, meaningful work, access to food, or a sense of purpose and connection, no amount of medication or clinical care alone will create long-term wellbeing.
SEs step into these spaces - offering support that feels human, not bureaucratic. From community cafés to local repair hubs, accessible mental health support to employability services, youth projects to supported housing cooperatives, social enterprises operate in the places where people live, learn, and connect. That makes them uniquely positioned to promote better mental health, build trust, and reduce stigma. Change happens at the speed of trust, after all.
Mental Health and the Importance of Participation
The relationship between mental health and inequality is well established. Chronic stress, trauma, poor physical environments, and exclusion from employment or education all increase the likelihood of poor mental health outcomes.
But there’s something else that matters too - agency. People who feel powerless, who are ‘done to’ rather than included, often struggle to feel safe or hopeful.
SEs can help reverse this dynamic. By involving local people not just as service users but as co-creators, employees, and leaders, SEs nurture confidence, connection, and community ownership. This participatory ethos is part of what makes them so powerful in supporting recovery and resilience.
Some social enterprises run peer-led programmes. Others provide accessible, non-clinical environments where people can rebuild routines, social networks, and a sense of purpose - all vital protective factors for mental wellbeing.
Asset-Based Approaches: Reframing the Narrative
The concept of Asset-Based Approaches (ABAs) challenges a traditional question in public health and social care — shifting focus from “What’s the problem here?” to “What strengths already exist?”
Too often, support systems are built on identifying and fixing ‘deficits.’ But this model can reinforce negative labels and reduce communities to their problems.
ABAs, by contrast, recognise that all communities — even those labelled as ‘deprived’ — contain rich assets: skills, networks, relationships, culture, identity, spaces, and resilience. The aim is to build on what’s already working and to amplify the capacity of local people to lead.
Frameworks like Asset-Based Community Development (ABCD) emphasise participation, relationship-building, and mapping of community resources. When organisations adopt these principles, the result is not just more effective support — it’s support that feels relevant, respectful, and sustainable.
Bringing SEs and ABAs Together
While SEs and ABAs can operate independently, their impact is greatest when they are combined.
SEs that adopt an asset-based philosophy don’t just “serve” communities — they evolve with them. They recognise that trust is built through relationship, not intervention. And they create opportunities for people to engage on their own terms — as contributors, not just recipients.
This blend of social entrepreneurship and community empowerment leads to approaches that are:
· Locally rooted and culturally relevant
· Flexible and adaptive to changing needs
· Focused on dignity, not dependency
· More likely to succeed long term because they are co-owned
Especially in areas where institutional trust is low, and where residents feel underserved or ignored, these hybrid models offer a real alternative — one that builds confidence, skills, and hope.
Challenges and the Risk of Co-option
Despite their promise, these approaches face serious challenges.
Most social enterprises operate in financially precarious conditions, often depending on short-term grants or unpredictable trading income. Measuring their impact — especially on something as complex as mental health — can be difficult and resource-intensive.
There’s also a risk that government and statutory agencies treat SEs and ABAs as cheap substitutes for properly funded public services. This “outsourcing of responsibility” without appropriate investment can lead to burnout, mission drift, or worse — the exploitation of community goodwill.
To protect the integrity and effectiveness of SEs and ABAs, it’s essential that they are not treated as stopgaps or side-projects, but as core parts of a long-term, integrated strategy for social change.
Local Potential, National Relevance
The Liverpool City Region, like many post-industrial areas, has experienced a long history of economic and social inequality. But it is also home to powerful networks of community-led innovation.
Supporting and scaling SEs and ABAs in places like LCR isn’t just a regional issue — it’s a national opportunity. These models can contribute to reducing the pressure on NHS services, preventing crises before they escalate, and restoring a sense of dignity and agency to individuals and communities alike.
Conclusion: Reimagining the System From the Ground Up
Social Enterprises and Asset-Based Approaches offer more than service delivery — they offer a different philosophy of care. One that recognises the importance of participation, the value of lived experience, and the power of local knowledge.
As we search for better ways to support mental health and tackle inequality, these models deserve attention not just as innovations, but as blueprints for systemic change.
The challenge now is to ensure they are valued, supported, and sustained — not just in pilot projects, but in the foundations of how we do social health.
Please click here for the assessment, should you wish to participate;
Good Luck!!
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